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Module 7 > UNIT 2: ABG > Flashcards

UNIT 2: ABG Flashcards

1
Q

Normal PH range?

A

(ACID) 7.35-7.45 (BASE)

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2
Q

What is considered a perfect PH level

A

7.4

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3
Q

What is considered an acid on the PH level?

A

Anything under 7.35 or if you have a PH level within normal range but below 7.4

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4
Q

What is considered an alkalotic range in the PH scale?

A

Anything over 7.45 or if you have a PH level in normal range… anything over 7.4.

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5
Q

Are the normal PaCo2 range?

A

(BASE)35-45(ACID) mmHg

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6
Q

What is considered a normal Hco3 level

A

(ACID) 22- 26 mEq/L (BASE)

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7
Q

WHat is a normal Pa02 level

A

80-100

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8
Q

What is a normal sao2 level

A

above 95%

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9
Q

What is normal oxygenation levels

A

80-100 mmHg

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10
Q

What are mild hypoxemia levels?

A

70-79mmHG

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11
Q

What is moderate hypoxemia levels?

A

60-69 mmHG

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12
Q

What is severe hypoemia levels?

A

less than 60 mmHg

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13
Q

What are the steps of ABG analysis?

A

Step 1: Determine acidosis or alkalosis using pH level
Step 2: Determine resp. effect on the body using PaCO2
Step 3: Determine metabolic effect on body using HCO3
Step 4: Determine compension
Step 5: Determine oxygenation

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14
Q

Describe the different types of compensations for ABGs

A
  1. None/Absent: If the value that does NOT match PH is NORMAL then NO compensation has taken place
  2. If the valure that does not match pH is ABNORMAL & PH is ABNORMAL, then partial compensation exists
  3. If the valure that does NOT match the pH is ABNORMAL but the pH is NORMAL then FULL compensation has taken place.
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15
Q

What is the purpose of ABG

A

homeostasis

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16
Q

What health problems are associated with acid-base balances?

A
  1. Diabetes melitus- specifically DKA
    • Blood glucose is OFF the chart- body starts drinking, eating, peeing which increases blood glucose even higher. Then you go into a stupor state. When you lose the ability to eat drink and pee this is when you really go downhill and youll see METABOLIC ACIDOSIS
    • Insulin drip, fluids to help rehydrate cells
  2. COPD
  3. Kidney disease- r/t kidneys being unable to filter
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17
Q

Acid-base balance is not a….

A

Disease…. it accompanies a disease

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18
Q

Whats important to know about oxygen sats.

A

SpO2 is not as reliable as an ABG but it is less invasive. Important to note that it works by sending a redlight through to measure the amount of hemoglobin you have attached to your RBCs

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19
Q

ABG analysis allows us to?

A
  1. Determine oxygen status– used in conjunction w/pulse ox
  2. Determine acid-base balance
    • Buffer system: Secretes more hydrogen ions out
    • Resp. system: lungs will breath faster or slower depending on the bodies needs
    • Renal system: Takes 2-3 days before kidneys help. It helps by holding in or secreting what we need
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20
Q

What is Pa02

A

It is the partial pressure of oxygen in the arterial blood

21
Q

What is sA02

A

Arterial o2 saturation- measures tissue perfusion

22
Q

What is PaCo2

A

Partial pressure of carbon dioxide in the arterial blood

23
Q

What is HCO3?

A

Bicarb.. formed when co2 diffuses into blood.

24
Q

Lets talk PH… what is neutral, alkalosis, acidosis?

A

7.4 is neutral
Above 7.4 alkaline
below 7.4 acidosis

25
Q

What is Co2?

A
  1. Co2 is the ACID component of our blood gas.
  2. The body’s fastest way of changing our PH
  3. Lungs regulate co2 (acid) levels within MINS.
26
Q

What will the lungs do to compensate for acidosis?

A

RR and depth will increase to blow off CO2

27
Q

What will our lungs do to compensate for Alkalosis?

A

RR and depth will decrease. Co2 will be retained

28
Q

What is bicarbonate?

A
  1. Bicarb is the base component of our blood gas
  2. Kidneys regulate HCO3 (base) layer
  3. Slower system, takes hours to days
29
Q

To compensate for acidosis our kidneys will…

A

H+ ions will be excreted & HCO3 will be retained

30
Q

To compensate for alkalosis the kidneys will?

