UNIT 2: ABG

Question 1

Normal PH range?

Answer 1

(ACID) 7.35-7.45 (BASE)

Question 2

What is considered a perfect PH level

Answer 2

7.4

Question 3

What is considered an acid on the PH level?

Answer 3

Anything under 7.35 or if you have a PH level within normal range but below 7.4

Question 4

What is considered an alkalotic range in the PH scale?

Answer 4

Anything over 7.45 or if you have a PH level in normal range… anything over 7.4.

Question 5

Are the normal PaCo2 range?

Answer 5

(BASE)35-45(ACID) mmHg

Question 6

What is considered a normal Hco3 level

Answer 6

(ACID) 22- 26 mEq/L (BASE)

Question 7

WHat is a normal Pa02 level

Answer 7

80-100

Question 8

What is a normal sao2 level

Answer 8

above 95%

Question 9

What is normal oxygenation levels

Answer 9

80-100 mmHg

Question 10

What are mild hypoxemia levels?

Answer 10

70-79mmHG

Question 11

What is moderate hypoxemia levels?

Answer 11

60-69 mmHG

Question 12

What is severe hypoemia levels?

Answer 12

less than 60 mmHg

Question 13

What are the steps of ABG analysis?

Answer 13

Step 1: Determine acidosis or alkalosis using pH level
Step 2: Determine resp. effect on the body using PaCO2
Step 3: Determine metabolic effect on body using HCO3
Step 4: Determine compension
Step 5: Determine oxygenation

Question 14

Describe the different types of compensations for ABGs

Answer 14

1. None/Absent: If the value that does NOT match PH is NORMAL then NO compensation has taken place
2. If the valure that does not match pH is ABNORMAL & PH is ABNORMAL, then partial compensation exists
3. If the valure that does NOT match the pH is ABNORMAL but the pH is NORMAL then FULL compensation has taken place.

Question 15

What is the purpose of ABG

Answer 15

homeostasis

Question 16

What health problems are associated with acid-base balances?

Answer 16

1. Diabetes melitus- specifically DKA
   
   • Blood glucose is OFF the chart- body starts drinking, eating, peeing which increases blood glucose even higher. Then you go into a stupor state. When you lose the ability to eat drink and pee this is when you really go downhill and youll see METABOLIC ACIDOSIS
   • Insulin drip, fluids to help rehydrate cells
2. COPD
3. Kidney disease- r/t kidneys being unable to filter

Question 17

Acid-base balance is not a….

Answer 17

Disease…. it accompanies a disease

Question 18

Whats important to know about oxygen sats.

Answer 18

SpO2 is not as reliable as an ABG but it is less invasive. Important to note that it works by sending a redlight through to measure the amount of hemoglobin you have attached to your RBCs

Question 19

ABG analysis allows us to?

Answer 19

1. Determine oxygen status– used in conjunction w/pulse ox
2. Determine acid-base balance
   
   • Buffer system: Secretes more hydrogen ions out
   • Resp. system: lungs will breath faster or slower depending on the bodies needs
   • Renal system: Takes 2-3 days before kidneys help. It helps by holding in or secreting what we need

Question 20

What is Pa02

Answer 20

It is the partial pressure of oxygen in the arterial blood

Question 21

What is sA02

Answer 21

Arterial o2 saturation- measures tissue perfusion

Question 22

What is PaCo2

Answer 22

Partial pressure of carbon dioxide in the arterial blood

Question 23

What is HCO3?

Answer 23

Bicarb.. formed when co2 diffuses into blood.

Question 24

Lets talk PH… what is neutral, alkalosis, acidosis?

Answer 24

7.4 is neutral
Above 7.4 alkaline
below 7.4 acidosis

Question 25

What is Co2?

Answer 25

1. Co2 is the ACID component of our blood gas. 2. The body's fastest way of changing our PH 3. Lungs regulate co2 (acid) levels within MINS.

Question 26

What will the lungs do to compensate for acidosis?

Answer 26

RR and depth will increase to blow off CO2

Question 27

What will our lungs do to compensate for Alkalosis?

Answer 27

RR and depth will decrease. Co2 will be retained

Question 28

What is bicarbonate?

Answer 28

1. Bicarb is the base component of our blood gas 2. Kidneys regulate HCO3 (base) layer 3. Slower system, takes hours to days

Question 29

To compensate for acidosis our kidneys will...

