Arterial Blood Gas

Question 1

Purpose of ABG

Answer 1

Excess acid base status in determine adequacy of oxygenation and ventilation

Question 2

what is a respiratory parameter?

Answer 2

paCO2

Question 3

what is a metabolic parameter?

Answer 3

HCO3

Question 4

Primary event

Answer 4

problem that causes the acid base imbalance

Hypoventilation
Hyperventilation
Vomiting, diarrhea

Question 5

Primary disorder

Answer 5

what results from primary event

Respiratory acidosis
Metabolic alkalosis

Question 6

compensation mechanisms

Answer 6

Physiologic process that adjust the pH back to normal

Question 7

ROME

Answer 7

respiratory
Opposite
Metabolic
Equal

Question 8

Respiratory alkalosis

Answer 8

PH increases
pCO2 decreases

pH >7.45
paCO2 <35

Question 9

respiratory acidosis

Answer 9

Ph decreases
pCO2 increases

pH<7.35
paCO2 >45

Question 10

metabolic alkalosis

Answer 10

HCO3 and pH increase

pH >7.45
HCO3 >26

Question 11

metabolic acidosis

Answer 11

HCO3 and pH decrease

pH <7.35
HCO3 <22

Question 12

causes of metabolic alkalosis

Answer 12

Excess baking soda
Alka-Seltzer
Antacids
Prolonged vomiting
NG tube
Diuretics

Question 13

s/sx metabolic alkalosis

Answer 13

Tachycardia, dysrhythmias
Hypokalemia
Nausea, vomiting, diarrhea
CNS over excited
Confusion, tremors
Muscle cramps, restless
Paresthesias

Question 14

causes of respiratory alkalosis

Answer 14

Hyperventilation – CO2 blown off
Fever, sepsis
Meds
Acute anxiety
Hypoxia
PE, lung disease
CNS lesions
Ventilator settings

Question 15

s/sx respiratory alkalosis

Answer 15

CNS over excited
Tachypnea
Lightheaded
Syncope
Confusion
Blurred vision
Paresthesia
Hyperactive reflexes, seizures
N/V

Question 16

causes of respiratory acidosis

Answer 16

Hypoventilation
Cardiac arrest
Head injury
Narcotics/sedatives/anesthesia
pulmonary disorders – asthma, COPD, pneumonia
Pain
Abdominal distention
Airway obstruction
Chest wall deformity
Neuromuscular disorders

Question 17

s/sx respiratory acidosis

Answer 17

CNS depression
Hypoventilation
Dyspnea
Respiratory distress
Shallow breathing
Headache
Restless
Tachycardia, arrhythmias
Decreased LOC

Question 18

causes of metabolic acidosis

Answer 18

Renal failure
Fistulas
Type one diabetes – DKA
Lactic acidosis
Prolonged diarrhea
Starvation
Shock, cardiac arrest

Question 19

s/sx metabolic acidosis

Answer 19

lethargy, drowsy
Confusion, tremors
Muscle cramps
Paresthesias
Increased BP
Decreased K
Deep breathing – Kussmaul respirations

Question 20

Respiratory compensation

Answer 20

rapid
Lungs
Hyper/hypoventilation
Metabolic acid base abnormality

Question 21

Metabolic compensation

Answer 21

slow
Kidneys
Retention/excretion of H/HCO3

Question 22

intervention for respiratory acidosis

Answer 22

Increase ventilation
Narcan
Intubate

Question 23

intervention for respiratory alkalosis

Answer 23

Calm patient
Antianxiety meds
Rebreather, paper bag
Decrease respirations

Question 24

intervention for metabolic acidosis

Answer 24

Sodium bicarb
Rapid acting insulin

Question 25

intervention for metabolic alkalosis

Answer 25

Treat the cause H2 blockers, PPI

Question 26

steps for compensation

Answer 26

One – look at pH Two – look at PCO2 Three – look at HCO3 Four – check compensation

Question 27

uncompensated

Answer 27

PH abnormal Acid or base abnormal

Question 28

partially compensated

Answer 28

PH abnormal Acid and base abnormal Indicates body is trying to compensate

Question 29

Compensated

Answer 29

PH is within normal limits Acid/base neutral, not corrected Acid/base abnormal, but balanced Arrows going same direction

Question 30

what occurs when the pH, acid and base are all within normal limits?

Answer 30

Correction

Question 31

what indicates an acute situation?

Answer 31

When the body is uncompensated HCO3 is within normal limits, unchanged