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Pathopharmacology II > Wk 2 ABGs > Flashcards

Wk 2 ABGs Flashcards

1
Q

Why do we use ABGs?

A

Gives us the best representation of the pH and CO2

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2
Q

What is the purpose of ABGs?

A

to ASSESS acid/base status and to determine adequacy of oxygenation and ventilation

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3
Q

Normal PaCO2 range

A

35-45 mmHg

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4
Q

pH is essentially the balance of…

A

hydrogen ions

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5
Q

PaCO2 is a __ parameter

A

respiratory (H20 + CO2 = carbonic acid)

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6
Q

HCO3 is a __ parameter

A

metabolic

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7
Q

Normal HCO3 range on ABG

A

22-26 mEq/L

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8
Q

HCO3- is a __ value on the ABG

A

calculated

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9
Q

What is HCO3- reported as on the venous chemistry panel?

A

CO2

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10
Q

What is a primary event for acid/base balance?

A

The problem that initiates the acid/base balance

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11
Q

4 examples of primary even for acid/base balance

A

Hyperventilation
Hypoventilation
Vomiting
Diarrhea

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12
Q

What is the primary disorder?

A

The result of the primary event

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13
Q

Two examples of a primary disorder?

A

Respiratory acidosis

Metabolic alkalosis

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14
Q

If there is a problem with the kidneys, the lungs will compensate. What is the problem with this?

A

The lungs cannot compensate for a long period of time like the kidneys can

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15
Q

What would we do for a patient with renal failure?

A

Dialysis and/or bicarb

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16
Q

Metabolic imbalances are related to…

A

Bicarbonate (HCO3-)

Kidneys

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17
Q

Respiratory imbalances are related to…

A

H2CO3 (carbonic acid)

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18
Q

Increase or decrease in CO2, changes in ventilation

A

respiratory alkalosis or acidosis

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19
Q

Changes in [H+] or bicarbonate ions

A

metabolic alkalosis or acidosis

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20
Q

Acid base pneumonic ROME

A

R- Respiratory
O- Opposite
M- Metabolic
E- Equal

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21
Q

If pH is up and PCO2 is down then it is…

A

respiratory alkalosis

22
Q

If pH is down and PCO2 is up then it is…

A

respiratory acidosis

23
Q

If pH is up and HCO3 is up then it is…

A

metabolic alkalosis

24
Q

If pH is down and HCO3 is down then it is…

A

metabolic acidosis

25
Q

What is HCO3?

A

bicarbonate

26
Q

What is metabolic alkalosis?

A

Too much bicarbonate or not enough carbonic acid

27
Q

What are the ABGs of someone with metabolic alkalosis?

A

pH: >7.48
PaCO2: 35-45 (lungs not compensating yet)
HCO3: >26

28
Q

What are dietary causes metabolic alkalosis

A

Taking in excess baking soda or alia-seltzer (too much base)

29
Q

What happens if you take in too much base?

A

Hydrogen shift outside the cell causing potassium to go into cell (hypokalemia)

30
Q

3 other causes of metabolic alkalosis?

A 
Prolonged vomiting (losing HCl from stomach)
NG tube (pulling out HCl from stomach)
Diuretics (loop)
31
Q

What are neurologic symptoms of metabolic alkalosis?

A

CNS over-excitability, muscle tremors, cramps, confusion, parathesias, coma,

32
Q

What are two other symptoms of metabolic alkalosis?

A

Respiratory depression
N/V/D
Hypokalemia

33
Q

In respiratory alkalosis, there is a __ __ deficit

A

carbonic acid (H2CO3)

34
Q

What are the ABG levels of someone with respiratory alkalosis?

A

pH >7.45
PaCO2 <35
HCO3 22-26 (kidneys not begun to compensate yet)

35
Q

What causes respiratory alkalosis?

A

Anything that can cause an increase in breathing

36
Q

What are the symptoms of respiratory alkalosis?

A

CNS over-excitability

Tachypnea, confusion, light headedness, parathesia, hyperactive reflexes, coma, hypotension

37
Q

What causes respiratory acidosis?

A

Excess carbonic acid, hypoventilation

38
Q

Acute versus chronic respiratory acidosis

A

respiratory arrest versus COPD

39
Q

ABGs of someone with respiratory acidosis

A

pH <7.35
PaCO2 >45
HCO3 22-26 (kidneys react slow with acute)

40
Q

In a patient with COPD and respiratory acidosis, their pH will…

A

Return to normal once the kidneys have had time to compensate. HCO3 will be high.

41
Q

What are the symptoms of respiratory acidosis?

A

CNS depression including hypoventilation
Headache, restlessness, confusion
tachycardia, LOC, coma

42
Q

3 causes of respiratory acidosis

A 
Cardiopulmonary arrest
Head injury
Narcotics
Anesthesia 
Pulmonary disorders
Uncontrolled pain (hurts to breath)
Abdominal distention 
Airway obstruction
Chest wall deformities
43
Q

What is metabolic acidosis?

A

Excess acids or loss of bicarb (base)

44
Q

ABGs of metabolic acidosis

A

pH <7.35
PaCO2 35-45
HCO3 <22

45
Q

Common causes of metabolic acidosis

A 
Renal disease
fistulas 
diabetes
lactic acidosis 
prolonged diarrhea
starvation
shock
cardiac arrest
46
Q

What type of diabetes is associated with metabolic acidosis?

A

Type 1 - DKA

47
Q

How does prolonged diarrhea cause metabolic acidosis?

A

Relative increased acid due to loss of HCO3

48
Q

How does starvation cause metabolic acidosis?

A

Using fat for energy causing ketosis

49
Q

Metabolic acidosis causes an increase in what type of acid and why?

A

Lactic acid due to lack of oxygen to the tissues

50
Q

What are the s/s of metabolic acidosis?

A

CNS over-excitability
Confusion, lethargy, tremors, parathesias
hypotension, hyperkalemia
Kussmal respirations

Pathopharmacology II (12 decks)

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