EXAM 1 - ABGS

Question 1

What is the normal range for pH?

Answer 1

7.35-7.45

Question 2

what is the normal range for HCO3?

Answer 2

22-26 mEq/L

Question 3

what is the normal range for sodium?

Answer 3

135-145 mEq/L

Question 4

What is the normal Base to Acid ratio?

Answer 4

20:1

Question 5

what metabolic alteration do COPD clients typically have?

Answer 5

Compensated Respiratory Acidosis - Cant expel carbon-dioxide as easily, but the kidneys help keep this compensated.

Question 6

what is the slower response by the body to an acid-base imbalance?

Answer 6

Renal/Kidneys - responds in hours to days

Question 7

What kind of breathing causes respiratory alkalosis?

Answer 7

Fast, Hyperventilation

Question 8

What is the normal range for calcium?

Answer 8

8.5 to 10.5 mg/dL

Question 9

twitching, muscle spasm, positive chvostek, tetany, convulsions are all S/S of what?

Answer 9

hypocalcemia

Question 10

How do the Kidneys compensate for Respiratory Acidosis?

Answer 10

Retain HC03, Excrete H+

Question 11

How do the lungs compensate for metabolic alkalosis?

Answer 11

Hypoventilation

Question 12

what is the normal range for paO2?

Answer 12

80-100 mm Hg

Question 13

How do you treat respiratory alkalosis?

Answer 13

Treat Underlying causes - Breathing techniques (to slow breathing), anxiolytics (like ativan)/sedatives

Question 14

How do the lungs compensate for metabolic acidosis?

Answer 14

Hyperventilation/Kussmauls

Question 15

What are some causes of Metabolic Acidosis?

Answer 15

DKA, Starvation, Lactic Acidosis, Prolonged Diarrhea, Renal failure, Asprin(salycilic acid)/Ethylene Glycol(glycolic acid)/alcohol, Cardiovascular failure

Question 16

What are some signs and symptoms of Hyperkalemia?

Answer 16

Paralysis, confusion, stupor

Question 17

What can be administered to a patient to help them eliminate potassium from their system?

Answer 17

Kayexelate (sodium polystyrene)

Question 18

what is the normal range for saO2

Answer 18

95-100%

Question 19

What electrolyte imbalance increases risk of digoxin toxicity? why?

Answer 19

hypokalemia. Digoxin binds more easily when potassium levels are low.

Question 20

What drug can be used to take potassium from the ECF and into the cell?

Answer 20

Insulin Drip during hyperkalemia - watch for hypoglycemia and hypokalemia

Question 21

What Drugs are the most common cause of hypokalemia?

Answer 21

K-wasting diuretics

Question 22

What are some signs and symptoms of Metabolic Alkalosis?

Answer 22

Irritability (muscle and cardiac), Dysrhtymias (irregular rhythm), Twitching/cramps-tetany, Hypokalemia, Hypocalcemia (+cvostek,+trousseau)

Question 23

How do the Lungs compensate for Respiratory Acidosis?

Answer 23

Hyperventilation

Question 24

What happens to a clients EKG during hypokalemia?

Answer 24

Flat or inverted T-wave

Question 25

**_How do the Kidneys compensate for Respiratory alkalosis?_**

Answer 25

Excrete more Base and retain more Acid

Question 26

what is the normal range for chloride?

Answer 26

96-106 mEq/L

Question 27

**_What are some causes of respiratory Alkalosis?_**

Answer 27

Conditions causing Hyperventilation: Anxiety, Pain, fear, early pumonary embolism, Septicemia, Hypermetabolic states (fever), CNS stimulants (catacholamines such as epi, dopamine), Hypoxemia, overventilation, pregnancy (from progesterone)

Question 28

At what paO2 is supplemental oxygen required? What can oxygen for a hypoxic patient prevent?

Answer 28

50 mmHg/ an acid-base imbalance

Question 29

**_How do you treat metabolic Acidosis?_**

Answer 29

Treat underlying causes: (Insulin + K+-this keeps patient from becoming hypokalemic from insulin), Sodium Bicarbonate, IV fluids

Question 30

what is the normal range for PaCO2?

Answer 30

35-45 mm Hg

Question 31

**_What are some signs and symptoms of Metabolic Acidosis?_**

Answer 31

Compensatory Kussmaul breathing (rapid, deep), Dysrythmias, Hyporeflexia, weakness, N/V, Stupor-coma, Hyperkalemia, Hypercalcemia

Question 32

What kind of Breathing can cause respiratory acidosis?

