Documente Academic
Documente Profesional
Documente Cultură
A. pH: 7.35-7.45
B. PaCO2: 35-45
C. PaO2: 80-100 mg
D. HCO3: 22-26
E. O2 Saturation: 95-100%
F. Base excess or deficit: + or – 3 mEq/L
G. Anion Gap: < 12 mEq
a. Acids: are molecules that can release hydrogen ions. There are
two groups of acids:
S/S:
Treatment of Hypercapnea:
1. Improve ventilation
2. Intubate and ventilate
3. Pulmonary toilet
4. Tx the cause (ie: hold sedation)
1. Anxiety
2. Panic attacks
3. Fever
4. O2 deficiency
5. Early salicylate toxicity
6. Encephalitis
7. Anesthesia
8. Treatment for IICP
9. Metabolic acidosis (compensatory)
1. Light-headedness
2. Dizziness
3. Tingling & Numbness of the fingers and toes,
seizures
4. Sweating
5. Palpitations
6. Air hunger, dyspnea
7. Possible Chvostek and trousseaus if calcium drops
8. Tetany and convulsions (Hypocalcemia)
Tx:
1. Rebreathe air from a paper bag or cupped hands
2. Calm the patient
1. Mental confusion
2. Hyperactive reflexes
3. Tetany
4. Hypoventilation (Compensatory)
Treatment:
The difference between the number of cations (+) and anions (-) is
called the anion gap.
PaCO2 = 35-45
HCO3 = 22 – 26
pH = 7.32 PaCO2 = 48 HCO3 = 24. Only the pH & paCO2 are abnormal.
The kidneys will begin to excrete H+ and hold onto bicarb in an attempt to
compensate causing a partially compensated ABG:
1. Respiratory Acidosis
2. The patient has hyperventilated due to fear and anxiety and “Blown off”
their CO2.
a. Light-headedness, dizziness
b. Tingling and numbness of the fingers and toes
c. Sweating and palpitations
d. Air hunger, dyspnea
e. Chvostek and Trousseaus
f. Tetany and convulsions
4. Slow down the patient’s breathing, have them re-breathe CO2 from a
bag.
5. Other conditions which can cause this problem include: panic attacks,
fever, Oxygen deficiency, early salicylate toxicity, encephalitis,
anesthesia, and treatment for IICP.
1. Metabolic equal means that the pH and the HCO3 go in the same
direction if the problem is metabolic in nature.
2. This patient has metabolic alkalosis because their HCL acid is removed
by naso-gastric suctioning.
3. GI suctioning
3. His CO2 is low because they have been hyperventilating him with 100 %
via ambu bag.
6. The patient will increase their respiratory rate if at all possible to blow off
CO2 and correct the acidosis.
Case studies and quiz are under: Case studies: acid-base lecture