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about 20% Sats level: % of o2 bond to Hgb paO2: actual amt. bonded |
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0-0.5 Cardiac specific for MI |
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1.5 - 2.5 30-40 sec. normal to monitor Heparin therapy |
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2-3 Specific test for coumadin therapy |
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| carbon dioxide related to carbonic acid |
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pH levels that indicate death |
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| Respiratory compensation begins when? |
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| Respiratory compensation is made by what organ? |
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kidneys renal compensation of bicarb, concentration and secretion of H+ ions |
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| Metabolic compensation begins when? |
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| Metabolic compensation is made by? |
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Respiratory system controls co2 via respiratory rate and depth |
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| ABG level for respiratory alkalosis |
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| Causes of Respiratory alkalosis |
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anxiety FA pain salicylates voluntary/mechanical hyperventilation renal insuffiency HYPOXEMIA |
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Respiratory alkalosis IV fluid of choice |
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Clinical manifestations of Respiratory Alkalosis |
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Confusion HYPOKALEMIA (leads to tetany) CARDIAC ARRTHYMIAS lightheadedness HYPERventilation deep, rapid breathing tingling of extremities (circumoral numbness) |
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| Respiratory Alkalosis is a..... |
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reduction of CO2 (holding too much o2) |
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Respiratory Alkalosis can be caused by... |
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| an asthma or panic attack |
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Respiratory Acidosis ABG looks like? |
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Respiratory Acidosis is a.... |
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| retention of too much acid (co2) |
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IV fluid of choice in Respiratory Acidosis? |
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| What med would be given for a pt. in respiratory acidosis with cardiac dysrthymias? |
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Respiratory acidosis clinical manifestations |
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HYPOventilation lethargy ventricular dysrthymias cyanosis (late sign) HYPERkalemia HYPOXIA confusion/restlessness tachycardia muscle weakness diaphoresis |
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| Acute causes of Respiratory Acidosis |
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sedative overdose anesthesia cerebral trauma/infarct pulm. edema pulm. emboli pneumothorax smoke inhalation |
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Metabolic Alkalosis ABG's look like? |
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| Metabolic alkalosis is what? |
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Metabolic alkalosis IV fluid of choice? |
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| When a pt is in a metabolic state (either alkalosis or acidosis), what med should be administered in addition to the IVF if they are diabetic? |
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What med is administered to a CHF pt. in metabolic alkalosis? Why? |
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Acetazolamide (diamox) Pt can't tolerate rapid volume expansion Causes large loss of bicarb Give a K+ supplement before starting tx |
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| What is the goal of treatment in a pt that is in metabolic alkalosis? |
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| Treat the underlying cause |
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Clinical manifestations in Metabolic Alkalosis |
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restlessness followed by lethargy muscle weakness DYSRTHYMIAS (b/c of k+ loss) compensatory HYPOventilation CONFUSION (b/c of na+ loss) stupor nausea and vomiting slowed respirations HYPOkalemia DIARRHEA |
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| What IVF can be given to a pt that is in metabolic alkalosis to correct nausea and vomiting? |
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Causes of Metabolic Alkalosis |
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vomiting prolonged suctioning diuretics (thiazides) HYPERcalcemia HYPOkalemia cystic fibrosis |
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Metabolic Acidosis ABG's look like? |
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| What is the fluid of choice for a pt that is in metabolic acidosis? |
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Use caution in sodium bicarb IVF in these pts... Why? |
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PE and CHF Because R/F fluid overload |
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Clinical manifestations in Metabolic Acidosis |
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H/A disorentation/confusion/change in LOC KUSSMAUL RESPIRATIONS (compensatory HYPERventilation) flush, warm, dry skin fruity breath N/V HYPOtension DYSRYTHMIAS DIARRHEA muscle twitching |
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| a loss of base, or retention of acid |
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Causes of Metabolic Acidosis |
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diarrhea billary and pancreatic drainage DIAMOX (acetazolamide) ketoacidosis ETOH induced starvation salyclates cocaine/methamphetamines/ecstacy renal failure K+ sparing diuretics |
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Respiratory Alkalosis Nursing Interventions |
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assess degree of anxiety, pain and treat encourage normal breathing pattern (demonstrate) encourage paper bag/resevior breathing monitor o2 sats before and during tx Can cause dysrythmias in preexsisting heart pts on cardiotropic meds, monitor EKG's and report the MD |
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Nursing interventions for Respiratory Acidosis |
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Monitor pt response to therapy (abd. distention) encourage cough suctioning monitor bowel sounds semi-fowler's position |
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Nursing Interventions for Metabolic Alkalosis |
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monitor EKG for dysrythmias apical/radial pulse for pulse deficit monitor labs for effectiveness of tx monitor K+ for hypokalemia (enhances dig. tox.) daily wt and I&O gastric contents measured |
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A nursing intervention for metabolic alkalosis is gastric suctioning... What type of solution should be used for this? Why? |
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Isotonic solution To prevent electrolyte washout |
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Nursing Interventions for Metabolic Acidosis |
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monitor for ventricular dysrythmias follow established protocols (rx, tx) monitor for pulse deficits monitor ABG's and other labs for effectiveness of tx |
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| What does a pulse deficit indicate in a pt with a metabolic disorder? |
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| indicates a weak heart contraction and leads to heart failure |
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