ABGs and Lines

Question 1

What does PO2 measure

Answer 1

free unbound O2

Question 2

PO2 is the driving force for…

Answer 2

Hb saturation with O2

Question 3

PO2 is determined by

Answer 3

1. Alveolar ventilation
2. V/Q
3. FiO2

Question 4

What are ABGs a measure of

Answer 4

partial pressure and pH of O2 and CO2 in the blood

Question 5

PCO2 is controlled by ____

Answer 5

ventilation

Question 6

HCO3- is regulated by

Answer 6

Renal

Question 7

CO2 is regulated by

Answer 7

respiratory

Question 8

Normal range for pH

Answer 8

7.35-7.45

Question 9

Normal range for PaCO2

Answer 9

35-45

Question 10

Normal range for HCO3-

Answer 10

22-28

Question 11

Normal range for PaO2

Answer 11

80-100mmHg

Question 12

Normal range for SaO2

Answer 12

95-100%

Question 13

metabolic and respiratory acidosis =

Answer 13

pH is lower than normal

Question 14

metabolic and respiratory alkalosis

Answer 14

pH is higher than normal

Question 15

Respiratory acidosis =

Answer 15

pH Declined
PaCO2 increase
HCO3 normal

Question 16

Respiratory alkalosis =

Answer 16

pH increase
PaCO2 decrease
HCO3 normal

Question 17

Metabolic acidosis =

Answer 17

pH decreased
PaCO2 normal
HCO3 decreased

Question 18

metabolic alkalosis =

Answer 18

pH increased
PaCO2 normal
HCO3 increase

Question 19

6 rules for examining ABGs

Answer 19

1. look at pH first to see what primary process it is (acidosis or alkalosis)
2. remember clinical context (respiratory or metabolic condition)
3. respiratory compensation can take minutes to hours
4. renal compensation can take 1-5 days to occur
5. compensation can be partial or total
6. for alveolar hypoventilation the PO2 should only decrease 1 mmHg for every 1 mmHg increase in PaCO2

Question 20

What is an ART line? where might it be inserted?

Answer 20

constantly monitor arterial BP

- may be inserted into radial, axillary, femoral or pedal artery

Question 21

Precautions with ART lines

Answer 21

• infusion bag must be kept above insertion site
• notify RN if transducer disconnected
• ROM restrictions (ie. no hip flexion past 90° with femoral ART line)

Question 22

What is a PICC line? Where might it be inserted?

Answer 22

to deliver chemotherapy or antibiotics (often simultaneously)
- inserted into large vein of the arm near bend of elbow and pushed until tip sits above heart

Question 23

Precautions with a PICC line

Answer 23

do not mobilize until proper insertion confirmed with x-ray

Question 24

What is an ECG line

Answer 24

Measures Electrical activity of heart

Question 25

What are the contraindications with an ECG line

Answer 25

sternotomy – limitations in lifting (10 lb. above waist, no pushing STS, and no pull/push over 5 lbs.)

Question 26

What is a patient controlled analgesic

Answer 26

self-administered meds, will preset how much they can get

Question 27

Precautions with a patient controlled analgesic

Answer 27

look for BP drop, RR less than 10, altered mental status

Question 28

Precautions with epidural

Answer 28

• careful with movements of trunk, hips, LE – can be very uncomfortable
• always check orders
• if dislodged get help immediately

Question 29

Precautions/contraindications with NG Tube

Answer 29

• Feed is kept above site of insertion, need feeds turned off before start of therapy, HEAD OF BED NOT FLAT FEED WILL FLOW BACK (keep at least 30 degrees incline)!

Question 30

Precautions/contraindications with chest tube

Answer 30

Keep below site of insertion to prevent backflow

Question 31

Precautions/contraindication with urinary catheter

Answer 31

Foley - keep below site of insertion to prevent backflow