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Flashcards in Acid/ Base Management Deck (158)
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1

base excess refers to a patient's (metabolic/ respiratory) acid/base status

metabolic

2

What does base excess tell us clinically?

an ABG value that reveals if patient has too much or too little base in the blood

3

Normal base excess

-2 to 2 mmol/L

4

What is negative base excess value?

What does it mean?

How do you treat it?

below -2mmol/L

there is not enough base in the body; metabolic acidosis

treated with bicarb

5

What is a positive base excess value?

What does it mean?

How do you treat it?

above 2mmol/L

there is too much base in the body; metabolic alkalosis

treated by reversing the cause of alkalosis

6

A high concentration of H+ ions will = (high/low) pH?

low= acidotic (acid)

7

a low concentration of H+ ions will = (high/low) pH?

high= alkalosis (basic)

8

What is the normal pH range?

7.35-7.45 (7.4)

9

pH > 7.45 = (acidosis/alkalosis)?

alkalosis

10

pH < 7.35= (acidosis/alkalosis)?

acidosis

11

What is pH determined by?

HCO3-/ PaCO2 ratio

12

6 consequences of Acidosis:

1. contractility?

2. catecholamines?

3. bleeding?

4. vasculature?

5. arrythmias?

6. ion concentrations?

1. decrease cardiac contractility

2. decrease the response to catecholamines

3. impair coagulation and increase bleeding

4. increase PVR

5. Makes Vfib more likely

6. increases plasm K+
-H+ enters the cell and K+ exits

13

5 consequences of Alkalosis:

1. hemoglobin?

2. vasculature? (3)

3. ion concentrations?

1. Shifts the oxyhemoglobin dissociation curve to the left
-hemoglobin will bind oxygen more tightly

2. increase SVR

3. Cerebral vasoconstriction
-because of the left shift of the oxyhemoglobin curve

4. Decreases PVR

5. decreases plasma K+ concentration
-H+ exits the cell and K+ enters

14

What is a normal venous CO2 measurement?

24-30 mEq/L
*includes both the CO2 dissolved in plasma and the HCO3- dissolved in plasma

15

What is a normal arterial HCO3- measurement?

22-26 mEq/L

16

normal PaCO2

35-45 mmHg

17

normal PvCO2

40-50 mmHg
~5 mmHg higher than PaCO2

18

What does the PaCO2 and PvCO2 gradient tell you about your patient?

If the PaCO2 and PvCO2 gradient increases, the patient is poorly perfused

19

PaO2 of the atmosphere (at sea level)

160mmHg
-O2 makes up 21% of atmospheric pressure 760mmHG

20

normal PaO2

70-100 mmHg
-decreases with age

21

normal PvO2

30-40mmHg

22

normal CaO2

16-20 mL/ dL

23

normal CvO2

12-16 mL/dL

24

normal DO2 (total delivery of oxygen per minute)

1000 mL of oxygen delivered per minutes

*assumes normal hemoglobin (15g/dL), normal SaO2 of (97.5%), and normal cardiac output (5 L/min)

25

normal mvO2

60-80% (in awake patients)

90% with 100% FiO2

26

normal SaO2

93-98%

27

normal ScvO2

70-75%

28

normal A-a gradient in room air

5-15mmHg

29

normal A-a gradient in elderly patients

15-25mmHg

30

normal A-a gradient on FiO2 of 100%

10-110mmHg