A- Knowledge for Practice > ABGs/ Electrolyte Balance > Flashcards

ABGs/ Electrolyte Balance Flashcards

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1
Q

What is an ABG?

A

Measures the levels of oxygen and carbon dioxide in your arterial blood

It checks the balance of acids and bases, known as the pH balance

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2
Q

What is PaCO2 (ABG)

A

Amount of carbon dioxide in the blood

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3
Q

Whats is PaO2 (ABG)

A

The amount of oxygen dissolved in the blood.

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4
Q

What is SaO2 (ABG)

A

The percentage of hemoglobin in your arterial blood that is carrying oxygen

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5
Q

Whats HCO3 (ABG)

A

Bicarbonate content of the blood

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6
Q

How is HCO3 regulated?

A

Concentration is regulated by the kidneys and the renal production of bicarbonate

The HCO3 level is the metabolic component of the ABG

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7
Q

What PaO2 level results in hypoxia?

A

Any level less than 60 mmHg

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8
Q

What determines an acid?

A

Acids = compounds that release H+ ions The HCO3 level is the metabolic component of the ABG.

Hydrogen containing compounds thatrelease H+ions when dissolved in water

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9
Q

What determines a base?

A

Compounds that pick-up/ bind to H+ ions

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10
Q

Why are H+ important?

A

Hydrogen levels affect enzyme activity

Most pathological conditions disturb acid-base balance

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11
Q

How does the body maintain pH range of 7.35 – 7.45?

A

Buffers help regulate pH, keeping it within normal limits, until acids can be excreted

Respiratory & Renal system compensation

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12
Q

Whats the main acid in the blood?

A

carbonic acid (H2CO3)

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13
Q

What can carbonic acid (H2CO3) be broken down into?

A

CO2 & H2O

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14
Q

Whats the main base in the blood?

A

bicarbonate (HCO3)

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15
Q

What acid/base disturbances occur in respiratory acidosis?

A

Build-up of CO2

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16
Q

What acid/base disturbances occur in respiratory Alkalosis?

A

Loss of too much CO2

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17
Q

What acid/base disturbances occur in Metabolic Acidosis?

A

build-up of non-volatile acids (acids produced in the body from sources other than carbon dioxide)

OR loss of bicarbonate

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18
Q

What acid/base disturbances occur in Metabolic Alkalosis?

A

reduced amounts of non-volatile acids

(acids reduced in the body from sources other than carbon dioxide)

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19
Q

How does the body compensate for acid-base disturbances?

A
  • Buffer systems
  • Renal compensation (slower acting – up to 1 day) - will change bicarb level. (kidneys can excrete or conserve acids or bases)
  • Respiratory compensation (quick acting – minutes) – will change CO2 level. (ventilation)
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20
Q

What are electrolytes?

A

Are CHARGED PARTICLES found in body fluids which contribute to a wide variety of vital roles in the body.

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21
Q

How are electrolytes controlled?

A

Key electrolytes are tightly controlled through renal excretorymechanisms.

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22
Q

What hormone regulates both sodium (Na+) and potassium (K+) levels?

A

Aldosterone

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23
Q

What does aldosterone do to sodium (Na+)?

A

Stimulates increased sodium (Na+) reabsorption/retention

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24
Q

What does aldosterone do to potassium (K+)?

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A

Potassium (k+) secretion on the renal tubules.

