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2ABGs
Understanding ABGs MS1 exam2
| Question | Answer |
|---|---|
| ABGs purpose? | evaluate overall oxygen status |
| normal ABGs | pH 7.35-7.45 PaCO2 35-45 HCO3 22-26 PaO2 80-100 |
| respiratory system (PaCO2) | regulates acid-base by eliminating or retaining CO2 respiratory center=medulla oblongata.responds to >CO2 |
| pH response: RespSystem | responds within minutes, but less effective overtime due to fatigue |
| renal system (HCO3) | conserve and reabsorb all the HCO3 it filters as well as excreting weak acids |
| pH response: renalsystem | takes 2-3days to repond, but is more powerful |
| at risk health conditions for acid-base imbalance | DM, COPD, KIDNEY DISEASE, ELDERLY (L333) |
| why are elderly more at risk to acidbase imbalance? | they have <kidney,resp compensatory functions (L333) |
| pH | measure of H+ concentrations acid=donates H+ base=accepts H+ |
| CAUSES: RespACIDOSIS | pH<7.35, PaCO2>45 HYPOVENTILATION(<RR/DEPTH)retains CO2 opiate/sedative overdose, aspiration, chest trauma, brain injury, pneumonia, pulmo edema, COPD, respiratory muscle weakness (spinal cord injury, Guillain-barre) |
| S/S: RespACIDOSIS | hypoventilation, drowsiness, disorientation, headache, coma; <BP, ventricular fibrillation r/t hyperkalemia from compensation, warm, flushed skin; seizure |
| CAUSES: RespACIDOSIS | pH>7.45, PaCO2<35 HYPERVENTILATION(>RR,O2)blows off CO2 septicemia, salicylate intoxication, anxiety, initial response to hypoxia (pneumonia, hf, pe) |
| S/S: RespALKALOSIS | hyperventilation, lethargy, light-headed, confusion; tachycardia, dysrrhythmias r/t hypokalemia; NV, epigastric pain; tetany, numbness/tingling, hyperreflexia, seizure |
| altered concentrations causing Imbalances | RespImbalances=carbonic acid concentrations MetabolicImbalances=base bicarbonate concentrations |
| CAUSES: MetabolicACIDOSIS | pH<7.35, HCO3<22 lactic acidosis, ketoacidosis r/t DM, starvation, alcoholism; renal failure, diarrhea, GI fistulas, shock |
| S/S: MetabolicACIDOSIS | kussmaul respiration, drowsiness, confusion, headache, coma; <BP, dysrrhythmias r/t hyperkalemia; warm/flushed skin, NV, diarrhea, abd pain |
| CAUSES: MetabolicALKALOSIS | pH>7.45, HCO3>26 vomiting/gastric suctioning, excessive antacids/steroids intake, diuretic therapy |
| S/S: MetabolicALKALOSIS | dizziness, irritability, nervousness, confusion; tachycardia, dysrrhythmias r/t hypokalemia; NV, anorexia; tetany, tremors, tingling, muscle cramps,hypertonic muscles, seizure, hypoventilation (lungcompensation) |
| PaO2 vs SaO2 | assessment of oxygenation -amnt of O2 dissolved in plasma, 80-100; usually >70 adequate if person is hemodynamically stable -% of O2 bound to hgb, >95 |
| compensation | resp and renal systems compensate for each other, 20:1 ratio (bicarb:carbonic) *partial or total/ incomplete or complete goal: normal pH metabolic imbalance=lungs excrete CO2 resp imbalance=kidneys alter bicarb |
| interpreting ABGs | 1. pH ?acidosis or alkalosis 2. PaCO2 ?35-45 3. pH-PaCO2 relationship = resp problem? 4. HCO3 ?22-26 5. pH-HCO3 relationship = metabolic problem? 6. Look Complensation |
| if compensating... | respAcidosis = >HCO3 respAlkalosis = <HCO3 metabolicAcidosis = <PaCO2 metabolicAlkalosis = >PaCO2 |
Created by:
sarahjqs
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