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Stack #239785
| Question | Answer |
|---|---|
| Arterial blood gas test is | performed on arterial blood to determine level of O2, CO2, pH, & HCO3, tells how well metabolic gases are being exchanged between the atmospher & the cells/tissue, gives an indication of the delivery side of perfusion |
| ABGs gives a snap shot of | the balance of metabolic & respiratory processes in the body (oxygenation & acid/base balance) |
| pH normal values | 7.35-7.45 |
| PaCO2 normal values | 35-45 |
| HCO3 normal values | 22-26 |
| Acid/Base balance is evaluated by | pH, PaCO2, HCO3 |
| Oxygenation is evaluated by | PaO2, SaO2 |
| PaO2 normal values | 80-100 |
| SaO2 normal values | 95-100% |
| Increase breathing means | less CO2less acidhigher pH |
| Decreased breathing means | more CO2more acidlower pH |
| If you hyperventilate you | excrete CO2 |
| If you hypoventilate you | retain CO2 |
| pH reflects | the hydrogen ion (acid) concentration in the body |
| if too many hydrogen ions | pH decreases |
| if too few hydrogen ions | pH increases |
| Human body normal pH is | 7.40, for most metabolic fuctions to work properly, the body maintains a slightly alkalotic state |
| PaO2 is the best indicator for adequacy of | alveolar ventilation/breathing |
| Base increases or decreases the pH in the body | increase the pH because the chemically "soak up" hydrogen ions |
| HCO3 is produce by | the kidneys & the red blood cells |
| The body deals with pH changes in 3 wyas | chemical buffer systemlungs aid in expelling excess CO2kidneys excrete excess through the urine |
| Respiratory acidosis results when the body | produces CO2 faster than the lungs can expel usually resulting from insufficient respiration &/or ventilation, tired, neuromuscular disease, treated with Nabicarb |
| Respiratory acidosis ABGs | pH < 7.35 PaCO2 > 45 |
| Respiratory alkalosis ABGs | pH >7.45 PaCO2 < 35 |
| Respiratory alkalosis results when | patient hyperventilates due to pain, anxiety, stress, ventilated patient overbreathe always evaluate for hypoxia |
| Metabolic Acidosis ABGs | HCO3 < 22 |
| Metabolic alkalosis ABGs | HCO3 > 26 |
| In metabolic acidosis consider if the patient is | retaining acid or making too much, or is losing base |
| In metabolic alkalosis is a difficult state to achieve consider | actions by healthcare team |
| The lungs assist in acid/base balance by | eliminating CO2 & getting O2 into the body |
| 5 step process to transporting O2 (cellular level) | 1. O2 into to lungs & alveoli2. O2 across alveolar membrane & into blood (respiration)3. hemoglobin available, have affinity & bind O2 for transport4. CV system (transport system) must be working & intact5. hemoglobin releases O2 for diffusion. |
| Oxyhemoglobin Dissociation curve | reflects how O2 normally jumps off of hemoglobin when the body is @ normal pH & temperature |
| 2 main factors affecting dissociation curve | pH, temperature |
| PaO2 represents | the available O2 dissolved in the serum (80-100) |
| SaO2 represents | the saturation of O2 on hemoglobin (95%-100%) |
| ABGs and compensation occur | whenever the body's pH is outside the normal range, these mechanism aim to bring pH back into range so metabolism can continue as normal |
| Fully compensated ABGs occurs when | PaCO2 & HCO3 are abnormal & the pH is normal |
| 2 main test to assess pulmonary function | A:a gradientP/F ratio |
| A:a gradient test assesses | O2 crossing over from alveoli to arterial blood (normal < 10mmhg) |
| P/F ratio test assesses | oxygenation status PaO2 divided by FiO2(normal 400-500)paO2/FiO2 (as a decimal) |
| Pulmonary funtion assesses | ventilatory ability & function: compliance, elasticity, respiratory muscle strength(used to determine if mechanically ventilated patients are ready to get off of ventilator) |
| Forced vital capacity measures | volumes, flow, & speed of the ventilatory cycleit is used to determine adequate ventilation |
| Negative inspiratory force measures | muscle strength & assesses how much negative pressure the patient is able to produce (normal -20cm H20) |
| Negative ispiratory force value directly relates to | diaphragmatic & intercostal muscle strength, therefore the patient's ability to draw into the lungs adequate volumes of air. Good predictor of ability to take a deep breath & cough, critical for maintaining a clear airway |
| V/Q scan evaluates | ventilation/perfusion mismatches, most commonly when a PE is suspected, have 90% accuracy rate ID PE |
| When the dissociation curve shifts to the left | blood picks up O2 more readily in the lungs but delivers O2 less readily to the tissues i.e alkalosis, hypothermia increase pH, decrease temperature, decrease pCO2 |
| When the dissociation curve shifts to the right | blood picks up O2 less rapidly in the lungs but delivers O2 readily to the tissues i.e acidosis, hyperthermia, PaCO2 increases decrease pH, increase temperature, increase PCO2 |
Created by:
tauvia2003