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What is the test performed before doing an ABG?
Allens Test
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What is the normal pH of Blood?
7.35-7.45
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What is the normal range of PaCO2?
35-45 mmHg
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What is the normal range of PaO2?
80-100 mmHg
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What is the normal range of HCO3?
22-26 mEq/L
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What is a normal O2 Sat?
>94%
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What does PaO2 represent?
The oxygen diffused in the body & dissolved in the blood
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What does a higher PaO2 indicate?
Higher pressure indicates higher concnetrations of 02 in the blood
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What is PaO2?
- partial pressure of oxygen
- amount of oxygen dissolved in teh blood
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What is SaO2?
Percentage of oxygen combined with or carried by hemoglobin
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What is the SaO2 dependent on?
PaO2
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What is pH?
An indicator of hydrogen ion concentration in plasma
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What does acidic mean?
the greater the hydrogen concentration the lower the pH
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What does alkaline mean?
the lower the hydrogen concentration the higher the pH
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What pH range is compatible with life?
6.8-7.8
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What is a buffer system?
- Prevent major changes in the pH of the body by removing or releasing hydrogen
- Can be accomplished by using intracellular or extracellular buffers
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What are the 2 major buffer systems?
- Respiratory (lungs)
- Metabolic (Kidneys)
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What are the lungs controlled by?
The medulla
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How do lungs adjust ventilation?
They adjust in response to CO2 (acid) in the blood
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What does a rise in PaCO2 in arterial blood do?
It can stimulate respirations, thereby decreasing the acid
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What does a decrease in PaCO2 in arterial blood do?
It decreases the respiratory rate in order to increase the acidity
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What happens to the PaCO2 when the pH goes down?
When the pH goes down, PaCO2 goes up
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What hapens to the pH when the PaCO2 goes up?
when the PaCO2 goes up, the pH goes down
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What happens to the PaCO2 when the pH goes up?
When the pH goes up, PaCO2 goes down
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What happens to the pH when the PaCO2 goes down?
when to PaCO2 goes down, the pH goes up
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What is the pH and PaCO2 in respiratory acidosis?
- pH below 7.35
- PaCO2 above 45
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What causes respiratory acidosis?
- emphysema
- chronic bronchitis
- asthma
- pneumonia
- pulmonary edema
- oversedation with narcotics
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what are the signs & symptoms of respiratory acidosis?
- incrased RR, BP & P
- Mental cloudiness
- Hyperkalemia
- Muscle weakness
- Hypoxemia
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What is the pH & PaCO2 in respiratory alkalosis?
- pH above 7/45
- PaCO2 below 35
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What causes respiratory alkalosis?
- hyperventilation
- hypoxemia
- gram negative bacteremia
- inappropriate ventilator settings
- early phase of salicylate intoxication
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What are the signs & symptoms of respiratory alkalosis?
- Lightheadedness
- Inability to concentrate
- numbness & tingling
- Tinnitus
- Loss of consciousness
- Hypokalemia
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What is the main responsibility of the nurse after an ABG is done?
- apply pressure for at least 5 minutes
- apply pressure dressing after bleeding has stopped
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What does the metabolic buffer system regulate?
the bicarbonate level in the ECF (range 22-26 mmHg)
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What do the kidneys do in alkalosis situations?
the kidneys retain hydrogen ions & excrete bicarb (HCO3)
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What do the kidneys do in acidotic situations?
the kidneys excrete hydrogen ions & conserve bicarb
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What does HCO3 do?
HCO3 carries CO2 from tissues to the lungs so it can be blown out
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What does a decrease in HCO3 in the arterial blood do?
- it can stimulate the kidneys to:
- Regenerate
- Reabsorb bicarb
- cause hyperventilation in order to blow off acid
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What does an increase in HCO3 in the arterial blood do?
- It can stimulate the kidneys to:
- Excrete bicarb
- cause depressed respirations to hold onto acid
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What happens to the pH when HCO3 goes up?
when the HCO3 goes above 26, the pH goes up above 7.45
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What happens to the pH when the HCO3 goes down?
when the HCO3 goes below 22, the pH goes down below 7.35
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What happens to the HCO3 when the pH goes down?
when the pH goes down below 7.35, the HCO3 goes below 22
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what is the pH & HCO3 in metabolic acidosis?
- pH below 7.35
- HCO3 below 22
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what causes metabolic acidosis?
- diarrhea
- renal failure
- DKA
- lactic acidosis
- sepsi
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What are the signs & symptoms of metabolic acidosis?
- Hyperkalemia
- headache
- confusion
- drowsiness
- kussmaul respirations
- nausea
- vomiting
- dysrhythmias
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what is the pH & HCO3 in metabolic alkalosis?
- pH above 7.45
- HCO3 above 26
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What causes metabolic alkalosis?
- Vomiting
- Gastric Suctioning
- Diuretics that increase exretion of potassium
- excessive antacid intake
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what happens to the HCO3 when the pH goes up?
when the pH goes up above 7/45, the HCO3 goes up above 26
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What are the signs & symptoms of metabolic alkalosis?
- restlessness
- depressed respirations
- hypokalemia
- tingling of extremeties
- tetany symptoms
- confusion
- dysrhythmias
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