ABG Flashcards

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1
Q

pH

A

7.35-7.45

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2
Q

PaCo2

A

45-35

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3
Q

HCO3

A

21-28

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4
Q

Resp Rate

A

Acidosis: RR and Depth inc
Alkalosis: RR and Depth dec

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5
Q

Compensation

A

Occurs in the kidneys; takes hours/days

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6
Q

Potassium

A

Acidosis leads to Hyperkalemia

Alkalosis leads to Hypokalemia

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7
Q

Resp Acidosis

A

pH: <7.35
PaCo2: >45

Causes: Asthma; Atelectasis; Brain Trauma; Bronchiectasis; Bronchitits; CNS Depressants; Emphysema; Hypoventilation; Pneumonia; Pulmonary Edema; Pumonary Emboli

Interventions: Monitor for resp distress; admin 02; Place in semi-Fowler’s; COPD is risk factor; Monitor Potassium level

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8
Q

Resp Alkalosis

A

pH: >7.45
PaCo2: <35

Causes: Fever; Hyperventilation; Hypoxia; Hysteria; Overventilation by mechanical vents; Pain

Interventions: Monitor for resp distress; provide emotional support and reassurance; Assist with breathing techniques and breathing aids as prescribed (hold breath, rebreathing mask, CO2 breaths aka breath in a paper bag); monitor vents; monitor K and Ca levels; Ca gluconate for tetany

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9
Q

Met Acidosis

A

pH: <7.35
HCO3: <21

Inadequate insulin for DM1 => DKA aka Met Acid

Causes: DM or DKA; Excessive ingestion of acetylsalicylic acid (aspirin); High-fat diet; Insufficient met of carbs; Malnutrition; Renal insufficiency or failure; Sever diarrhea

Interventions: Monitor for signs of resp distress, LOC changes, and CNS depression; I/O; fluid/electorlyte replacement; safety and seizure precautions; monitor K closely (as met acid resolves, K levels dec)

DKA Interventions: Give Insulin; monitor circulatory collapse caused by polyuria (extracellular vol deficit may require fluid and electrolyte replacement)

Kidney Disease Interventions: Dialysis to remove protwin and waste products; diet low in protein and high in calories dec the amount of protein waste products (this lessens the acidosis)

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10
Q

Met Alkalosis

A

pH: >7.45
HCO3: >28

Causes: Diuretics; Excessive vomiting or gastrointestinal suctioning; Hyperaldosteronism; Ingestion and/or infusion of excess sodium bicarbonate; Massive transfusion of whole blood

Interventions: Monitor for signs of resp distress, K, and Ca levels; Safety precautions; Med and IV fluids to promote kidney excretion of bicarb; K replacement; Tx underlying cause

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11
Q

Acidosis S/S

A

Both- Drowsiness; Disorientation; Dizziness; Headache; Confusion; Coma; Dec bp; Dysrhythmia (r/t hyperkalemia from compensation); Warm, flushed skin (r/t peripheral vasodilation)

Resp Acid- Seizure; Hypoventilation with hypoxia (lungs are unable to compensate when there is a resp problem)

Met Acid- Nausea; Vomiting; Diarrhea; Abdominal Pain; Deep, rapid resp (Compensatory action by the lungs)

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12
Q

Alkalosis S/S

A

Both- Lethargy; Lightheadedness; Confusion; Drowsiness; Dizziness; Nervousness; Tachycardia; Dysrhythmia (r/t hypokalemia from compensation)

Resp Alk- Nausea; Vomiting; Epigastric Pain; Tetany; Numbness; Tingling of Extremities; Hyperreflexia; Seizure; Hyperventilation (lungs are unable to compensate when there is a resp problem)

Met Alk- Aorexia; Nausea; Vomiting; Tremors; Hypertonic Muscles; Muscle Cramps; Tetany; Tingling of Extremities; Seizure; Hypoventilation (compensatory action by the lungs)

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13
Q

Allen’s Test

A
  • Performed before obtaining an ABG from radial artery
  • determines the presence of collateral circulation and adequacy of the Ulnar artery
  • Apply pressure over both the radial and ulnar arteries simultaneously
  • Have patient open and close hand repeatedly. Hand should blanch
  • Release Ulnar artery
  • Hand should repink in 6-7 sec
  • Document
  • If >6-7 sec: Ulnar artery is insufficient. Choose alt site (brachial or femoral artery)
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14
Q

ABG Collection

A

RN or higher; Heparinized syringe; Provide emotional support during; hold pressure 5 mins post draw (10 mins if on anticoagulants); Record patient temp; record supplemental O2; trans on ice to lab

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15
Q

Respiratory Imbalance

A

Opposite relationship between pH and PaCO2
(R-Acid: pH Decreased, PaCO2 Increased.
R-Alk: pH Increased, PaCO2 Decreased)

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16
Q

Metabolic Imbalance

A

Corresponding relationship between pH and HCO3
(M-Acid: pH Decreased, HCO3 Decreased
M-Alk: pH Increased, HCO3 Increased)

17
Q

Analyzing ABG

A
  1. pH: Acidosis or Alkalosis
  2. PaCO2: opposite relationship to pH? Yes: Resp issue, No: Metabolic Issue
  3. HCO3: corresponding relationship to pH? Yes: Metabolic