Flashcards in Arterial Blood Gas Deck (58):
Arterial blood gas is an essential part of diagnosing and managing
Acid base balance
Normal pH range
Normal PaO2 range
Normal PaCO2 range
Normal HCO3 range
Bicarbonate is a _________ value.
The base excess indicates the amount of excess or insufficient level of
Normal range of BE
A negative BE indicates a base
-2 to 2 mEq/L
Deficit in the blood
A normal [H+] of ______ corresponds to a pH of 7.40
Changes in pH are inversely related to changes in [H+]. A decrease in pH is associated with
An increase in [H+]
How much CO2 does the body produce daily?
How much nonvolatile acids does the body produce daily?
50-100 mEq nonvolatile acids
What organs attempt to maintain balance of acids in the body?
Lungs and kidneys
These two buffers work in pairs
carbonic acid and base bicarbonate
H2CO3 and NaHCO3
The respiratory buffer response maintains that blood pH will change according to the level of ____ which triggers the lungs to
Increase or decrease the rate and depth of ventilation
Activation of the lungs to compensate for an imbalance starts to occur within
The renal buffer response is that kidneys excrete or retain bicarbonate. If blood pH decreases, the kidneys will compensate by
How long can it take the renal system to correct an imbalance?
Hours to days
If decreased pH
What can cause respiratory acidosis
Compensation for metabolic alkalosis
All of these can decrease ventilation
What is the difference between acute and chronic respiratory acidosis?
Acute - little kidney involvement
Chronic - renal compensation via synthesis and retention of HCO3
With acute resp acidosis, pH decrease by ___ for 10 mmHg increase in CO2
Retention of CO2 results in decreased
Can lead to hypochloremia because the body wants to balance charges
With chronic resp acidosis, pH decreases by __ for 10 mmHg increase in CO2
If increased pH
What can cause respiratory alkalosis?
Inter cerebral hemorrhage
Salicylate and progesterone drug usage
Anxiety, which decreases lung compliance
Cirrhosis of the liver
What is the difference between acute and chronic respiratory alkalosis?
Acute - HCO3 decreases by 2 mEq/L for every 10 mmHg in PCO2
Chronic - HCO3 decreases by 4
Respiratory alkalosis causes decreased bicarb _____ and decreased ______ excretion to normalize pH
If decreased pH
What is Winter's formula and what does it tell you?
PCO2 = 1.5(HCO3) + 8 +/- 2
The degree of compensation for metabolic acidosis
How long does it take for complete activation of respiratory compensation?
For met acidosis, there is a decrease of ____ for every decrease of 1 mEq/L HCO3
Causes of metabolic gap acidosis
Causes of nongap metabolic acidosis
RTA (calculate urine anion gap)
If increased pH
In metabolic alkalosis, PCO2 increases by ___ for every increase of 1 mEq/L in HCO3
Metabolic alkalosis is caused by
Mixed acid base disorders describes ___ acid base disorders at one time
Two or more
What is the delta gap? What value equals metabolic alkalosis?
Delta HCO3 = HCO3 + change in anion gap
What kind of respiratory problem is it if pH and PaCO2 move in opposite directions?
What kind of problem is it if pH and HCO3 are moving in the same direction?
What level of Pao2 indicates hypoxemia?
< 80 mmHg
Change in PaO2 is associated with a change in pH, the disorder is ______. If the compensatory process brings the pH to within the clinically acceptable range (7.30 - 7.50), the disorder is
The estimate of how much strong base or acid needed to correct the metabolic component of an acid base disorder is
The formula for the amount needed to correct an acid base disorder is
0.3 x body weight x BE
Formula for anion gap
AG = (Na + K) - (Cl + HCO3)
T or F. The system does not have the ability to overcompensate.
If pH remains outside of the normal range after compensation, then it is
In a compensated state, when the pH decreases, PaCO2 should also decrease because
The lungs are acting as a buffer response
Always strongly suggest a metabolic acidosis
High anion gap
Ketones present, diabetic ketoacidosis
Hypokalemia and or hypochloremia
Suggests metabolic alkalosis
Common with normal anion gap acidosis
Elevated creatinine and urea
Suggests uremic acidosis or hypovolemia (prerenal renal failure)
Consider ketoacidosis or hyperosmolar nonketotic syndrome