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Flashcards in Arterial Blood Gas Deck (41):
1

Information From Arterial Blood Gasses

Oxygenation
Ventilation
Acid/base

2

First Choice for ABGs

Radial artery

3

Other Possible Arteries for ABGs

Femoral
Brachial

4

Complications of ABGs

Hematoma
Arterial damage
Stinger (if you hit the nerve)

5

Normal pH Range

7.35-7.45

6

Normal CO2 Range

35-45 mmHg

7

Normal PaO2 Range

83-102 mmHg

8

Normal HCO3 Range

22-28 mmol/L

9

Normal Anion Gap Range

10-16 mmol/L

10

What can acidosis cause?

Decreased force of cardiac contraction
Decreased vascular response to catecholamines
Decreased response to the effects and action of certain medications

11

What can alkalosis interfere with?

Tissue oxygenation
Neurological and muscle function

12

Factors that Control pH

Diet
Metabolic production of CO2
Regulation through the GI tract
Influence of other electrolyte
Buffers

13

3 Systems that Maintain Body pH

Chemical buffering
Respiratory center
Kidneys

14

Main Chemical Buffer

Carbonic acid system
H2O + CO2 -> H2CO3 -> HCO3 + H

15

What concentrations trigger the respiratory center as the respiratory buffer?

CO2
Carbonic acid
HCO3

16

What is altered to increase or decrease ventilation?

Respiratory rate
Tidal volume

17

Length of Time for the Respiratory Buffer

1-3 minutes

18

Length of Time for the Renal Buffer

Hours to days
More powerful regulatory system

19

Define Chemical Buffer

System of one or more compounds that act to resist pH changes when strong acid or base is added

20

Types of Chemical Buffer Systems

Bicarbonate buffer system
Phosphate buffer system
Protein buffer system

21

Respiratory Acidosis: pH, CO2, Causes

pH: down
CO2: up
Cause: hypoventilation

22

Causes of Respiratory Acidosis

CNS depression
Impaired muscle function
Pulmonary disorders
Massive PE
Hypoventilation

23

Signs and Symptoms of Respiratory Acidosis

Dyspnea
Respiratory distress
Shallow respiration
Headache
Restlessness
Confusion
Tachycardia
Dysrhythmias

24

Management of Respiratory Acidosis

Increase the ventilation
Treat pneumothorax, pain, and CNS depression
May require mechanical ventilation

25

Causes of Respiratory Alkalosis

Psychological responses
Pain
Increased metabolic demands
Respiratory stimulants
CNS lesions

26

Reasons for Increased Metabolic Demands

Fever
Sepsis
Pregnancy
Thyrotoxicosis

27

Signs and Symptoms of Respiratory Alkalosis

Light headedness
Numbness
Tingling
Confusion
Inability to concentrate
Blurred vision
Dysrhythmias and palpitations
Dry mouth
Diaphoresis
Tetanic spasms of the arms and legs

28

Metabolic Acidosis: pH, HCO3

pH: low
HCO3: low

29

Causes of Metabolic Acidosis

Renal failure
DKA
Anaerobic metabolism
Starvation
Salicylate intoxication
Sepsis

30

Signs and Symptoms of Metabolic Acidosis

Headache
Confusion and restlessness progressing to lethargy
Stupor or coma
Dysrhythmias
Kussmaul's respirations
Warm, flushed skin
N/V

31

Management of Metabolic Acidosis

Treat the cause
Hypoxia will produce metabolic acids
Restore tissue perfusion
Use of bicarbonate if indicated
Hydration

32

Metabolic Alkalosis: pH, HCO3

pH: high
HCO3: high

33

Causes of Metabolic Alkalosis

Ingestion of excess antacids
Excess use of bicarbonate
Use of lactate in dialysis
Protracted vomiting
Gastric suction
Hypochloremia
Excess use of diuretics
High levels of aldosterone

34

Signs and Symptoms of Metabolic Alkalosis

Dizziness
Lethargy Disorientation
Seizures
Coma
Weakness
Muscle twitching
Muscle cramps & tetany
N/V
Respiratory depression

35

Define Base Excess

Calculated value estimates that metabolic component of an acid/base abnormality

36

How much of Cl is reabsorbed under normal pH conditions?

99%

37

What happens to Cl- reabsorption when acidosis is present?

Fewer ions are reabsorbed

38

Anion Gap Equation

Anion gap = Na - (Cl + bicarb)

39

Define Partial Compensation

pH remains outside the normal range

40

Define Full Compensation

pH has returned within the normal range

41

Compensation in Primary Respiratory Acidosis

Increased PaCO2
Decreased pH
Increased HCO3