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11 Cards in this Set
- Front
- Back
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ABG Interpretationi Values
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• Analyze the pH
• Analyze the PaCO2 • Analyze the HCO3 • Match either the PaCO2 or the HCO3with the pH. • Look for compensation • Analyze the PaO2 and SaO2 for hypoxemia |
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Step One
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Use pH to determine acidosis or alkalosis
• pH < 7.35 = acidosis • pH 7.40 = absolute normal • pH 7.35-7.45 = normal or compensated • pH > 7.45 = alkalosis |
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Step Two
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Use pCO2 to determine respiratory effect
• pCO2 < 35 = alkalosis • pCO2 35-45 =normal • pCO2 > 45 = acidosis |
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Step Three
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Use Huu3 - to determine metabolic effect
• HCO3 < 22 = acidosis • HCO3 22-26 = normal • HCO3 > 26 = alkalosis Step Four |
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Step Four
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Match either the pCO2 or the HCO3 with the pH to
determine the acid-base disorder. For example, if the pH is acidotic and the pCO2 is acidotic, then the acid-base disturbance is being caused by the respiratory system. Therefore, it will be respiratory acidosis. However, if the pH is acidotic and the HCO3 is acidotic, then the acid-base disturbance is being caused by the metabolic or renal system. Therefore, it will be metabolic acidosis. |
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Step Five
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Determine whether the pCO2 or the HCO3 go in the
opposite direction of the pH. If so, then there is compensation. Compensation is the body's attempt to regain a normal pH through whichever system is not causing the problem. For example: if metabolic acidosis exists, the respiratory system creates respiratory alkalosis by increasing ventilation to eliminate a greater amount of CO2 and return pH to normal range. |
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Step Six
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Examine the puz and the bau2 levels to determine if hypoxemia exists. If the pO2 is less than 80, or the Sa02 is less than 95%, the patient has hypoxemia.
• pO2 60-80 mmHg (mild hypoxemia) • pO2 40-59 mmHg (moderate hypoxemia) • pO2 < 40mmHg (severe hypoxemia |
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Step Seven
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• Put it all together-let's try an example
pH 7.27 acidosis pCO2 53 acidosis HCO3 24 normal pO2 50 moderate hypoxemia Sa02 84% hypoxemia |
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another example
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ph 7.55 alkalosis
pco2 38 normal hco2 30 alkalosis po2 96 normal sao2 98% normal |
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Critical Thinking
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- ihe client is a 6t> year old woman with type 1 diabetes mellitus and pneumonia. Her vital signs on admission are as follows: Temp 103.4F; HR 122, thready; RR 34, shallow. Her urine is positive for ketones. Her ABGs are as follows: pH 7.21;HCO3 22; pCO2 50; PaO2 78"
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Questions
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What acid-base imbalance does this client
most likely have? Is the origin of the imbalance metabolic or respiratory? Is compensation present or not present? |
