Stack #239785
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| 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
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| ABGs gives a snap shot of | the balance of metabolic & respiratory processes in the body (oxygenation & acid/base balance)
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| pH normal values | 7.35-7.45
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| PaCO2 normal values | 35-45
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| HCO3 normal values | 22-26
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| Acid/Base balance is evaluated by | pH, PaCO2, HCO3
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| Oxygenation is evaluated by | PaO2, SaO2
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| PaO2 normal values | 80-100
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| SaO2 normal values | 95-100%
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| Increase breathing means | less CO2less acidhigher pH
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| Decreased breathing means | more CO2more acidlower pH
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| If you hyperventilate you | excrete CO2
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| If you hypoventilate you | retain CO2
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| pH reflects | the hydrogen ion (acid) concentration in the body
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| if too many hydrogen ions | pH decreases
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| if too few hydrogen ions | pH increases
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| Human body normal pH is | 7.40, for most metabolic fuctions to work properly, the body maintains a slightly alkalotic state
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| PaO2 is the best indicator for adequacy of | alveolar ventilation/breathing
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| Base increases or decreases the pH in the body | increase the pH because the chemically "soak up" hydrogen ions
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| HCO3 is produce by | the kidneys & the red blood cells
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| The body deals with pH changes in 3 wyas | chemical buffer systemlungs aid in expelling excess CO2kidneys excrete excess through the urine
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| 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
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| Respiratory acidosis ABGs | pH < 7.35 PaCO2 > 45
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| Respiratory alkalosis ABGs | pH >7.45 PaCO2 < 35
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| Respiratory alkalosis results when | patient hyperventilates due to pain, anxiety, stress, ventilated patient overbreathe always evaluate for hypoxia
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| Metabolic Acidosis ABGs | HCO3 < 22
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| Metabolic alkalosis ABGs | HCO3 > 26
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| In metabolic acidosis consider if the patient is | retaining acid or making too much, or is losing base
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| In metabolic alkalosis is a difficult state to achieve consider | actions by healthcare team
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| The lungs assist in acid/base balance by | eliminating CO2 & getting O2 into the body
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| 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.
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| Oxyhemoglobin Dissociation curve | reflects how O2 normally jumps off of hemoglobin when the body is @ normal pH & temperature
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| 2 main factors affecting dissociation curve | pH, temperature
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| PaO2 represents | the available O2 dissolved in the serum (80-100)
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| SaO2 represents | the saturation of O2 on hemoglobin (95%-100%)
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| 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
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| Fully compensated ABGs occurs when | PaCO2 & HCO3 are abnormal & the pH is normal
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| 2 main test to assess pulmonary function | A:a gradientP/F ratio
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| A:a gradient test assesses | O2 crossing over from alveoli to arterial blood (normal < 10mmhg)
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| P/F ratio test assesses | oxygenation status PaO2 divided by FiO2(normal 400-500)paO2/FiO2 (as a decimal)
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| 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)
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| Forced vital capacity measures | volumes, flow, & speed of the ventilatory cycleit is used to determine adequate ventilation
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| Negative inspiratory force measures | muscle strength & assesses how much negative pressure the patient is able to produce (normal -20cm H20)
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| 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
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| V/Q scan evaluates | ventilation/perfusion mismatches, most commonly when a PE is suspected, have 90% accuracy rate ID PE
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| 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
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| 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
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