Arterial Blood Gas

Question 1

Information From Arterial Blood Gasses

Answer 1

Oxygenation
Ventilation
Acid/base

Question 2

First Choice for ABGs

Answer 2

Radial artery

Question 3

Other Possible Arteries for ABGs

Answer 3

Femoral

Brachial

Question 4

Complications of ABGs

Answer 4

Hematoma
Arterial damage
Stinger (if you hit the nerve)

Question 5

Normal pH Range

Answer 5

7.35-7.45

Question 6

Normal CO2 Range

Answer 6

35-45 mmHg

Question 7

Normal PaO2 Range

Answer 7

83-102 mmHg

Question 8

Normal HCO3 Range

Answer 8

22-28 mmol/L

Question 9

Normal Anion Gap Range

Answer 9

10-16 mmol/L

Question 10

What can acidosis cause?

Answer 10

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

Question 11

What can alkalosis interfere with?

Answer 11

Tissue oxygenation

Neurological and muscle function

Question 12

Factors that Control pH

Answer 12

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

Question 13

3 Systems that Maintain Body pH

Answer 13

Chemical buffering
Respiratory center
Kidneys

Question 14

Main Chemical Buffer

Answer 14

Carbonic acid system

H2O + CO2 -> H2CO3 -> HCO3 + H

Question 15

What concentrations trigger the respiratory center as the respiratory buffer?

Answer 15

CO2
Carbonic acid
HCO3

Question 16

What is altered to increase or decrease ventilation?

Answer 16

Respiratory rate

Tidal volume

Question 17

Length of Time for the Respiratory Buffer

Answer 17

1-3 minutes

Question 18

Length of Time for the Renal Buffer

Answer 18

Hours to days

More powerful regulatory system

Question 19

Define Chemical Buffer

Answer 19

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

Question 20

Types of Chemical Buffer Systems

Answer 20

Bicarbonate buffer system
Phosphate buffer system
Protein buffer system

Question 21

Respiratory Acidosis: pH, CO2, Causes

Answer 21

pH: down
CO2: up
Cause: hypoventilation

Question 22

Causes of Respiratory Acidosis

Answer 22

CNS depression
Impaired muscle function
Pulmonary disorders
Massive PE
Hypoventilation

Question 23

Signs and Symptoms of Respiratory Acidosis

Answer 23

Dyspnea
Respiratory distress
Shallow respiration
Headache
Restlessness
Confusion
Tachycardia
Dysrhythmias

Question 24

Management of Respiratory Acidosis

Answer 24

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

Question 25

Causes of Respiratory Alkalosis

Answer 25

``` Psychological responses Pain Increased metabolic demands Respiratory stimulants CNS lesions ```

Question 26

Reasons for Increased Metabolic Demands

Answer 26

Fever Sepsis Pregnancy Thyrotoxicosis

Question 27

Signs and Symptoms of Respiratory Alkalosis

Answer 27

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

Question 28

Metabolic Acidosis: pH, HCO3

Answer 28

pH: low HCO3: low

Question 29

Causes of Metabolic Acidosis

Answer 29

``` Renal failure DKA Anaerobic metabolism Starvation Salicylate intoxication Sepsis ```

Question 30

Signs and Symptoms of Metabolic Acidosis

Answer 30

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

Question 31

Management of Metabolic Acidosis

Answer 31

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

Question 32

Metabolic Alkalosis: pH, HCO3

Answer 32

pH: high HCO3: high

Question 33

Causes of Metabolic Alkalosis

Answer 33

``` 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 ```

Question 34

Signs and Symptoms of Metabolic Alkalosis

Answer 34

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

Question 35

Define Base Excess

Answer 35

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

Question 36

How much of Cl is reabsorbed under normal pH conditions?

Answer 36

99%

Question 37

What happens to Cl- reabsorption when acidosis is present?

Answer 37

Fewer ions are reabsorbed

Question 38

Anion Gap Equation

Answer 38

Anion gap = Na - (Cl + bicarb)

Question 39

Define Partial Compensation

Answer 39

pH remains outside the normal range

Question 40

Define Full Compensation

Answer 40

pH has returned within the normal range

Question 41

Compensation in Primary Respiratory Acidosis

Answer 41

Increased PaCO2 Decreased pH Increased HCO3