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complex care 2 > ABG > Flashcards

ABG Flashcards

1
Q

Why is Acid Base Balance Important?

A
  • Necessary to maintain homeostasis-
  • The relative acidity or alkalinity of a solution can be indicated by its pH.
  • Refers to balance of hydrogen ions (H+)
  • Hydrogen ion concentration is expressed as pH level
  • pH is inversely proportional to concentration of H+ ions

-If the hydrogen (H+) ion concentration goes UP then the pH…. Down

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2
Q

PH levels

A

-If the hydrogen ion concentration goes up
the level of acidity goes up and the pH goes down

-The lower the pH indicates higher levels of acidity

  • <7.35 is acidosis
  • > 7.45 is alkalosis
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3
Q

Body Fluids: Acids or Bases

A
  • Acids: Body produces acids
  • H+: positive Charge and can causes electrolyte imbalances
  • Body produces Bases
  • Neutralize and excrete acids
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4
Q

Acid Base Basics

A

Acids
Form hydrogen ion in solution

Bases
Combine with hydrogen ions in solution

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5
Q

Acid Base Regulation

A

Metabolic processes produce acids
These acids must be neutralized and excreted
3 Mechanisms to regulate acid base balance and maintain pH: Buffer system, Respiratory system & Renal system

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6
Q

Buffers

A

First line of defense
Chemical actions
Change acids, or neutralize acids
Can also release needed H+ ions

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7
Q

Respiratory system

A

Changing level of CO2
Hypercarbic drive
Hypoxic drive

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8
Q

renal

A

Changing level of HCO3

Kidneys regulate H+ ions or bicarbonate ions

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9
Q

symptoms of acid bace imbalances

A
  1. CNS Depression: in both acidosis and alkalosis
    - HA, lethargy, weakness, confusion…..
    - May also lead to coma and death
  2. Compensatory mechanisms :
    - Also produce clinical changes
    - Example metabolic acidosis: deep rapid respirations as the respiratory system attempts to compensate

-Example: Alkalosis: S/S are usually from electrolyte disturbances
-With alkalosis, hypocalcemia may result
S/S of hypocalcemia: muscle cramping, numbness, tetany….

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10
Q

ph normal

A

7.35-7.45

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11
Q

PaCO2

A

35-45

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12
Q

HCO3

A

22-26

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13
Q

Pa02

A

80-100

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14
Q

Sa02

A

> 95%

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15
Q

Respiratory Acidosis

A

-Low ph
-high CO2
Build up of CO2
Pulmonary issues
HYPOVentilation
Accumulation/excess: carbonic acid in blood –
This leaves extra H+
pH ↓ decreases

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16
Q

respiratory alkalosis

A 
High pH   Low CO2
Increased CO2 excretion
Carbonic acid deficit
HYPERventilation
Lower partial pressure of CO2 = decreased carbonic acids and alkalosis
pH ↑  increases
17
Q

metabolic acidosis

A

ACIDS ACCUMULATE
Ketoacids
Or
Lactic acids

Or bicarb is lost

pH is low
HCO3 is low
PCO2 could be normal

If bicarb is lost = more acid than base = acidosis
In renal disease: kidneys have poor reabsorption of HCO3 and secrete H+

18
Q

metabolic alkalosis

A

Loss of acids
Gastric loss

Or increase HCO3

Increased Intake
pH high
HCO3 high

19
Q

compensation

A

Blood Gases are more specifically defined by Compensation
Degree of compensation.
ABGs are defined as :
uncompensated,partially compensated, andfully compensated.
To determine the level of compensation, the pH, PaCO2, and HCO3-are analyzed

20
Q

If primary acid base disorder is Metabolic…

A
  • Respiratory system may COMPENSATE
  • By retaining CO2 or removing CO2
  • Respiratory compensation : Rapid
21
Q

If primary acid base disorder is Respiratory

A

Renal system may compensate
By excreting or retaining hydrogen and bicarb
Renal compensation is slower and can take up to 24 hours

22
Q

diarrhea

A

-Dehydration
-Loss of HCO3
-Metabolic acidosis
What will the body do to compensate?*
Lungs: ↑ RR to blow off CO2
Kidneys:
Retain HCO3
Excrete H+

23
Q

vomiting

A

Acid Base
Loss of acids
Metabolic Alkalosis

What will the body do to compensate?*  
Lungs: ↓ or maintain Regular  RR
Kidneys: 
Excrete HCO3
Retain H+
To help correct pH
24
Q

Symptoms in both acidosis and alkalosis

A
  • CNS depression

- HA, lethargy, Weakness, confusion, coma, death

25
Q

alkalosis usually affects…

A
  • signs from electrolyte imbalances

- common to have low calcium

26
Q

low calcium in alkalosis causes

A
  • muscle cramping, numbness, tetany
27
Q

normal serum lactate levels

A

0.5 to 2.2

complex care 2 (8 decks)

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