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Description
Flashcards by david felipe molina ramos, updated more than 1 year ago
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Created by david felipe molina ramos
about 4 years ago
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| Question | Answer |
| The three steps, in order of frequency, that should be used to interpret a blood gas measurement are: | Step 1. Determine the pH; if it is altered, see the direction of the alteration Step 2. Determine PaCO2; if it is altered, see the direction of the disturbance (respiratory acidosis or respiratory alkalosis) Step 3. Determine the base or EB; if it is altered,see the direction of the alteration |
| Respiratory Acidosis Evaluate the CO2 value, if it is high. This disorder is characterized by an elevation of CO2 due to hypoventilation, HCO3- increases as a compensatory response. This alteration is due to hypoventilation and the consequence is hypercapnia. Hypercapnia occurs as a result of inadequate ventilation, which may be due to the inability of the ventilatory pump to maintain ventilation, ventilatory pump failure due to respiratory disease, central nervous system depression, abnormal neuromuscular transmission or respiratory muscle dysfunction. This leads to an inability to remove CO2 and increased levels of it in the arterial blood. | CAUSES: • Depression of the respiratory center. • Drugs (opiates, anesthetics, sedatives) • Injuries to the central nervous system. • Oxygen therapy in COPD. • Hypothyroidism. • Foreign body. CLINICAL MANIFESTATIONS • Headache. • Confusion. • Irritability. • Anxiety. • Asterixis. • Heart decreases contractility |
| Metabolic Acidosis In this disorder, low HCO3 should be assessed. It is characterized by low HCO3- < 22 mEq/L. Metabolic acidosis is produced by two ways: accumulation of fixed acids in the blood, in this case is given by tissue hypoxia which produces anaerobic metabolism and produces lactic acid, the result is the accumulation of H + which reacts with HCO3- achieving its decrease. Due to the damping by increase of H+ during the metabolic acidosis, hyperventilation is produced by stimulation of the central and peripheral receptors, usually in 1 to 2 hours. | CAUSES • Loss of HCO3- due to alterations Renal, Digestive • Increased H+ load from intrinsic or extrinsic causes Kidney failure (inability to excrete acid) CLINICAL MANIFESTATIONS • Thirst for air • Hyperventilation • Dyspnea • Hypernea • Tachypnea • Anxiety • Hypotension • Kussmaul breathing • Convulsions |
| Respiratory alkalosis It is the reduction of CO2 as a primary disorder; for evaluation of this disorder should be assessed the CO2 is high or low. This disorder is characterized by a decrease in CO2 due to hyperventilation, the HCO3- decreases as a renal response compensatory. | Causes • Hypoxemia, anemia, • stay at great heights. • Sepsis. • Hyperthyroidism. • Pregnancy. • Neurological disorders. • Tumor infections • Asthma. • Fever. • Exercise. • Pulmonary embolism. • Mechanical respirator (selection • inadequate of parameters) Clinical manifestations • Symptoms of hypocalcemia. • Deterioration of the level of consciousness. • Syncope. • Ventricular tachyarrhythmias • supraventricular and • Tachypnea. • Paresthesias. • Spasms. |
| Metabolic alkalosis In order to verify this disorder, one must evaluate whether the value of HCO3- is normal, high or low. It is characterized by pH > 7.45, as an alteration primary, there is an increase of HCO3- in blood plasma > of 26Meq/L, and an increase of PCO2 by compensatory hypoventilation. This induces release of H+ from intracellular tampons and later hypoventilation by inhibition of the centers respirators | Causes - Loss of H+ - Digestives - Vomiting, nasogastric tube - Oral antacids - Diarrhea with chlorine loss - Kidney losses - Intracellular movement - Retention / exogenous administration of HCO3 Clinical manifestations - Hyperreflexia - Paresthesia - Mareos - Tetania |
| Mnemonic |
Image:
Ph (binary/octet-stream)
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| Mixed disorders | - Respiratory acidosis and metabolic acidosis High CO2 values do not correspond to the decrease in HCO3 - Respiratory acidosis and metabolic alkalosis HCO3- values are high in relation to PCO2 - Metabolic acidosis and respiratory alkalosis PCO2 values are very low in relation to HCO3 |
| pH Ranges Black: Acid Grey: Balance White: Alkalosis |
Image:
Ph1 (binary/octet-stream)
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| Normal newborn gas values |
Image:
Cuadro (binary/octet-stream)
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| Anion GAP | It is related to the law of electroneutrality, where the total of number of positive charges, is equal to the negative charges in body fluids. The GAP anion is the difference between anions and cations measured in blood, their value results in reference values results from the difference between cations and anions, usually excludes potassium, its value is 12 ± 4 mEq/L |
| List of anions and cations |
Image:
Gap (binary/octet-stream)
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| Practice the artery gases | Go to quizz and do the evaluation https://quizizz.com/join/quiz/5f81adde20eda4001b8b8d9b/start?studentShare=true |
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