Answer 29

H+ ions will be excreted & HCO3 will be retained

Question 30

To compensate for alkalosis the kidneys will?

Answer 30

H+ ions will be retained and HCO3 will be excreted

Question 31

Explain ROME?

Answer 31

Resp. Oppsite Metabolic Equal

Question 32

What are s/s of respiratory acidosis?

Answer 32

1. Hypoventalation--> hypoxia 2. Rapid, shallow respirations 3. Decrease BP with vasodilation 4. Dyspnea 5. Headache 6. Hyperkalemia 7. Dysrthythmias (increase K+) 8. Drowsiness, Dizziness, disorientation 9. SOB- cant catch breath 10. Muscle weakness, hyperreflexia

Question 33

What are causes of resp. ACIDOSIS?

Answer 33

1. Decreased stimuli (anesthesia, drug overdose) - Morphine- causes resp. depression. 2. COPD 3. Pneumonia/ Edema- fluid in lungs 4. Atelectasis- lungs not opening up like they should

Question 34

What is happening to our PH and Pco2 in resp. Acidosis?

Answer 34

PH is below 7.4 Pco2 is above 45 Lungs are retaining Co2

Question 35

What is our treatment for resp. acidosis?

Answer 35

1. Adequate ventilation. Most likely on a vent. 2. Other interventions prior to venting- TCDB, HOB elevated, oxygen, 3. Sodium bicarbonate-- rarely given r/t it not being very effective 4. MUST TREAT CAUSE

Question 36

Dont give an asthma patient what kind of medication?

Answer 36

Cough suppreseant. Will tighten airway.

Question 37

Max o2 level for nasal cannula? Non Rebreather Venturi

Answer 37

1. 6L for less than 30 mins 2. Non rebreather- 10 3. Venturi 10L Adequate ventilation is key in resp. aacidosis

Question 38

What are s/s of Respiratory alkalosis?

Answer 38

1. Seizures 2. Deep, rapid breathing 3. Hyperventilation 4. Tachycardia 5. Decreased or normal bp 6. Hypokalmia 7. Numbess/tingling of extremities 8. Lethagy & confusion 9. Light headheadness 10. N/V

Question 39

What are causes of respiratory alkalosis?

Answer 39

1. Hyperventilation (anxiety, PE, Fear) 2. Mechanical ventilation

Question 40

What is the number 1 cause of resp. Alkalosis?

Answer 40

Anxiety r/t hyperventilation

Question 41

How is resp. Alkalosis treated?

Answer 41

Treat underlying cause... if from anxiety treat anxiety... Paper bag or a non rebreather with 100% o2

Question 42

What are s/s of metabolic acidosis?

Answer 42

1. Headache 2. Decreased bp 3. hyperkalemia 4. Muscle twitching 5. warm flushed skin (vasodilation) 6. N/V 7. Decreased muscle tone, decreased reflexes (confusion, increased drowsiness) 8. Kussmaul respirations (compensatory hyperventilation)

Question 43

What are some causes of metabolic acidosis?

Answer 43

1. increased H+ production (DKA, hypermetabolism) 2. Decreased H+ elemination (renal failure)- most common 3. Decreased HCO3 production (dehydration, liver failure) 4. Increased Elimination (diarrhea, fistulas)

Question 44

Whats the main issue with metabolic acidosis?

Answer 44

Too much h+ (acid) too little bicarb

Question 45

How do we treat metabolic acidosis in a DKA patinet?

Answer 45

1. Insulin/Insulin drip 2. Check levels every hour 3. Start fluids 4. Apply oxygen 5. Give bicarb

Question 46

What is s/s of metabolic alkalosis?

Answer 46

1. Restlessness followed by lethargy 2. Dysrhythmias (tachycardia 3. Compensatory hypoventilation 4. Confusion (decreased LOC, Dizzy, irritable) 5. N/V/D 6. Tremors, muscle cramps, tingling of fingers and toes 7. Hypokalemia

Question 47

What causes metabolic alkalosis?

Answer 47

1. Severe vomiting 2. Excessive GI suctioning - Suction should never be set to contionus... only intermittent or off 3. Diuretics 4. Excessive NaHCO3

Question 48

How do we treat metabolic alkalosis?

Answer 48

1. replace fluids 2. Replace electrolytes 3. Replace sodium cholride 4. Hemodialysis