- dry heparin syringe - rt 15 mins

exam Flashcards by Emily Treadwell

Reason to for obtaining blood gases

to determine the acid base state of the patient

2. to determine how well oxygen

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Parameters in ABG

PCO2: respiratory influences
HCO3: metabolic

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Amperometic measurements

pO2, Glucose, Lactate

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penetentiometeric

pH, pCO2, Na+, K+, Ca++, Cl,

- ISE

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Hemoglobin

visual

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Derived measurements

Total CO2

Base excess

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Specimen Requirements for ABG/VBG

arterial or venous blood

pulsator syringe
peds abg
dry heparin syringe
15 min room temp
30 min ice

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Whole Blood profile

dry heparin syringe

- rt 15 mins

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Capillary gas

AVL microsampler

- 30 min rt no ice

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CO OX

Sodium heparin vacutainer
- sodium heparin microtainer
-Anerobic pulsator syringe
- specimen handling
-- 15 min rt
-- 30 min ice
COHgb:  roomtemp or 2-8 for 5 days

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ICAL

dry heparin syringe

- AVL microsampler device 1 hr rt or 6 hr on ice

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Allens test

test performed to ensure that the hand has viable blood flow if damage to artery is damaged

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Blood gas inaccuracy

sending venous sample and calling it an arterial blood

- Po2 less than 65 and o2 saturation less than 80

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mechanisms for compensation of resiratory Acidosis/ alkalosis

acidosis: (pCO2 is increased) increase the bicarb by the kidneys excreting more acid and less bicarb
alkalosis: (pCO2 decreased) decrease the bicarb: excreting less acid and more bicarb

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mechanisms for compensation of metabolic

acidosis: ( decreased bicarb) decrease the PCO2 by hyperventilation
alkalosis: ( increased bicarb) increase the PCO2 by hypOventilation

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disease associated with Respiratory acidosis

sedative overdose

- pulmonary embolism

Diseases associated with Respiratory alkalosis

CNS pain
anxiety and panic disorder
hypoxemia

Disease associated with metabolic acidosis

lactic acidosis
ketoacidosis
- diarrea or intestinal losses

diseases associated with metabolic alkalosis

Vomiting/nasogastric suction
massive diuresis
hypokalemia

right shift of hemoglobin affinity

increased: temp, pCO2, 2-3 DPG
decreased PH
- decreased affinity

left shift hemoglobin affinity

increased: pH
decrease temp, PCO2, 2-3 dpg
- increased affinity

hypoxia

decreased oxygen

- involves SO2 and PO2

parameters measured in CO OX

optical absorbance of sample that measures hemoglobin and it derivatives

What does a CO OX measure

total hemoglobin
Oxyhemoglobin
deoxyhemoglobin
methemoglobin
carboxyhemoglobin

abnormal results

- methemoglobin - cytochrome b5 deficiency | - carbonmonoxide posioning

Clinical used for an uring osmolgap

increased output: primary polydipsia-> compulsion to drink water diabetes insipidis and mellitus decreased output: dehydration, acute tubular injury

Clinical used for a serum osmol gap

- screening toxins: alcohols and glycols - monitoring osmolitacally active agents: mannitol - evaluating hypanatremia: exclusion of pseudo hypanatremia amd pressure of other osmostic agens

Calcuating serum osmolity

2 X NA + (glu/18)+(BUN/2.8) | normal between 280 and 300

osmol gap

the difference between the measured and calculated ions - MUDPILES - -methanol - -uremia - - diabetes - - parahylde - - isopropanol - - lactate - - ethanol - - salicylates

FFN

fetal fibrinectin | - if negative less than 1% chance of giving birth in the next 14 days

TEG

evaluates coagulation and clot formation of bllod

R time

time it takes for the initial fibrin formation | - checks plasma

speed at which the clot reaches a certain level of strength

alpha

measures the rapidity of fibrin buildip and crosslinking strength - measures cryoprecipitate

strength of the clot | - checks the platelets

Ly30

clot lysis | - drugs tranexamic/ amicar