ABGs

Question 1

Normal pH

Answer 1

7.35-7.45
Acidosis: >7.35
Alkalosis: <7.45

Question 2

PaO2

Answer 2

80-100mmHg

Question 3

PaCO2

Answer 3

• Partial pressure of carbon dioxide
• Respiratory component
• 35-45mmHg

Question 4

HCO3

Answer 4

• Bicarbonate
• Metabolic component
• 22-26mEq/L

Question 5

Respiratory Acidosis

Answer 5

• When resp func is impaired & causes retention of CO2
  > resp depression due to anesthetics, drugs (opioids), & electrolyte imbalance
  > inadequate chest expansion
  > airway obstruction
  > reduces alveolar-capillary diffusion; pneum, TB, emphysema, chest trauma, pulm emboli, pulm edema, drowning

Question 6

Respiratory Acidosis Treatment

Answer 6

Focus on improving ventilation & oxygenation and maintaining a patent airway

Question 7

Metabolic Acidosis

Answer 7

• State of excess acid or reduced base bicarbonate in body
  > excessive oxidation of fatty acids (diabetic ketoacidosis, starvation)
  > hypermetabolism (heavy exercise, seizure activity, fever, hypoxia, ischemia)
  > excessive ingestion of acids (ethanol or methanol intox, salicylate intox)
  > kidney failure
  > pancreatitis, liver fialure, dehyration
  > diarrhea

Question 8

Metabolic Acidosis Treatment

Answer 8

Focus on hydration & drugs or treatment to control problem causing acidosis; IV Sodium Bicarbonate is admind only if serum bicarb lvls are low

Question 9

Respiratory Alkalosis

Answer 9

• Caused by an excessive loss of CO2 through hyperventilation
  > fear
  > anxiety
  > mechanical ventilation
  > salicylate toxicity
  > high altitudes
  > shock
  > early-stage acute pulm probs

Question 10

Respiratory Alkalosis Treatment

Answer 10

Correct underlying cause
If due to hyperventilation/axiety or panic attack intruct pt to take slow, deep breaths or breathe into brown paper bag

Question 11

Metabolic Alkalosis

Answer 11

• Caused by either an incr of bases (base excess) or a dcr of acids (acid deficit)
  > incr of base components: oral ingestion of antacids, blood transfusion, sodium bicarbonate, TPN
  > OR dcr of acid components: prolonged vomiting, NG suctioning, thiazide diuretics, or hypokalemia

Question 12

Metabolic Alkalosis Treatment

Answer 12

Correct underlying cause

Question 13

Steps for ABG Analysis

Answer 13

1. Determine pH
   > acidotic is less than 7.35
   > alkalotic is greater than 7.45
2. Determine PaCO2
   > if respiratory issue, PaCO2 will be abn
3. Determine HCO3
   > if metabolic issue, HCO3 will be abn