ABG

Question 1

What is the substance that acts as a chemical sponge because it soaks up or releases __

Answer 1

Buffer

Hydrogen ions

Question 2

What is the Henderson Hasselbalch Equation?

Answer 2

The higher the H ions, the lower the number

Question 3

Lower pH = ___

Higher pH = ____

Answer 3

ACIDIC

ALKALINE

Question 4

Carbonic acid (H2CO3) is formed from what?

Answer 4

Carbon dioxide and water

Question 5

Which is faster? The lungs or the kidneys? Why?

Answer 5

The lungs can correct the buffer system in mins-hrs because it uses CO2

The kidneys take hrs-days because it uses bicarbonate/HCO3

Question 6

Define the phosphatase and protein buffer system

Answer 6

Phosphatase: active in kidneys
Protein: involves hgb (hemoglobin)

Question 7

We have no means to control the phosphatase and

protein buffer systems since they are i____ and r____

Answer 7

Instantaneous

Reflexive

Question 8

Explain the respiratory control of pH (arrows)

Answer 8

The lower the pH (acid) = higher RR, higher CO2 = ALK

The higher the pH (alk) = lower RR, lower CO2 = ACID

Question 9

What part of the brain monitors the respiratory control of pH?

Answer 9

Brainstem

Question 10

(T/F) Kidneys are more of the short term maintenance of acid-base balance

Answer 10

FALSE, kidneys are more of long term maintenance

Question 11

ABG Analysis is obtained from ____ drawn blood

Answer 11

arterially

Question 12

Blood is taken from the ____ artery

Answer 12

right

Question 13

Which of the following is true:
A. Blood does not have to be immediately brought to the laboratory
B. Use an ice bag to maintain natural levels
C. Pull the syringe plunger when drawing blood

Answer 13

B

Question 14

The earth receives _% of O2

Answer 14

21

Question 15

Provide the normal values of the ff:

1. pH
2. pO2
3. pCO2
4. HCO3

Answer 15

pH: 7.35-7.45
pO2: 80-100 mmHg
pCO2: 35-45 mmHg
HCO3: 22-26 mEq/L

Question 16

How can we see the effects of uncompensated metabolic acidosis on a patient?

Answer 16

Since it is a metabolic problem, refer to respi control:

The patient’s RR will increase to blow excess CO2 to compensate and become more alkaline

Ex: Kussmaul breathing

Question 17

What happens during metabolic acidosis? Give at least 3 (HDT)

Answer 17

Hyperkalemia (H in, K out)
Dysrhythmias
Tachypnea 
Lethargy
Confusion

Question 18

What happens during metabolic alkalosis? (3, HIN)

Answer 18

Hypokalemia (H out, K in)
Irritability
Numbness or tingling

Question 19

When is an ABG taken? (3, IOU)

Answer 19

After getting intubated
After receiving oxygen
Unconscious, suspected metabolic cause

Question 20

Why is it important to get baseline before ABG?

Answer 20

To assess if body has compensated or not

To evaluate effectiveness of intervention

Question 21

Match the ff

1. deficit in HCO3
2. excess in HCO3

A. Metabolic alkalosis
B. Metabolic acidosis

Answer 21

1B - aciD = Deficit
2A - alKalosis = exCess

Directly proportional

Question 22

Give at least 3 causes of metabolic acidosis (SRD)

Answer 22

Starvation
Diabetic ketoacidosis 
Renal tubular acidosis
Renal failure
Diarrhea
Shock
Use of drugs

Question 23

Match the ff interventions
MD = metabolic acidosis
MK = metabolic alkalosis

1. Administer sodium bicarbonate as ordered
2. Breathing into paper bag
3. Alkaline mouthwash
4. Lubricate lips
5. Sedation as ordered
6. Seizure precautions
7. Mechanical ventilation

Answer 23

1. MD
2. MK
3. MD
4. MD
5. MK
6. MD
7. MK

Question 24

Give at least 3 causes of metabolic alkalosis (VSD)

Answer 24

Excess vomiting (lose H)
Hypercalcemia
Prolonged GI suctioning
Cushing’s syndrome Hyperaldosteronism 
Use of drugs

Question 25

Match the ff 1. deficit in H2CO3 2. excess in H2CO3 A. Respiratory alkalosis B. Respiratory acidosis

Answer 25

``` 1A 2B (bicarbonate = carbonic acid = higher = acidic) ```

Question 26

Give at least 3 causes of respiratory acidosis (PRO)

Answer 26

``` Pneumonia Respiratory failure Atelectasis Drug overdose Paralysis of respiratory system Traumatic injuries Obesity Airway obstruction Head injuries CVA or stroke Drowning Cystic fibrosis ```

Question 27

(T/F) Signs and symptoms of respiratory acidosis/alkalosis are similar to the signs and symptoms of metabolic acidosis/alkalosis

Answer 27

TRUE

Question 28

Match the ff interventions RD = respiratory acidosis RK = respiratory alkalosis 1. Semi-fowlers 2. Breath holding/paper bag 3. Deep breathing 4. Postural drainage 5. Low conc. O2 therapy 6. Sedation

Answer 28

1. RD 2. RK 3. RD 4. RD 5. RD 6. RK

Question 29

Give at least 3 causes of respiratory alkalosis (AAA)

Answer 29

``` Anxiety Fear Anemia Hypermetabolic states Disorders of the CNS Use of drugs Asthma Pneumonia ```