ABG Interpretation: Acid-Base Imbalances

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Questions and Answers

A patient's ABG results are: pH 7.30, PaCO2 50 mmHg, HCO3 24 mEq/L. What is the correct interpretation?

  • Metabolic acidosis
  • Respiratory acidosis (correct)
  • Metabolic alkalosis
  • Respiratory alkalosis

Which ABG result is consistent with metabolic alkalosis?

  • pH 7.50, PaCO2 30 mmHg, HCO3 22 mEq/L
  • pH 7.28, PaCO2 38 mmHg, HCO3 18 mEq/L
  • pH 7.48, PaCO2 40 mmHg, HCO3 30 mEq/L (correct)
  • pH 7.32, PaCO2 50 mmHg, HCO3 24 mEq/L

A nurse is caring for a patient with prolonged vomiting. What ABG imbalance is most likely?

  • Metabolic alkalosis (correct)
  • Metabolic acidosis
  • Respiratory acidosis
  • Respiratory alkalosis

A patient's ABG results show: pH 7.28, PaCO2 38 mmHg, HCO3 18 mEq/L. What is the interpretation?

<p>Metabolic acidosis (C)</p> Signup and view all the answers

Which condition is most likely to cause respiratory alkalosis?

<p>Anxiety-induced hyperventilation (B)</p> Signup and view all the answers

A patient with diabetic ketoacidosis (DKA) is most likely to have which ABG imbalance?

<p>Metabolic acidosis (B)</p> Signup and view all the answers

A patient with chronic obstructive pulmonary disease (COPD) is at risk for which acid-base imbalance?

<p>Respiratory acidosis (B)</p> Signup and view all the answers

A patient's ABG shows: pH 7.50, PaCO2 30 mmHg, HCO3 24 mEq/L. What is the interpretation?

<p>Respiratory alkalosis (A)</p> Signup and view all the answers

What compensatory mechanism occurs in metabolic acidosis?

<p>Hyperventilation to eliminate CO2 (C)</p> Signup and view all the answers

Which ABG finding suggests fully compensated metabolic acidosis?

<p>pH 7.38, PaCO2 28 mmHg, HCO3 18 mEq/L (B)</p> Signup and view all the answers

Flashcards

Respiratory Acidosis

Low pH, high PaCO2, and normal HCO3, indicating a respiratory cause of acidosis.

Metabolic Alkalosis

High pH and high HCO3 indicate a metabolic cause of alkalosis, with normal PaCO2 showing no respiratory involvement.

Vomiting and ABG imbalance

An acid-base imbalance often caused by loss of stomach acid (HCl), leading to increased bicarbonate levels.

Metabolic Acidosis

Low pH and low HCO3 indicate a metabolic cause of acidosis, with normal PaCO2 showing no respiratory involvement.

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Anxiety-Induced Hyperventilation

Induces excessive CO2 loss, raising pH and causing alkalosis.

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Diabetic Ketoacidosis (DKA)

Produces excess ketones, which lower pH and bicarbonate levels, causing acidosis.

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COPD and Acid-Base Imbalance

Leads to impaired CO2 excretion, causing CO2 retention and respiratory acidosis.

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Respiratory Alkalosis

High pH and low PaCO2 indicate respiratory alkalosis, with normal HCO3 confirming a respiratory cause.

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Compensatory Mechanism in Metabolic Acidosis

Hyperventilation to eliminate CO2, helping to raise pH.

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Fully Compensated Metabolic Acidosis

pH is within normal limits (but at the lower end), low HCO3 indicates metabolic acidosis, and low PaCO2 confirms respiratory compensation.

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Study Notes

  • ABG interpretation involves analyzing pH, PaCO2, and HCO3 values to determine acid-base imbalances

Respiratory Acidosis

  • Low pH, high PaCO2, and normal HCO3 indicate respiratory acidosis
  • COPD can lead to impaired CO2 excretion, resulting in CO2 retention and respiratory acidosis

Metabolic Alkalosis

  • High pH and high HCO3 suggest metabolic alkalosis with normal PaCO2 levels
  • Prolonged vomiting can cause metabolic alkalosis due to the loss of stomach acid (HCl), increasing bicarbonate levels

Metabolic Acidosis

  • Low pH and low HCO3 indicate metabolic acidosis, with normal PaCO2 to rule out respiratory issues
  • DKA produces excess ketones, lowering pH and bicarbonate levels, which can results in metabolic acidosis

Respiratory Alkalosis

  • High pH and low PaCO2 indicate respiratory alkalosis with normal HCO3 levels
  • Hyperventilation leads to excessive CO2 loss, raising pH and causing respiratory alkalosis
  • Anxiety-induced hyperventilation is a common cause of respiratory alkalosis

Compensation

  • The lungs compensate for metabolic acidosis by increasing respiration to remove excess CO2 (hyperventilation)
  • In fully compensated metabolic acidosis, the pH is within normal limits, HCO3 is low (indicating metabolic acidosis), and PaCO2 is low (indicating respiratory compensation)

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