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ABG final

QuestionAnswer
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