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58 Cards in this Set
- Front
- Back
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What is the Allen's Test?
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Used to check suffcientcy of artery to be used for Arterial blood stick draw
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Prior to receiving blood gas specimen you must?
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Obtain Vitals
Locate if pt has arterial line in place allens test assess for factors such as suctioning within last 20 min. |
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How is the Allens test done?
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Apply direct pressure to ulnar and radial arteries.
have pt pump hand release and eval color for 6 sec if slow return than artery is insufficient |
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What are the ABG normal values?
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ph = 7.35-7.45
PCO2 = 35-45 mmHg HCO3 = 22-26 mEq PO2 = 80-100 mmHg |
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What is PCO2?
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Cabon Doioxide
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What particle makes up your PH value
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Hydrogen Ion
Lower PH reading indicates acid higher number reflects alkaline. |
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What is HCO3?
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Bicarb. Controls Kidney and metabolic functions
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PCO2 imbalance is indicative of?
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Respiratory problem because PCO2 is Carbon Dioxide
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Respiratory Imbalances
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PH and PCO2 will always be opposite in regards to high and low
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Metabolic Imbalances
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PH and HCO3 are both elevated or decreased.
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What indicates compensation?
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when the PH level is within normal limits
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What indicates partial compensation?
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HCO3 is abnormal
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What reading indicates uncompensated condition?
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HCO3 is normal
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Alkalosis?
Acidosis? |
alkalosis is an elevated PH number and acidosis is a decreased PH number.
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How many buffer systems are present in our body?
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4 total
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Signs and Symptoms of Respiratory Acidosis?
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Diaphoretic,cyanotic, hyperkalemia, rapid respiration rate, dysthrhythmias
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Causes of repiratory acidosis?
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Pulmonary edema, broncholectasis, airway obstruction, hypoventilating, medications, atelectasis, bronchitis
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Causes of repiratory alkalosis?
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Hyperventilating, hysteria, hypoxia, over ventilating on vent, pain or brain trauma salicylates (aspirin)
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Signs and Symptoms of respiratory alkalosis?
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Headache, lightheadedness, mental status changes, paresthesias, hypokalemia, hypocalcemia,tetany, convulsions
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what are some interventions for resp acidosis?
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suction if needed, reduce restlessness by improving ventilation rather then using meds (they may further reduce respirations) Monitor electrolyes esp K, give ABX as RX
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what are some interventions for resp acidosis? 2nd card
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Monitor for S/S of resp distress, give 02 as RX, semi-fowler, turn, cough and deep breathe, give resp tx as rx, encourage fluid intake to thin secretions
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Define Emphysema, what is the main problem?
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Loss of elasisity of the aveolar sacs and restrics airflow in and out, primarily out, leading to an increased co2
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Why shouldn't you give a pt with COPD high amounts of 02?
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COPD pt's breathe when their 02 is low, if a high amount is being delivered they can forget to breathe
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What is Bronchiectasis?
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Bronchi become dilated due to inflammation and destructive changes and weakness in the walls of the bronci occur
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What can happen with resp alkalosis?
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hgb (normally has affinity for o2) will fill with co2 and go to the lungs, the pt still will look nice and pink but lungs aren't using it so they become alkalotic
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Describe respirations of a person with resp alkalosis
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initially, hyperventilation and respiratory stimulation will cause tachypnea, in an attempt to compensate, rr and depth go down
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what happen with K in resp alkalosis?
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hypokalemia-less H+ ions (shifting into the cell now)
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What are some interventions for resp alkalosis?
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monitor vent so the pt is not being forced to take rapid deep breaths, monitor electrolytes (K and Ca) give meds as rx, may give Ca Gluconate for tetany as rx
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Describe Metabloic Acidosis
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The total concentration of buffer base is lower than normal, with a relative increase in the H+ concentration
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Why does metabolic acidosis occur?
