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ABG final
| Question | Answer |
|---|---|
| An increase in the H+ of the blood only to an increase in the arterial PcO2 | Respiratory Acidosis |
| The primary goal of acid-base homeostasis is to maintain what? | Normal pH |
| Potential causes of Respiratory Alkalosis | Anxiety, Hypoxemia, Pain |
| which organ system maintains the normal level of HCO3- at 24 mEq/L? | Renal |
| According to Henderson-Hasslebalch equation, the pH of the blood will be normal as long as the ratio of HCO3- to dissolved CO2 is? | 20:1 |
| What is the limiting factor for H+ excretion in the renal tubules? | Insufficient buffers |
| What is the kidneys most important function? | Sodium maintenance |
| Normal range for BE | +2 mEq/L |
| What acts as the "first-line" or immediate defense against the accumulation of H+ ions? | Blood buffer systems |
| A primary Respiratory problem is determined by? | If the PaCO2 is less than 35mmHg or Greater than 45mmHg |
| H+ can be determined by the use of which factors? | HCO3- and H2CO3 |
| Which organ system actually excretes H+ from the body? | Kidneys |
| A primary Metabolic problem is when? | HCO3- is less than 33mEq/L or greater than 26mEq/L |
| A patient has a pH of 7.49, what would this define? | Alkalosis |
| Normal pH range? | 7.35 to 7.45 |
| Common sites for trancutaneous blood gas electrode | chest, abdomen, and lower back |
| What affect does hyperventilation have on the closed buffer systems? | Causes them to release more H+ |
| What is Buffer solution? | A solution that resists large changes in pH upon addition of an acid or a base. |
| PaO2 below what value is considered severe hypoxemia? | 40mmHg |
| What mechanisms help to eliminate excess H+ via kidneys? | Reabsorbtion of HCO3-, Phosphate buffering, Ammonia buffering |
| For continuous monitoring of adults and children, you should set a pulse oximeter's low alarm in what range? | 88% to 92% |
| Compensation for Respiratory Alkalosis occurs through? | Renal excretion of HCO3- |
| What chart information should be checked before performing artery puncture? | Patients primary diagnosis and history, presence of bleeding disorders or blood-borne infections, anti-couagulant or thrombolytic drug prescriptions, respiratory care orders. |
| What is a normal response of the body to a failure in one component of the acid-base regulatory mechanism | compensation |
| When a strong acid is added to the bicarbonate buffer system, what is the result? | weak acid neutral salt |
| Primary metabolic alkalosis is associated with which of the following? | Gain of buffer base |
| The majority of the acid the body produces in a day is excreted through the lungs as CO2, what happens to the H+ ions? | They bind to an OH- forming H2O |
| Sites used for Arterial Blood sampling by percutaneous needle puncture | femoral, radial, brachial |
| Before a sample of capillary blood is taken, what should you do to the site? | warm to 42degrees Celsius and clean with an antiseptic solution |
| A mechanically ventilated patient exhibits a sudden decrease in end-tidal CO2 levels. What are possible causes of this change? | massive pulmonary embolism, disconnection of the ventilator, sudden drop in cardiac output |
| Indications for pulse oximetry include | to assess changes in HbO2 during certain procedures, to comply with external regulations or recommendations, to monitor the adequacy of HbO2 saturation |
| Factors to determine the volume needed for an arterial blood sample include? | ABG analyzer's requirements, specific anticoagulant used, other tests that will be done |
| After obtaining an arterial blood sample, what should you do? | Apply pressure to the site until bleeding stops, place sample in a transport container with ice slush, mix the sample by rolling and inverting the syringe |
| Transcutaneous blood gas monitoring is indicated when what need exists? | To continuously analyze gas exchange in infants and children, to quantify the real-time responses to bedside interventions, to continuously monitor for hyperoxia in newborn infants |
| What is the appropriate interval for changing the site for a transcutaneous blood gas monitor sensor? | 2 to 6 hours |
| What should be monitored during the sampling of arterial blood? | Presence of pulsatile blood return and presence of air bubbles or clots in the sample. |
| what is a normal end-tidal PETCO2 range? | 35-43 mmHg |
| What size needle would you recommend to obtain an ABG sample on an infant? | 25 gauge |
| Indications for arterial blood sampling by percutaneous needle puncture include? | monitor the severity of a disease process, evaluate ventilation and acid base status, evaluate a patient's response to therapy |
| What is the normal range for end tidal CO2 as measured by capnography? | 5% to 6% |
| After obtaining an arteral blood sample from an Arterial Line, you would? | Flush the line and stopcock with heparinized intravenous solution, confirm stopcock port open to intravenous bag solution and catheter, confirm undamped pulse pressure waveform on monitor |
| Some causes of Metabolic Acidosis with an increase of anion gap include? | Ketoacidosis, Lactic Acidosis, Renal Failure |
| Patient parameters that should be assessed as part of Arterial Blood Sampling include? | Temperature, Position and Activity level, Clinical appearance |
| What factor would limit the ability of the H2CO3/ HCO3_ buffer system to perform efficiently? | Lungs failing to excrete adequate levels of CO2 |
| Clinical signs of Acute Respiratory Alkalosis include? | Convulsions, dizziness, parathesia |
| Normally the following occur when the kidneys eliminate H+ | Sodium ions and water are reabsorbed, HCO3- is reabsorbed in proportion to the H+ excreted, Bicarbonate bugger capacity is restored |
| Range of HCO3- | 22-26 mEq/L |
| Range of PaO2 | 80- 100 mmHg |
| Range of PaCO2 | 35-45 mmHg |
| Range of SaO2 | 93% to 100% |
| pH below 7.35 | Acidosis |
| pH above 7.45 | Alkalosis |
| In acute respiratory acidosis what would you expect the BE range to be? | +2 to -2 mEq/L |
| What is the role of Carbonic anhydrase in the kidneys? | It drives the recovery of HCO3- and excretion of H+ |
| Low PaCO2 best describes which of the following? | Respiratory Alkalosis |
| With partially compensated respiratory alkalosis, which of the following blood gas abnormalities would you expect to encounter? | decrease HCO3-, Decreased PCO2, Increase pH |
| Causes of Respiratory Acidosis in patients with normal lungs include | Neuromusclar disorder, spinal cord trauma, Anesthesia, central nervous system depression |
| what is buffer base? | The sum of all blood buffers in 1L of blood |
| Before connecting the sample syringe to an adult arterial line stopcock, what should you do? | Aspirate at least 5mL of fluid or blood using a wasted syringe |
| Why is the bicarbonate buffer system considered an open buffer system | Its acid (cardonic acid) is converted to Co2 and removed |
| Equipment for capillary blood sampling | lancet, capillary tubes, warming pad |
| When is capillary blood gas sampling indicated? | ABG analysis is needed but Arterial access is not availble |
| Primary chemical event in Metabolic Alkalosis | Increase in blood HCO3- |
| Compensation for metabolic acidosis occurs through? | Decrease in blood CO2 levels |
| Causes of Metabolic Alkalosis | Diuretics, Hypochloremia, Vomitting |
| Example of an Iatrogenic cause of Metabolic Alkalosis | Gastric suction |
| Clinical findings that you would expect in a fully compensated Respiratory Acidosis patient? | elevated HCO3- and pH between 7.35 and 7.39 |
Created by:
socalbritt
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