Week 3 ABG and Compensation Flashcards
What is the most common site to draw ABG?
Radial artery - must perform allen test first
Allen test – occlude radial and ulnar artery, ask pt to squeen hand and release their heir and then we as nurses release the ulnar arty (and hand should return pink but can take a while because the ulnar artery is small)
Arterial blood gas is drawn from what?
Artery - should be well oxygenated, bright red, blood will pulsate into syringe.
Normal values: pH, CO2, HCO3
pH: 7.35 - 7.45
CO2: 35-45
HCO3: 22-26
Acidosis: pH, CO2, HCO3
pH: less than 7.35
CO2: greater than 45
HCO3: less than 22
Alkalosis: pH, CO2, HCO3
pH: greater than 7.45
CO2: less than 35
HCO3: greater than 26
CO2 vs. Bicarbonate
CO2: acid, comes from lungs, respiratory
HCO3: alkalotic (base), kidneys, metabolic
Causes of respiratory acidosis
COPD (most common) pneumonia drowning opioid overdose hypoventilation
anything that prevents someone from getting CO2 out of body
Causes of metabolic acidosis
DKA
Diarrhea
Shock
What abnormality in ABG are you going to have is fluid is going out of body upward vs downward?
If fluid going up (vomit) going to cause alkalosis
If fluid going down (diarrhea) going to cause acidosis
Causes of respiratory alkalosis
Hyperventilation
Anything where you have too much bicarbonate in lungs or not enough CO2
Causes of metabolic alkalosis
Vomiting
NG drainage
What ABG dictates if someone is acidotic or alkalotic?
pH
ROME (respiratory opposite metabolic equal)
7.22 (acid)
38 (normal)
12 (acid)
Diagnosis: metabolic acidosis
Acidosis because pH is acidic
Metabolic because
What 3 questions do you ask when you are interpreting ABG?
- Is this a respiratory or metabolic problem?
- Do we have ACIDOSIS or ALKALOSIS
- Do we have COMPENSATION: uncompensated, partial, or full compensation?
Interventions for respiratory acidosis?
Bronchodilator
Antibiotics
Narcan (opioid OD)
Diuretics to remove fluid from lungs
Intervention for metabolic acidosis?
Insulin
Antidiarrheal
IV fluids
TREAT THE CAUSE
