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Understanding ABGs MS1 exam2

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