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Indentify a patient’s : ◦ Oxygenation◦ Adequacy of gas exchange in the lungs◦ Acid-base status◦ Body’s ability to regulate pH◦ Underlying cause of the imbalance
ABG’s are used to
pH: 7.35-7.45- normal level PaO2: 80-100-normal level SaO2: 92%-100%- normal level CO2: 35-45- normal level HCO3: 22-26- normal level Base excess: + or – 2 – normal level
What will the ABGs show?
The partial pressure of carbon dioxide in arterial blood and is a reflection of the depth of pulmonary ventilation.
PaCO2
Partial pressure of oxygen in arterial blood. PaO2 less than 60 leads to anaerobic
metabolism, resulting in lactic acid production and metabolic acidosis.
PaO2
Amount of blood buffer that exists (hemoglobin and bicarbonate)
High Value (Alkalosis) Low Value (Acidosis)
Base Excess
Major renal component of acid-base balance Kidneys excrete and retain bicarb to
maintain a normal acid-base environment.
Bicarbonate
Look at each number individually and label Evaluate Oxygenation Determine Acid-Base Status Determine whether Primary Acid-Base
Disorder is Respiratory or Metabolic Determine whether any form of
compensation response has occurred
How to interpret ABGs
Respiratory Acidosis: CO2 is high and pH is low
Respiratory Alkalosis: CO2 is low and pH is high
Metabolic Acidosis: HCO3 is low and pH is low
Metabolic Alkalosis: HCO3 is high and pH is high
4 possible Acid-Base Imbalances
Drowsiness, disorientation, dizziness, headache
Low BP Hypoventilation with hypoxia
Clinical manifestations of Respiratory Acidosis
Lethargy, light-headedness, confusion Tachycardia Hyperventilation
Clinical Manifestations of Respiratory Alkalosis
Low BP Warm, flushed skin Nausea, vomiting Deep, rapid respirations
Clinical manifestations of Metabolic Acidosis
Excess ingestion of antacids Excess administration of sodium
bicarbonate
Vomiting Nasogastric Suctioning
Causes of Metabolic Alkalosis
Dizziness, irritability, nervousness, confusion
Tachycardia Muscle cramps
Clinical Manifestations of Metabolic Alkalosis