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What is the test performed before doing an ABG?
What is the normal pH of Blood?
What is the normal range of PaCO2?
What is the normal range of PaO2?
What is the normal range of HCO3?
What is a normal O2 Sat?
What does PaO2 represent?
The oxygen diffused in the body & dissolved in the blood
What does a higher PaO2 indicate?
Higher pressure indicates higher concnetrations of 02 in the blood
What is PaO2?
- partial pressure of oxygen
- amount of oxygen dissolved in teh blood
What is SaO2?
Percentage of oxygen combined with or carried by hemoglobin
What is the SaO2 dependent on?
What is pH?
An indicator of hydrogen ion concentration in plasma
What does acidic mean?
the greater the hydrogen concentration the lower the pH
What does alkaline mean?
the lower the hydrogen concentration the higher the pH
What pH range is compatible with life?
What is a buffer system?
- Prevent major changes in the pH of the body by removing or releasing hydrogen
- Can be accomplished by using intracellular or extracellular buffers
What are the 2 major buffer systems?
- Respiratory (lungs)
- Metabolic (Kidneys)
What are the lungs controlled by?
How do lungs adjust ventilation?
They adjust in response to CO2 (acid) in the blood
What does a rise in PaCO2 in arterial blood do?
It can stimulate respirations, thereby decreasing the acid
What does a decrease in PaCO2 in arterial blood do?
It decreases the respiratory rate in order to increase the acidity
What happens to the PaCO2 when the pH goes down?
When the pH goes down, PaCO2 goes up
What hapens to the pH when the PaCO2 goes up?
when the PaCO2 goes up, the pH goes down
What happens to the PaCO2 when the pH goes up?
When the pH goes up, PaCO2 goes down
What happens to the pH when the PaCO2 goes down?
when to PaCO2 goes down, the pH goes up
What is the pH and PaCO2 in respiratory acidosis?
- pH below 7.35
- PaCO2 above 45
What causes respiratory acidosis?
- chronic bronchitis
- pulmonary edema
- oversedation with narcotics
what are the signs & symptoms of respiratory acidosis?
- incrased RR, BP & P
- Mental cloudiness
- Muscle weakness
What is the pH & PaCO2 in respiratory alkalosis?
- pH above 7/45
- PaCO2 below 35
What causes respiratory alkalosis?
- gram negative bacteremia
- inappropriate ventilator settings
- early phase of salicylate intoxication
What are the signs & symptoms of respiratory alkalosis?
- Inability to concentrate
- numbness & tingling
- Loss of consciousness
What is the main responsibility of the nurse after an ABG is done?
- apply pressure for at least 5 minutes
- apply pressure dressing after bleeding has stopped
What does the metabolic buffer system regulate?
the bicarbonate level in the ECF (range 22-26 mmHg)
What do the kidneys do in alkalosis situations?
the kidneys retain hydrogen ions & excrete bicarb (HCO3)
What do the kidneys do in acidotic situations?
the kidneys excrete hydrogen ions & conserve bicarb
What does HCO3 do?
HCO3 carries CO2 from tissues to the lungs so it can be blown out
What does a decrease in HCO3 in the arterial blood do?
- it can stimulate the kidneys to:
- Reabsorb bicarb
- cause hyperventilation in order to blow off acid
What does an increase in HCO3 in the arterial blood do?
- It can stimulate the kidneys to:
- Excrete bicarb
- cause depressed respirations to hold onto acid
What happens to the pH when HCO3 goes up?
when the HCO3 goes above 26, the pH goes up above 7.45
What happens to the pH when the HCO3 goes down?
when the HCO3 goes below 22, the pH goes down below 7.35
What happens to the HCO3 when the pH goes down?
when the pH goes down below 7.35, the HCO3 goes below 22
what is the pH & HCO3 in metabolic acidosis?
- pH below 7.35
- HCO3 below 22
what causes metabolic acidosis?
- renal failure
- lactic acidosis
What are the signs & symptoms of metabolic acidosis?
- kussmaul respirations
what is the pH & HCO3 in metabolic alkalosis?
- pH above 7.45
- HCO3 above 26
What causes metabolic alkalosis?
- Gastric Suctioning
- Diuretics that increase exretion of potassium
- excessive antacid intake
what happens to the HCO3 when the pH goes up?
when the pH goes up above 7/45, the HCO3 goes up above 26
What are the signs & symptoms of metabolic alkalosis?
- depressed respirations
- tingling of extremeties
- tetany symptoms