25
What are the most important electrolytes?
While all electrolytes are important, imbalances of the electrolytes making up the greatest proportion of the total electrolytes (or those that contribute the most to osmolarity)- sodium & potassium- can have significant impacts on body cell functioning. THESE ARE TIGHTLY CONTROLLED
26
Whats is one of the biggest issues when maintaining acid-base balance
Is being able to transport excess acids (or bases) through the blood until they can be excreted at the lungs and/or kidneys. 
27
What are the four buffer systems?
- Bicarbonate buffer system (Carbonate acid bicarbonate buffering system - Bicarb absorbs extra H+ to make carbonate acid (H+ not in blood = bufffer)) Carbonate acid can give up H+ if PH is too high. - Protein buffer system - Haemoglobin buffer system - Phosphate buffer system
28
What is the Bicarbonate buffer system?
Most important buffering system of the ECF. Begins with the movement of CO2 into the blood from body tissues.  The majority of CO2 generated by cellular metabolism/ respiration. Bicarbonate ions make up the bicarbonate buffer system which is an alkaline reserve that is available to pick up excess H+.  The levels of bicarbonate in the blood are mostly controlled by the urinary tract
29
What is the protein buffer system?
Proteins in either plasma (mainly albumin) or within ICF (e.g. amino acids) which can bind H+ ions Proteins in PLASMA OR IN ICF
30
What is the haemoglobin buffer system?
Haemoglobin (Hb) in red blood cells can buffer the H+ Hb buffering of H+ also facilitates the offloading of O2 at body tissues.
31
What is the phosphate buffer system?
Mostly buffers acids within urine, but is also an important buffer in the intracellular fluid (ICF) (and can also buffer in the ECF).
32
What is the downfall with buffers?
Buffering is only a temporary solution to reducing changes in blood pH.  Buffers cannot eliminate the H+ ions and there is a limited supply of buffers.  So the H+ that is produced must be eliminated from the body. IT IS ONLY A TEMPORARY SOLUTION AND THEY MUST BE EXCRETED AND CAUSE OF ACIDOSIS MUST BE STOPPED.
33
What can cause respiratory acidosis?
- Depression of brainstem respiratory centers (e.g. due to certain drugs or trauma) - Decreased neuromuscular control of ventilation (e.g. with conditions like Myasthenia gravis (muscle weakness) or Guillain-Barre) - Respiratory conditions/hypoventilation/decreased gas exchange (e.g. increased airway resistance, COPD, pneumonia) DECREASE BRAIN STEM CENTRE, DECREASE NEUROMUSCULAR CONTROL, RESP CONDITIONS
34
What are signs and symptoms of respiratory acidosis?
- Headache - Blurred vision - Breathlessness - Lethargy - Disorientation - Muscle twitching, tremors or convulsions
35
What causes respiratory alkalosis?
Hyperventilation from - Hypoxemia (e.g. with pulmonary disorders, congestive heart failure, increased altitude) - Pain - Anxiety or fear - Fever or sepsis
36
What are signs and symptoms of respiratory alkalosis?
- Dizziness - Confusion - Paraesthesia (tingling sensation) - Convulsions - Muscle spasms in fingers & toes, tetany
37
What causes metabolic acidosis?
Increased bicarbonate (HCO) loss (normal anion gap metabolic acidosis) - Renal loss (i.e. with renal failure) - GI loss (e.g. diarrhea, pancreatitis)
38
What are symptoms of metabolic acidosis
- Headache - Lethargy - Confusion, coma - Hyperventilation, Kussmaul's respiration - Nausea/vomiting, diarrhea - Arrhythmias, hypotension
39
What are causes of metabolic alkalosis
- Increased renal loss (e.g. diuretics, increased liquorice ingestion, Cushing's syndrome) - GI loss (e.g. vomiting) - Increased bicarbonate (HCO) retention occurs if there is excess administration of bicarbonate (e.g. IV solution) - Dehydration which can result in both acid loss and bicarbonate retention
40
What are signs of metabolic alkalosis?
- Weakness - Muscle cramps, tetany - Hyper-reflexia - Hypoventilation (slow, shallow breaths) - Confusion - Convulsions - Atrial tachycardia
41
Why does PH matter?
H+ ions help control how fast reactions are in the body. They also keep strong cell membranes Important for nerves H+ in same row at K+ and Na+, so can easily kick out ions from where they are meant to be.
42
How does the kidneys help with PH balance?
- They can excrete more acid in urine - They can excrete less acid in urine - Reabsorb bicarb (alkalotic) - Make more bicarb (acidotic)
43
How does the resp system help with PH?
- Breath faster to get rid of CO2 when acidotic - Breath slower and shallower when alkalotic and need to retain acid (CO2)
44
What are the nasogastric affects
Diarrhea- Metabolic acidosis (Gets rid of too much bicarb) Vomiting- Metabolic alkalosis (Gets rid of too much acid) Pain- Resp alkalosis. Increases hyperventilation, realising too much CO2 COPD- Resp acidosis. Traps CO2, causing retention of acid.
45
What is a primary cause of Respiratory Acidosis related to respiratory drive?
Decreased respiratory drive ## Footnote Causes include sedatives, neurological injuries, and stroke.
46
Name a condition that can lead to hypoventilation.
Paralysis of respiratory muscles ## Footnote Examples include Myasthenia Gravis and Guillain-Barre.
47
List two airway diseases that can cause Respiratory Acidosis.
* Asthma * Emphysema * Pneumonia ## Footnote These diseases affect the airway and can lead to impaired gas exchange.
48
What is a risk factor for Respiratory Acidosis related to sleep?
Sleep apnoea ## Footnote This condition can lead to intermittent hypoventilation.
49
Identify a risk factor for Respiratory Acidosis associated with body weight.
Severe obesity ## Footnote Obesity can impair respiratory function and lead to hypoventilation.
50
What are common respiratory signs of Respiratory Acidosis?
* Rapid, shallow respirations * Dyspnoea ## Footnote These symptoms indicate difficulty in breathing.
51
What cardiovascular symptoms may be observed in Respiratory Acidosis?
* Ventricular arrhythmias * Tachycardia ## Footnote These can result from hypoxia and acid-base imbalance.
52
What central nervous system symptoms are associated with Respiratory Acidosis?
* Headache * Confusion * Drowsiness * Decreased level of consciousness ## Footnote These symptoms reflect the effects of CO2 retention on brain function.
53
What gastrointestinal symptoms might be present in Respiratory Acidosis?
* Nausea * Vomiting ## Footnote GI symptoms can occur due to metabolic disturbances.
54
What neuromuscular signs can indicate Respiratory Acidosis?
* Tremors * Warm flushed skin * Decreased deep tendon reflexes ## Footnote These signs may be associated with electrolyte imbalances.
55
What nursing intervention involves monitoring oxygen levels?
Pulse oximetry ## Footnote This helps assess the patient's oxygen saturation.
56
What should be monitored in relation to ECG in Respiratory Acidosis?
ECG monitoring ## Footnote This is important to detect any arrhythmias.
57
Fill in the blank: It is important to monitor __________ for acute respiratory distress in patients with Respiratory Acidosis.
labs: potassium, ABG’s ## Footnote Monitoring these labs helps assess the patient's metabolic status.
58
True or False: Repositioning a patient can help with ventilation in Respiratory Acidosis.
True ## Footnote Optimal positioning can improve lung function and gas exchange.
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