Answer 32

Low and slow, hypoventilation

Question 33

**_How do you treat respiratory acidosis?_**

Answer 33

Underlying causes - Bringing p/t breathing back to normal so they are getting more oxygen and expelling more Co2. bronchodialators, O2, steroids, overdose reversal agents, mucolytic

Question 34

pH is below 7.35, PaCO2 is above 45, HCO3 is within range. How would you identify these labs?

Answer 34

uncompensated respiratory acidosis

Question 35

What are some precautions you can take for hypocalcemia?

Answer 35

seizure precuations - e.g. padded side rails

Question 36

What kind of Drugs cause respiratory acidosis? why?

Answer 36

CNS depressants - Alcohol, opioids, benzos - because the slow breathing.

Question 37

**_Agitation, restlessness, Lightheaded, dizzy, Parastheisa, Seizures, Hypokalemia, Hypocalcemia---These are signs and symptoms of what?_**

Answer 37

**_Respiratory Alkalosis_**

Question 38

What is the immediate action that should be taken after puncturing an artery to retrieve ABGs?

Answer 38

hold pressure on site for 5 minutes

Question 39

**_How do you treat Metabolic Alkalosis?_**

Answer 39

Underlying causes: potassium chloride (increases potassium), ammonium chloride (fixes metabolic alkalosis in two ways: It's broken down into urea by the liver, resulting in the liberation of H+ and Cl- ions. The increase in H+ ions acidifies the body. The increase Cl- ions promotes HCO3- excretion), antiemetics (stop from vomitting and losing more acid)

Question 40

what % of oxygen is dissolved in the blood and what % is bound to hemoglobin?

Answer 40

3% dissolved - 97% oxyhemoglobin

Question 41

**_What are some signs and symptoms of respiratory acidosis?_**

Answer 41

dyspnea (SOB), Depressed respirations, Headache, drowsiness, Tachycardia, Flushed warm skin, Weakness, Confusion

Question 42

What does a T- wave represent on an ECG?

Answer 42

ventricular repolarization (decrease of pressure in the ventricles)

Question 43

how do you perform an Allen test?

Answer 43

Have patient clench fist - occlude both ulnar and radial arteries- have patient relax hand and check for blanching - release finger from ulnar artery- if the hand flushes in 5 to 15 seconds, test is positive and ulnar artery is patent- If the hand does not flush, test is negative, ulnar artery is not patent, meaning radial artery cannot be punctured.

Question 44

What are two routes of administration of calcium for hypocalcemia?

Answer 44

Po an IM

Question 45

How is potassium Administered? What precautions should be taken?

Answer 45

Potassium is given orally or Slow IV infusion ( over 4 hours. Most bags hold 40 mEq/L and you usually run it at 10 mEq/L) . NEVER iv push. Wait until urine flow is established post-op and careful with people who have esophogeal issues.

Question 46

As blood pH becomes more acidic, what happens to Hemoglobin and temperature?

Answer 46

gives up O2 more easily, temperature rises

Question 47

**_How do the lungs compensate for respiratory alkalosis?_**

Answer 47

Hypoventilation

Question 48

Term for low oxygen content in the blood?

Answer 48

hypoxemia

Question 49

Characterizedd by a deep, rapid breathing pattern

Answer 49

Kussmaul Respirations

Question 50

**_How do the kidneys compnesate for metabolic alkalosis?_**

Answer 50

Retain Acid and Excrete Base

Question 51

What is the normal Anion gap range?

Answer 51

8-12

Question 52

What would an EKG look like for hyperkalemia?

Answer 52

Possible Tented T-waves

Question 53

what are the catastrophic pH numbers that will cause death?

Answer 53

Below 6.8 or Above 7.8

Question 54

What is the rapid response by the body to an Acid-Base imbalance?

Answer 54

Respiratory/Lungs - responds in minutes

Question 55

**_How do the Kidneys compensate for metabolic acidosis?_**

Answer 55

Excrete Acid and retain Base

Question 56

what is a sign of hypokalemia? how serious is this?

Answer 56

Muscle weakness, including the diaphragm. This is life threatening.

Question 57

**_What are some causes of metabolic alkalosis?_**

Answer 57

Vomitting, Gastric suctioning, Excessive bicarb or antacids, Kwasting diuretics, Massive blood transfusion

Question 58

**_What electrolyte imbalances/labs will you see with respiratory acidosis?_**

Answer 58

Hyperkalemia (tented-t waves), Hypercalcemia, Decreased PAO2 (not getting enough oxygen)