ABG

Question 1

Rule of B’s for ABG

Answer 1

• if the PH and Bicarb are both in the same direction = metabolic

Question 2

ph normal?

Which is acidic?

Which is basic?

Answer 2

7.35 - 7.45

acidic= 7.35

basic= 7.45

Question 3

CO2 normal?

Which is acidic?

Which is basic?

Answer 3

35-45

acidic=45

basic=35

Question 4

co3 normal?

Which is acidic?

Which is basic?

Answer 4

22-26

acidic=22

basic=26

Question 5

s/s of increased ph (alkalosis)

Answer 5

• as the ph increases (alkalosis), so does my patient (irritable) except K+ (decrease)

-irritable, hyperreflexia (3 and 4), hyper excitable, borborygmi (hyperactive bowl sounds), seize, tachypnea, tachycardia

Question 6

what does k+ do in alkalosis (increased ph)

Answer 6

• decreases

Question 7

what does k+ do in acidocis (decreased ph)

Answer 7

• increases

Question 8

s/s of decreased ph (acidosis)

Answer 8

• as the ph decreases (acidodic) so does my patient (body shuts down) except k+

-body shuts down, HR/RR down, lethargy, hyporeflexia (0 and 1), paralytic ileus, obtunded, resp. arrest, increased k

Question 9

is it the lungs?

Answer 9

• if yes: is it over ventilating (respiratory alkalosis because your over the normal) or under ventilating (respiratory acidosis because your under the normal)

if no: do you have vomitting or suctioning? if so = metabolic alkalosis
If no: everything else = metablic acidosis

Question 10

what to pick if you dont know

Answer 10

• metabolic acidosis

Question 11

which acid base imbalance has kussmaul breathing?

Answer 11

• metabolic acidosis
• MAC kussumal

Question 12

ventilation

Answer 12

• means gas exchange
• RR doesnt matter
• Only Sa02: if increased= increased vent = increased ph (alkalosis). if decreased = decreased vent = decreased ph (acidosis)

Question 13

when would you want suction at the bedside?

Answer 13

• for a patient with alkalosis bc of risk for seizures and aspiration

Question 14

when would you want an ambu bag at the bedside?

Answer 14

• for a patient with acidosis because of their risk for respiratory depression

Question 15

over venting means…

Answer 15

• blowing off too much c02 = alkalosis

Question 16

under vent means..

Answer 16

• holding onto c02- acidosis

Question 17

High pressure vent alarm

Answer 17

• working too hard
• increased resistance to airflow = machine working too hard to push air into lungs
• obstruction

Question 18

how to fix high pressure alarm

Answer 18

1. check for kinks –> unkink
2. water condensation in the tube –> empty it
3. mucus in the airway –> turn/cough/deep breathe and then if that doesnt work suction (last resort)

Question 19

low pressure alarm

Answer 19

• that was too easy
• working too little
• disconnect

Question 20

how to fix low pressure alarm

Answer 20

1. main tubing: reconnect
2. 02 sensor tubing (senses fi02 @ trachea area): reconnect

Question 21

respiratory alkalosis and vent

Answer 21

• ventilating over (settings are too high)
• this is when you may want to disconnect them if the dr has ordered it

Question 22

respiratory acidosis and vent

Answer 22

• ventilating under (settings are too low)
• don’t disconnect them here because they are under ventilating as is with the ventilator

Question 23

respiratory acidosis results from

Answer 23

• low and slow breathing (snoring, COPD)

Question 24

respiratory alkalosis results from

Answer 24

• fast breathing (panic attack, panting)

Question 25

intervention for respiratory acidosis

Answer 25

- bipap

Question 26

fully compensated

Answer 26

- ph is within normal range

Question 27

uncompensated

Answer 27

- ph is outside normal range and one of the other two (co2 or c03 is normal)

Question 28

partially uncompensated

Answer 28

- everything is outside normal range