Arterial Blood Gases Module
Terms
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- Why do we perform an Allen's Test?
- Test for the integrity of the radial and ulnar arteries at the wrist.
- What is an Arterial Blood Gas?
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- Determines the quality of gas exchange
- Acid-base balance - PaO2 normal value
- 80 - 100 mmHg
- SaO2 normal value
- 93-99%
- pH normal value
- 7.35 - 7.45
- PaCO2 normal value
- 35 - 45 mmHg
- HCO3 Normal Value
- 22-26 meq/L
- Respiratory Acidosis
- Inc PaCO2, Dec pH
- Cause of respiratory acidosis
- retention of CO2 by the lungs due to inadequate gas exchange or increased production.
- Respiratory Alkalosis
- Dec PaCO2 with Inc pH
- Causes of Respiratory alkalosis
- Increased excretion of CO2 from teh serum, Hyperventillation, Fever, sepsis
- Metabolic acidosis
- Dec HCO3, Dec pH
- Cause fo metabolic acidosis
- increased production of acids such as ketoacid or lactic acid or decreased concentration of HCO3
- Metabolic alkalosis
- Inc HCO3, Increase pH
- Causes fo rmetabolic alkalosis
- increased production of bicarbonate or increased loss of non volatile acids
- Types of acid-base compensation
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Respiratory - lungs compensate quickly
Metabolic - Kidneys compensate slowly - Respiratory Compensation
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Met acidosis - incrase rate and depth - lungs blow off CO2 to raise pH
Met alkalosis - decrease rate and depth - lungs retain CO2 to lower pH - Metabolic Compensation
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Resp Acidosis - HCO3 reabsorption and increased hydrogen secretion to increase pH - Kidneys retain
Resp Alkalosis - Decreased hydrogen secretion and HCO3 reabsorption - Kidneys excrete - Full Compensation
- Body is able to correct pH
- Partial Compensation
- Compensation has begun, and is moving pH to homeostasis
- Non-Compensated
- neither the respiratory sustem nor the renal system is adjusting to the alteration in acid base and therefor no compensation is occuring
- pH 7.28, PaCO2 57, HCO3 24
- Respiratory acidosis, uncompensated
- pH 7.32, PaCO2 40, HCO3 16
- Metabolic Acidosis, uncompensated
- Ph 7.20, PaCO2 65, HCO3 30
- Respiratory acidosis, partially compensated
- Ph 7.47, PaCO2 49, HCO3 30
- Metabolic Alkalosis, partially compensated
- pH 7.46, PaCO2 35, HCO3 28
- Metabolic alkalosis, uncompensated
- NI for COPD client
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Purse lip breathing exercises, relatixation techniques, diaphragmatic breathing, monitor ABG, oxygen support per physician, corticosteroid, mucolytic, suctioning if necessary, alleviate underlying cause if possible, high fowlers position
Ambulate or site in chair
Incentive spirometer
Tripod positioning
Oxygen via NC or mask
Bronchodialators to open airway
Observe for MI due to hyperkalemia