UT Arlington NURS-UL 3365 - ABGs interpretation summary-1 (6 pages)

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ABGs interpretation summary-1



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ABGs interpretation summary-1

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Pages:
6
School:
University of Texas at Arlington
Course:
Nurs-Ul 3365 - Pharmacology in Nursing Practice
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ABGs Interpretation Chart General info tips ABGs stands for arterial blood gases a measurement of oxygenation acid base balance in the blood norms pH 7 35 7 45 memorize this range but not necessary to memorize the others HCO3 bicarb 2226 PCO2 35 45 PO2 80 100 SO2 97 100 These things go together 1 High numbers of H or high CO2 or low HCO3 cause low pH acid state acidosis Think of H CO2 as the acid gang 2 Low numbers of H or low CO2 or high HCO3 bicarbonate cause high pH alkaline state alkalosis Think of HCO3 as the alkali guy If the acidosis or alkalosis is caused by a respiratory problem it is called respiratory acidosis or alkalosis If caused by anything else kidney problem diabetes etc it is called metabolic acidosis or alkalosis For TEST 1 material we will mostly focus on metabolic derangements then in the pulmonary section TEST 3 we will bring everything together more Compensation to fix a metabolic acid base problem the lungs compensate by getting rid of or hanging on to CO2 to fix a respiratory acid base problem the kidneys compensate by controlling H HCO3 getting rid of or hanging on to them Please note that there is a difference between talking about CO2 an acid in the body and PCO2 partial pressure of CO2 as a gas Methodical way to interpret ABGS 1 look at pH acidosis or alkalosis 2 look at HCO3 if it is not within normal range the subcategory is metabolic 3 look at pCO2 if it is not within normal range the subcategory is respiratory NOTE It is not enough to be able to label a set of numbers as metabolic acidosis or alkalosis or respiratory acidosis or alkalosis You have to know why those numbers have changed and then how the body fixes the problem For more info on that see the charts below same basic info in both but one might be easier for you to understand than the other CHART 1 alteration metab acidosis PCO2 PO2 SO2 examples causes S S body s compensation 22 norma l usuall y norma l usually normal found in situations in which either 1 a metabolic problem is causing increased numbers of H ex ketoacidosis ketones are basically full of H ie acid OR 2 something is causing inability to hang onto or create HCO3 less HCO3 tips the balance towards too much acid ex kidney failure altered mental status many other possible S S 26 norma l usuall y norma l usually normal found in metabolic situations in which either 1 something is causing decreased numbers of H ex profuse vomiting less HCl OR 2 something is causing an accumulation of HCO3 ex ingesting too much antacid Tums Rolaids AlkaSeltzer etc varies The starting problem the body has too much acid it has been caused by a metabolic alteration The fix to bring the body back to balance the lungs must get rid of some of the acid gang The lungs have power only over CO2 an acid so they must use CO2 in some way to fix the initial problem To do this the body causes an increase in rate and depth of respirations The faster you breathe the more CO2 is gotten rid of Thus CO2 is blown off bringing pH back up to normal range The starting problem the body has too much alkali or too little acid this has been caused by a metabolic alteration The fix to bring the body back to balance the lungs must get increase some of the acid gang The lungs have power only over CO2 an acid so they must use CO2 in some way to fix the initial problem To do this the body causes a decrease in rate and depth of pH HCO3 7 35 acidosis 7 45 alkalosis in some resources upper number is 28 7 35 7 45 7 35 7 45 22 26 35 45 this is when a metabolic problem causes low alkali guy or high acid gang metab alkalosis this is when a metabolic problem causes high alkali guy or low acid gang 80100 97 100 respirations The slower you breathe the more CO2 you accumulate Thus CO2 is retained bringing pH down to normal range chart 1 contin alteration pH HCO3 PCO2 PO2 SO2 examples causes S S body s compensation 7 35 acidosis 7 45 alkalosis in some resources upper number is 28 7 35 normal 45 varies usuall y low varies usually low SOB restless altered mental status other S S The starting problem the body has too much acid it has been caused by a respiratory alteration The fix to bring the body back to balance the kidneys must act because the lungs are sick The kidneys control H and HCO3 so to bring up pH they can rid of some of the acid gang H in the urine or counteract acidity by increasing HCO3 can either make more HCO3 or get rid of LESS HCO3 in the urine 7 45 normal 35 varies depen ds on contex t varies depends on context Often occurs as result of some disease process that affects lungs ability to get rid of appropriate amount of CO2 an acid CO2 retention results thus increasing acidity Ex blow to head resp centers in brain affected respiratory depression hypoventilation low RR or shallow breathing CO2 not blown off Too much CO2 is being exhaled blown off Ex hyperventilation due to anxiety or as seen in emphysema varies sometim es tingling of hands feet varies may or varies may or varies may 80 97 most often occurs in restrictive pulmonary diseases when either SOB restless The starting problem the body has NOT ENOUGH acid it has been caused by a respiratory alteration The fix to bring the body back to balance the kidneys must act because the lungs are sick The kidneys control H and HCO3 so to bring down pH they can decrease excretion of some of the acid gang H into the urine or decrease HCO3 can either make less HCO3 or get rid of more HCO3 in the urine Often respirations increase in effort to get in more O2 7 35 7 45 22 26 35 45 resp acidosis 80100 97 100 this is when a respiratory problem causes high acid gang resp alkalosis this is when a respiratory problem causes low acid gang hypoxemia may not change may not change or may not chang e 1 can t get O2 from atmosphere to alveoli ex pneumonia OR 2 or can t get blood to alveoli to be oxygenated ex pulmonary embolus altered mental status other S S medical interventions give O2 fix the problem antibx etc CHART 2 Here s another chart with a different perspective if the previous chart didn t help acidosis LOW pH due to 1 too much of the acid gang A G too many H or CO2 or 2 not enough of the alkali guy HCO3 the fix body s compensatory response to acidosis or alkalosis Note The responses that are given in this row are the body s natural compensations …


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