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A result of losing too many bases and holding too many acids w/o sufficient bases
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Give some causes of metabolic acidosis
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DM, Diabetic ketoacidosis, renal insuff, failure, insuff metabloism of carbs, excessive ASA, severe diarrhea, malnutrition, high fat diet
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(M ACID)
DM, Diabetic ketoacidosis |
Insuff supply of insulin causes increased fat metabolism, leading to an accumulation of keytones or other acids: the bicarb then ends up being exhausted
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(M ACID)
Renal Insuff/failure |
Increased waste products of protein metabolism are retained, excessive acids build up, and bicarb is unable to maintain acid base balance
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(M ACID)
Insuff metabolism of carbs |
when an insuff supply of o2 is available for the proper burning of carbs, glucose, and water, lactic acid increases and lactic acidosis results
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(M ACID)
Excessive ASA |
Causes an increase in the H+ concentration
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(M ACID)
Severe diarrhea |
Intestinal and pancreatic secretions are normally alkaline therefore, excessive loss of base leads to acidosis
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(M ACID)
Malnutrition |
Improper metabolism of nutritients causes fat catabolism, leading to an excess buildup of keytones and acids
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(M ACID)
High fat diet |
A high intake of fat causes a much too rapid accumulation of the waste products of fat metabolism, leading to a buildup of keytones and acids
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what is a good example of a high fat diet that may cause metabolic acidosis
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ADKINS
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what type of resp may a pt with metabolic acidosis have?
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kussmauls-in an attempt to blow off the extra co2 and compensate for the acidosis, hyperpnea and kussaumauls resp occurs
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name some assessment findings you may observe with M Acidosis
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headache, N/V/D, fruity breath (improper fat metabolism) CNS depression:mental dullness, drowsiness, stupor, coma, twitching, convulsions, hyperkalemia
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What are some interventions you may have for a pt with M Acidosis?
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Assess LOC for CNS depression, I&O, monitor fluid and electrolyte replacements as rx
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what kind of IV solutions may a pt with Metabolic Acidosis have?
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NS, 5% dextrose, 1/2NS, Sodium Lactate, or Bicarbonate to increase the buffer base
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What happens with K in metabolic acidosis
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when acidosis is being treated, K will move back into the cell and the serum K level will drop
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what might you do for a pt with DM/D ketoacidosis that is in metabolic acidosis?
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Insulin is given to hasten the movement of glucose into the cell, thereby decreasing the concurrent ketosis, when glucose is used properly the body will stop converting fat to glucose
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what other complication may hyperglycemia cause with M ACID?
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circulatory collapse due to polyuria, because polyuria or diuresis may lead to extracellular volume deficit
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Implementation with renal failure
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Dialysis may be used to remove waste products, lessening the acidosis state, a low protein diet and high calories will lessen the protein catabolism, which will lessen acidosis
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what is the degree of compensation?
ph-7.38 PaC02- 65 HC03-32 |
completely compensated
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what is the degree of compensation?
pH-7.32 PaCO2-65 HCO3-28 |
partially compensated
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pH-7.20
PaCO2-65 HCO3-24 |
uncompensated
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Evaluating the degree of compensation
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1st determine whether the primary abnormality id resp or metabolic related
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Evaluating the degree of compensation
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next determine the presence an degree of compensation
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what is the degree of compensation?
ph-7.38 PaC02- 65 HC03-32 |
completely compensated
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what is the degree of compensation?
pH-7.32 PaCO2-65 HCO3-28 |
partially compensated
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pH-7.20
PaCO2-65 HCO3-24 |
uncompensated
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Evaluating the degree of compensation
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1st determine whether the primary abnormality id resp or metabolic related
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Evaluating the degree of compensation
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next determine the presence an degree of compensation
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Evaluating the degree of compensation
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Compensation is the attempt by the non-primary abnormality to normalize the pH (do this by using <7.40 acid,>7.40 alk) look this up
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