Beruflich Dokumente
Kultur Dokumente
INTERPRETATION
Child (> 24
months)
Neonate(< 12
months)
1* - Radial A.
2* - Brachial A.
3* - Femoral A.
1* - Radial A.
2* - Brachial A.
1* Brachial A.
2* Umbilical V.
3* Capilliary
and Heel Stick
samples
(opitional)
4* -Dorsalis
Pedis A.
5* - Posterior
Tibial A.
30-40
Radial
90
Femoral
45-60
10-20
Sampling Hazards
-
Sampling Problems
-
Air Bubbles
* PaCo2
* Pa02 or
* pH
Improper cooling (> 1 hr.)
* PaCo2
* Pa02
* pH
Too much heparin
*pH
Post suctioning
Nebulization (after?)
Movement (Turning)
Medications (I.V.)
Activity/Procedures
Handling of sample
Normal Values:
Parameters
Range
Absolute
Mixed Venous
7.35-7.45
7.40
7.31-7.41
PaCO2
35-45 mmHg
40 mmHg
41-51 mmHg
PaO2
80-100 mmHg
95 mmHg
37-43 mmHg
HCO3
22-26 mmHg
24 mEq/L
22-26 mEq/L
-2 to +2
mEq/L
0 mEq/L
-2 to +2
mEq/L
> 95%
98%
68-75 %
pH
BE/BD
O2 Sat %
pH - <7.35=Acidotic
>7.45=Alkalotic
HCO3 - <22mEq/L=Acidotic
>26mEq/L=Alkalotic
BE/BD - <-2 Acidotic
>+2 Alkalotic
PaCO2 - > 45mmHg=Acidotic
< 35mmHg=Alkatotic
Compensatory Response
PaCO2
HCO3
PaCO2
HCO3
With Hypoxemia @ O2
Normal/adequate Oxygenation
Overcorrected oxygenation
= > 100mmHg
Corrected oxygenation
= 80-100mmHg
Uncorrected/inadequate
oxygenation
= <80mmHg
= 80-100mmHg
Mild Hypoxemia
= 60-79mmHg
Moderate Hypoxemia
= 40-59mmHg
Severe Hypoxemia
= < 40mmHg
3.
4.
Determine the pH
Determine whether respiratory or
metabolic in origin
Determine the compensation
Determine the Oxygenation Status
________
3
pH= 6.90
PaCO2=70mmHg
PaO2=39mmHg
HCO3= 23mEq/L
BE/BD= -4mEq/L
O2 Sat= 90%
Age: 20 y/o
Fi02: R.A.
Interpretation: Uncompensated Respiratory
Acidosis w/ Severe Hypoxemia
S/Sx
RR & depth
HA, visual disturbance,
restlessness, drowsiness, confusion
Diaphoresis
Cyanosis
Hyper K
dysrhythmias (VF)
O2, coughing
Hydration
Suction
secretions
WOF RR distress, hyper K
Antibiotics & other meds as
ordered
pH= 7.60
PaCO2=52mmHg
PaO2=77mmHg
HCO3= 28mEq/L
BE/BD= +3mEq/L
O2 Sat= 94%
Age: 35 y/o
Fi02: 50% Simple Face Mask
Interpretation: Partially compensated
Respiratory Alkalosis w/ uncorrected
oxygenation
ABG: RESPIRATORY
ALKALOSIS
ABG: RESPIRATORY
ALKALOSIS
S/Sx
RR & depth then RR
HA, light-headedness, vertigo
Hypo Ca: paresthesia, tetany,
convulsion
Hypo K
pH= 7.00
PaCO2=40mmHg
PaO2=88mmHg
HCO3= 29mEq/L
BE/BD= -8mEq/L
O2 Sat= 90%
Age: 54y/o
Fi02: 2LPM Via nasal cannula
Interpretation: Uncompensated metabolic
acidosis w/ corrected oxygenation
Causes
DM & DKA
ASA toxicity
High fat diet
Insufficient CHO metabolism
Malnutrition
RF
Severe diarrhea
S/Sx
RR, Kussmauls respiration
HA, N/V/diarrhea
Fruity-smelling breath
CNS depression
Twitching, convulsion
Hyper K
Tx
NaHCO3 IV
Sz precaution
For DKA: NS & Regular Insulin
IV
For RF: CHON, calorie diet;
dialysis
pH= 7.48
PaCO2= 42mmHg
PaO2= 73mmHg
HCO3= 30mEq/L
BE/BD= +8.8mEq/L
O2 Sat= 96.21%
Age: 10 y/o
Fi02: R.A.
Interpretation: Uncompensated Metabolic
Alkalosis w/ mild hypoxemia
Causes
Diuretics
Excessive vomiting or GI
suctioning
Hyperaldosteronism
Excessive NaHCO3 intake
Massive BT (citrate converted to
HCO3)
S/Sx
RR & depth
N/V/diarrhea
Restlessness
Paresthesia, twitching
HypoK, HypoCa
HR, dysrhythmias
Case Studies:
1. A 20 y/o female with known DM II entered the ER
with Kussmauls breathing and irregular pulse. 02
@ 4Lpm via nasal prong, V/S and ABG were
taken.
V/S = RR-25 bpm
CR-108 bpm
BP- 100/50 mmHg
ABG = pH 7.12
PaCO2 35mmHg
PaO2- 101mmHg
HCO3- 13 mEq/L
O2 Sat%- 99.0%
Case Studies:
2., A client recovering from surgery in the post-anesthesia
care unit (PACU) is difficult to arouse two hours following
surgery. The nurse in the PACU has been administering
Morphine Sulfate intravenously to the client for complaints
of post-surgical pain. The clients respiratory rate is 7 per
minute and demonstrates shallow breathing. The patient
does not respond to any stimuli
.
V/S = RR- 8 bpm
CR- 40bpm
BP- 50 palp
O2 3lpm n.c.
ABG = pH 7.10
PaCO2 60mmHg
PaO2- 41mmHg
HCO3- 29mEq/L
O2 Sat%- 85%
Case Studies:
3. A two-year-old is admitted to the hospital with a diagnosis
of asthma and respiratory distress syndrome. The father
of the infant reports to the nurse that he has observed
slight tremors and behavioral changes in his child over the
past three days. The attending physician orders routine
ABGs following an assessment of the ABCs. The ABG
results are:
V/S = RR-25 bpm
CR-135 bpm
BP- 175/110 mmHg
O2 7lpm tusk mask
ABG = pH 7.40
PaCO2 47mmHg
PaO2- 115mmHg
HCO3- 39mEq/L
O2 Sat%- 100.0%