Arterial blood gases (ABGs)

PHAB45
PaCO GungsongsS
HCO
-AY ,

↑ H" the hydrogenions the more acidic

acidicity
= + more =

↓ Ht hydrogen ions the more alkalotic

Alkalinity the less
= - :

Acidosis #" goes into cell-K++ Mg + are pushed out of cell-UpHTH

+

>
-
hyperkalemia hypermagnesia
+
push K + Mg
+
Alkalosis push #+ out into ECF - into cell
+
-
hypokalemia hypomagnesia
 ↓ PH < 7 35 ↓ PH < 7 35
↑ CO2745
.

Respiratory Acidosis ·

atlectasis Metabolic Acidosis ↓ HCO <22

.

OD DKA renal failure Shock salicylate OD

airway obstruction COPD · Chest traunea·
pulmonary edema drug Severe diarrhea
·
·
·

CNS depressants (ETOH Opioids "-pam") asthma attack sepsis-anaerobic breakdown -lactic acidosis
PNA
·
.

, .

sleep appea head trauma post op Neuromusculardz impaired gas exchange ↓ ability of kidney to excrete acid or converse base
·

NIVID
lungs less CO breath out hypoventilation hypoxia dyspnea ↓BP
-
-
HA hyperkalemia muscle twitching
·
-

rapid shallow respirations tBP w/ vasodilation HA

airway obstruction warm flushed Skin vasodilation changes in LOC (confusion
·

=
·

, ,

drowsiness. dizziness disorientation muscle weakness/hyperreflexia Kussmaul Respirations (compensatory respirations

·

hyperkalemia dysrhythmias peaked I waves

- -

resp depression inadequate chest expansion ↓ alveolar capillary diffusion

.
Interventions insulin to treat DKA antidiarrheals
retention of CO2
by lungs bicarbonate (only wh low serum levels)
·

sepsis
-

drugs fluids
, ,
bolus (isotonic fluids - LRENS)
Interventions improve ventilation · oxygenation
·

renal failure dialysis

-

maintain airway. O, therapy ventilation support

drug therapy bronchodilators antiinflammatories mucolytics
-
, ,

tx for
drug OD is narcan
pursed lip breathing breathing excercises IS use ·
↑ ↑ pH > 7 45
pH> 7 45
↓ CO2 <35
.

Respiratory Alkalosis Metabolic Alkalosis ↑ HCO " 26

.

↑ loss of CO , from lungs anxiety high altitudes severe

vomiting excessive NG suctioning diuretics" thiazides"
·

fever hypoxiainitial stages of PE base excess -

excessive intake of HCOs carbonates acetates citrates
·

pregnancy , , ,

fear improper vent

hyperventilation anxiety settings blood transfusion has citrate to keep blood Stable
-
·

, ,

stimulation of central resp dlt fever CNS lesions ·

Salicylates acid deficit >
-
prolonged vomiting &NG suction ↑ Cortisol
hyperaldosterone,
·

.
, , ,

mechanical ventilation seizures diuretics

· ·

NIV light headedness lethargy confusion ,

hypokalemia confusion (ALOC dizzy irritability) , ,
·

NIVID
↓ or normal BP tachycardia deep rapid breathing hypokalemia-dysrhythmias compensatory hyperventilation
tremors muscle cramps
tingling of fingers toes
·

Interventions deep breathing . O2 therapy restlessness followed by lethargy

sedatives
breathe into paper
bag
·

check mechanical ventilation Interventions prevent further loss of H" K+, Ca * Cl ,

restore fluid balance (isotonic

monitor As provide safety
·

modify/stop gastric suctioning ,

IV solutions wl base

drugs that promote H

+
ion excretion
·