ECC1- Blood Gas

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  1. When do you use arterial versus venous blood for blood gas analysis?
    • assessment of oxy/vent required arterial
    • assessment of acid/base balance can use either, usually use venous b/c easier
  2. Define acidemia.
    anything less than pH 7.4
  3. Define alkalemia.
    anything over pH 7.4
  4. What are the physiologic effects of acid base imbalance? (4)
    • proteins denature, enzymes deactivate
    • catecholamines lose function (myocardial function impaired, loss of vascular tone)
    • CNS disturbance (loss of osmotic gradients, impaired depolarization)
    • muscle weakness
  5. Any gain of acid or loss of base, leading to a net effect of decreased HCO3.
    metabolic acidosis
  6. Any reduction in alveolar ventilation relative to CO2 production, resulting in high PCO2.
    respiratory acidosis
  7. Any loss of acid or increase in base, leading to a net effect of increased HCO3.
    metabolic alkalosis
  8. Any increase in alveolar ventilation relative to CO2 production, resulting in low PCO2.
    respiratory alkalosis
  9. What are the body buffering systems? (3)
    • chemical buffers (seconds to hours)- phosphates, proteins, hemoglobin
    • respiratory buffers (minutes to hours)- change ventilation to alter CO2
    • renal buffering (hours to days)- change H+ or HCO3- excretion
  10. What equation describes the body's buffering systems?
    H+ + HCO3- <--> H2CO3 <--> H2O + CO2
  11. Describe respiratory compensation.
    changes in CO2 in response to a primary metabolic disturbance
  12. Primary metabolic acidosis leads to ______________.
    Primary metabolic alkalosis leads to ______________.
    • compensatory resp alkalosis (hyperventilation)
    • compensatory resp acidosis (hypoventilation)
  13. Describe metabolic compensation.
    changes in HCO3- in response to a primary respiratory disturbance, which has acute (chemical) and chronic (renal) components
  14. How do you know which is the primary disturbance on a blood gas?
    look at the pH; the compensation will almost never return the pH to normal
  15. Amount of acid or base required to return the blood pH to the reference interval with CO2 held at a standard value.
    Base Excess/ Deficit
  16. Base excess is the amount of acid or base that must be added to ____________ at __________.
    return pH to 7.4; pCO2 of 40mmHg
  17. Describe interpretation of base excess.
    • normally 0
    • positive BE= metabolic alkalosis
    • negative BE (deficit)= metabolic acidosis
  18. Anion gap=
    Na+ + K+ - (Cl- + HCO3-)
  19. Increased in _________ will widen the anion gap.
    unmeasured anions (adding acid to the system)
  20. Relative difference between Na+ and Cl-, which can have an impact on acid-base balance.
    strong ion difference (SID= Na+ - Cl-)
  21. In order to develop a change in SID,...
    Na+ or Cl- must change independently or disproportionately.
  22. Decreased SID means...
    decreased Na+ or increased Cl---> acidosis b/c HCO3- decreases to maintain electroneut
  23. Increased SID means...
    increased Na+ or decreased Cl- --> alkalosis b/c HCO3- increased to maintain electroneut
  24. What is the effect of albumin on acid base?
    albumin has a significant negative charge' decreased albumin effectively means less acid --> alkalosis
  25. Hypoalbuminemia--> __________
    Hyperalbuminemia--> __________
    • metabolic alkalosis
    • no true cause/ relative to dehydration--> no effect on acid base
  26. With respiratory acidosis, the primary change is ___________; the compensatory response is ___________.
    increased PCO2; increased HCO3-
  27. With respiratory alkalosis, the primary change is ___________; the compensatory response is ___________.
    decreased PCO2; decrease HCO3-
  28. With metabolic acidosis, the primary change is ___________; the compensatory response is ___________.
    decreased HCO3-; decreased PCO2
  29. With metabolic alkalosis, the primary change is ___________; the compensatory response is ___________.
    increased HCO3-; increased PCO2

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Author:
Mawad
ID:
322646
Filename:
ECC1- Blood Gas
Updated:
2016-09-01 20:47:36
Tags:
vetmed ECC1
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vetmed ECC1
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