Acid Base Balance and Ventilators

Question 1

Arterial Blood Gas (ABG) interpretation

Answer 1

Rule of the B’s
If the pH and bicarb are both in the same direction, it is metabolic

Follow the direction for pH - acidosis is low, alkalosis is high

Question 2

normal pH and bicarb

Answer 2

7.35-7.45 and 22-26

Question 3

partially compensated

Answer 3

if ALL three are abnormal

Question 4

signs and symptoms of acid-base imbalance

Answer 4

As the pH goes, so does my patient Except for potassium.

High pH = everything goes up + low potassium

Low pH = everything goes down + pH goes up

Question 5

causes of acid-base imbalance

Answer 5

is it lung? yes = respiratory

are they overventilating or underventilating?
respiratory alkalosis or respiratory acidosis

if its not lung then its metabolic. are they vomiting? metabolic alkalosis (RAREST) everything else metabolic acidosis

Question 6

high pressure alarm triggers

Answer 6

increased resistance - 3 obstructions: tube kink (unkink) water in tubing (NEVER OPEN SYSTEM AND DRAIN) mucous (turn cough, suction)

Question 7

low pressure alarm triggers

Answer 7

decreased resistance = disconnection (if tube goes on floor, ambo bag and call resp therapist)

Question 8

ventilator settings

Answer 8

rate and tidal volume (increase or decrease air)

look at ABGsv- respiratory alkalosis = ventilator settings are too high, turn down

respiratory acidosis = ventilator settings too low, turn up