Acid-Base (ABGs)

Question 1

what is the most effective buffering system?

Answer 1

Renal Buffering

Question 2

what is respiratory buffering?

Answer 2

it happens when there is an increase in CO2, there is more hydrogen ions. this lowers pH to which creates acidotic state. then RR increases to let out the CO2 out. which then the CO2 decreases, which hydrogen ions decreases leading to a higher pH. RR will slow to conserve CO2. (changes in RR will alter pH faster than metabolic changes)

Question 3

what is renal buffering in alkalosis?

Answer 3

begins within hours but requires several days.
in alkalosis, kidneys release bicarb, which reabsorb hydrogen ions. urine will be more alkaline which decrease pH.

Question 4

what is renal buffering in acidosis

Answer 4

kidney excrete hydrogen ions, reabsorb bicarb. urine becomes acidic, and pH increases.

Question 5

whose at risk for ABGs abnormalities?

Answer 5

very young and very old.

Question 6

normal pH

Answer 6

7.35-7.45

Question 7

normal PaCO2

Answer 7

35-45

Question 8

normal HCO3

Answer 8

22-26

Question 9

what does it need to be partially compensated?

Answer 9

pH- abnormal
CO2- abnormal
HCO3- abnormal

Question 10

fully compensated?

Answer 10

pH- normal
CO2- abnormal
HCO3- abnormal

Question 11

primary prevention for acid-base imbalance?

Answer 11

healthy eating
safe weight loss
smoking cessation
poison control
safe food handling

Question 12

exemplars for respiratory acidosis

Answer 12

asthma
bacterial pneumonia
COPD

Question 13

exemplars for metabolic acidosis

Answer 13

DKA
severe hypovolemia
circulatory shock
oliguric renal disease

Question 14

exemplars for respiratory alkalosis

Answer 14

hyperventilation

Question 15

exemplars for metabolic alkalosis

Answer 15

prolonged vomiting
mild hypovoemia
hypokalemia

Question 16

normal PaO2

Answer 16

80-100

Question 17

what pH is considered lethal?

Answer 17

less than 6.8
more than 7.8

Question 18

how do you perform and ABG sample?

Answer 18

aspesis
herparinized syringe
direct pressure for at least 5 minutes, or 20 min if theyre on anticoag.

Question 19

how do you do allen’s test?

Answer 19

1. pt clench their fist
   occlude their radial/ulnar arties
   have pt open hand
   remove pressure from ulnar artery
   color should return to hand

Question 20

causes for respiratory acidosis

Answer 20

cns depression
excessive o2 to copd
PE
ards
sleep apnea
pneumothorax
myasthenia gravis
Guillain-barre

Question 21

S/S or respiratory acidosis

Answer 21

dyspnea
respiratory distress
tachycardia
low LOC
low BP
HYPERKALEMIA
dysrhythmias

Question 22

tx for respiratory acidosis

Answer 22

o2
hydration
semi fowler
deep breathing
bronchodialotrs
mucolytic
antibiotics if infection
thrombolytic if PE
mechanical ventilation

Question 23

causes for respiratory alkalosis

Answer 23

hyperventilation, fever, pain,

Question 24

S/S for respiratory alkalosis

Answer 24

tachycardia/tachypnea
lightheadedhness
confusion
hypokalemia
hypocalcemia
TETANY
cramping

Question 25

tx respiratory alkalosis

Answer 25

anti-anxiety slow, deep breathing rebreather mask oxygen= if hypoxic

Question 26

causes for metabolic acidosis

Answer 26

renal failure, diarrhea, loss of fluid in gi tract, DKA, fasting

Question 27

S/S for metabolic acidosis

Answer 27

low LOC, drowsy KUSSMAUL respiration HOTN low CO hyperkalemia dysthymias

Question 28

tx for metabolic acidosis

Answer 28

sodium bicard (PH<7.1) monitor high potassium levels monitor low calcium levels

Question 29

causes for metabolic alkalosis

Answer 29

vomiting, gastric suction, excessive antacids

Question 30

s/s metabolic alkalosis

Answer 30

hypocalcemia hypokalemia respiratory depression tachycardia tetany seizures

Question 31

tx for metabolic alkalosis

Answer 31

stop diuretics IVF with NS KCL to IVF

Question 32

s/s for acidosis for saunders

Answer 32

lethargy confusion dizzy headache coma dysthymias muscle weakness seizures

Question 33

s/s for respiratory acidosis (saunders)

Answer 33

warm flushed skin respiratory rate increased

Question 34

s/s for metabolic acidosis

Answer 34

cold clammy skin nausea, vomiting, diarrhea, abdominal pain KUSSMAUL respiration