Exam #3: ABG

Question 1

Before performing an ABG, what test should be done, and why?

Answer 1

Allen Test

- Draw from radial a. so must ensure good blood flow

Question 2

What component of an ABG determines how well patient is oxygenated, but is NOT used in acid-base?

Answer 2

pO2

Question 3

Primary respiratory issue involves…?

Answer 3

pCO2

Question 4

Primary metabolic issue involves…?

Answer 4

HCO3

Question 5

High pCO2 indicates? Low pCO2 indicates?

Answer 5

• HIGH (>45) = acidosis

- LOW (<35) = alkalosis

Question 6

High HCO3 indicates? Low HCO3 indicates?

Answer 6

• HIGH (>26) = alkalosis

- LOW (<22) = acidosis

Question 7

Lungs compensate for…?

Answer 7

Metabolic processes

Question 8

Kidneys compensate for…?

Answer 8

Respiratory processes

Question 9

What is an uncompensated state?

Answer 9

Primary defect in pCO2 or HCO3- WITHOUT change in other

Question 10

What is a compensated state?

Answer 10

Primary defect in pCO2 or HCO3- WITH change in other (SAME DIRECTION)

Question 11

How does partial compensation differ from full compensation?

Answer 11

• Partial: outside 7.35 and 7.45

- Full: between 7.35 and 7.45

Question 12

Low pH, HIGH pCO2 and HIGH HCO3 indicates?

Answer 12

Respiratory acidosis

Question 13

High pH, LOW pCO2 and LOW HCO3 indicates?

Answer 13

Respiratory alkalosis

Question 14

Low pH, LOW pCO2 and LOW HCO3 indicates?

Answer 14

Metabolic acidosis

Question 15

High pH, HIGH pCO2 and HIGH HCO3 indicates?

Answer 15

Metabolic alkalosis

Question 16

Respiratory Acidosis is due to? What might cause this (3)?

Answer 16

HYPOventilation

- Lung disease, neuro disease, drug-induced (opioids)

Question 17

Respiratory Alkalosis is due to? What might cause this (4)?

Answer 17

HYPERventilation

- Anxiety, fear, sepsis, high elevation

Question 18

What type of acid-base disorder presents with hypercapnia?

Answer 18

Respiratory Acidosis

Question 19

What is the treatment for Respiratory Acidosis?

Answer 19

BiPAP

- Treat underlying cause

Question 20

What type of acid-base disorder presents with tachypnea, palpitations, lightheadedness?

Answer 20

Respiratory Alkalosis

Question 21

What is the treatment for Respiratory Alkalosis?

Answer 21

Treat underlying cause

Question 22

Metabolic Acidosis is due to (2)?

Answer 22

• Gain of H+

- Loss of HCO3

Question 23

What is the normal anion gap range? What is considered an elevated anion gap?

Answer 23

Normal: 8-12

- ELEVATED: 12+

Question 24

What might cause an elevated anion gap?

Answer 24

MUDPILES = acids gain

• Methanol
• Uremia
• DKA
• Propylene glycol
• Iron/INH
• Lactic acidosis/lactate
• Ethylene glycol
• Salicylate, Starvation

Question 25

What might cause a non-anion gap?

Answer 25

Bicarbonate loss | - Diarrhea

Question 26

What type of acid-base disorder presents with compensatory hyperventilation, hyperkalemia?

Answer 26

Metabolic Acidosis

Question 27

What is the recommended treatment for Metabolic Acidosis?

Answer 27

Dialysis

Question 28

Metabolic Alkalosis is due to (2)?

Answer 28

- Loss of H+ | - Gain of HCO3

Question 29

If Metabolic Alkalosis is being considered, what test should be performed?

Answer 29

URINE CHLORIDE

Question 30

If urine chloride <20, is this responsive or unresponsive? What does this mean for volume?

Answer 30

Responsive | - Volume DEPLETION

Question 31

If urine chloride 20+, is this responsive or unresponsive? What does this mean for volume?

Answer 31

Unresponsive | - Volume OVERLOAD

Question 32

What type of acid-base disorder presents with reduced ventilation rate; arrhythmias, hypokalemia?

Answer 32

Metabolic Alkalosis

Question 33

What type of of acid-base disorder presents with hyperkalemia?

Answer 33

Metabolic Acidosis

Question 34

What type of of acid-base disorder presents with hypokalemia?

Answer 34

Metabolic Alkalosis

Question 35

If an acid-base disorder is mixed, what does this mean for pCO2 and HCO3 levels?

Answer 35

pCO2 and HCO3- go in opposite directions

Question 36

What are the four steps in evaluating an acid-base disorder?

Answer 36

1. Examine pH 2. Respiratory vs. Metabolic 3. Assess for compensation 4. Calculate Anion Gap IF Metabolic Acidosis (>12 = elevated anion gap)

Question 37

Which acid-base disorder involves an anion gap?

Answer 37

Metabolic Acidosis