A

H+ ions will be retained and HCO3 will be excreted

31
Q

Explain ROME?

A

Resp. Oppsite
Metabolic Equal

32
Q

What are s/s of respiratory acidosis?

A
  1. Hypoventalation–> hypoxia
  2. Rapid, shallow respirations
  3. Decrease BP with vasodilation
  4. Dyspnea
  5. Headache
  6. Hyperkalemia
  7. Dysrthythmias (increase K+)
  8. Drowsiness, Dizziness, disorientation
  9. SOB- cant catch breath
  10. Muscle weakness, hyperreflexia
33
Q

What are causes of resp. ACIDOSIS?

A
  1. Decreased stimuli (anesthesia, drug overdose)
    • Morphine- causes resp. depression.
  2. COPD
  3. Pneumonia/ Edema- fluid in lungs
  4. Atelectasis- lungs not opening up like they should
34
Q

What is happening to our PH and Pco2 in resp. Acidosis?

A

PH is below 7.4
Pco2 is above 45

Lungs are retaining Co2

35
Q

What is our treatment for resp. acidosis?

A
  1. Adequate ventilation. Most likely on a vent.
  2. Other interventions prior to venting- TCDB, HOB elevated, oxygen,
  3. Sodium bicarbonate– rarely given r/t it not being very effective
  4. MUST TREAT CAUSE
36
Q

Dont give an asthma patient what kind of medication?

A

Cough suppreseant. Will tighten airway.

37
Q

Max o2 level for nasal cannula?
Non Rebreather
Venturi

A
  1. 6L for less than 30 mins
  2. Non rebreather- 10
  3. Venturi 10L

Adequate ventilation is key in resp. aacidosis

38
Q

What are s/s of Respiratory alkalosis?

A
  1. Seizures
  2. Deep, rapid breathing
  3. Hyperventilation
  4. Tachycardia
  5. Decreased or normal bp
  6. Hypokalmia
  7. Numbess/tingling of extremities
  8. Lethagy & confusion
  9. Light headheadness
  10. N/V
39
Q

What are causes of respiratory alkalosis?

A
  1. Hyperventilation (anxiety, PE, Fear)
  2. Mechanical ventilation
40
Q

What is the number 1 cause of resp. Alkalosis?

A

Anxiety r/t hyperventilation

41
Q

How is resp. Alkalosis treated?

A

Treat underlying cause… if from anxiety treat anxiety…

Paper bag or a non rebreather with 100% o2

42
Q

What are s/s of metabolic acidosis?

A
  1. Headache
  2. Decreased bp
  3. hyperkalemia
  4. Muscle twitching
  5. warm flushed skin (vasodilation)
  6. N/V
  7. Decreased muscle tone, decreased reflexes (confusion, increased drowsiness)
  8. Kussmaul respirations (compensatory hyperventilation)
43
Q

What are some causes of metabolic acidosis?

A
  1. increased H+ production (DKA, hypermetabolism)
  2. Decreased H+ elemination (renal failure)- most common
  3. Decreased HCO3 production (dehydration, liver failure)
  4. Increased Elimination (diarrhea, fistulas)
44
Q

Whats the main issue with metabolic acidosis?

A

Too much h+ (acid) too little bicarb

45
Q

How do we treat metabolic acidosis in a DKA patinet?

A
  1. Insulin/Insulin drip
  2. Check levels every hour
  3. Start fluids
  4. Apply oxygen
  5. Give bicarb
46
Q

What is s/s of metabolic alkalosis?

A
  1. Restlessness followed by lethargy
  2. Dysrhythmias (tachycardia
  3. Compensatory hypoventilation
  4. Confusion (decreased LOC, Dizzy, irritable)
  5. N/V/D
  6. Tremors, muscle cramps, tingling of fingers and toes
  7. Hypokalemia
47
Q

What causes metabolic alkalosis?

A
  1. Severe vomiting
  2. Excessive GI suctioning
    • Suction should never be set to contionus… only intermittent or off
  3. Diuretics
  4. Excessive NaHCO3
48
Q

How do we treat metabolic alkalosis?

A
  1. replace fluids
  2. Replace electrolytes
  3. Replace sodium cholride
  4. Hemodialysis

Module 7 (22 decks)

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