AIELLO ABG Interpretation Quiz

AIELLO ABG INTERPRETATION QUIZ 1. pH: 7.29 CO2: 49 mmHg HCO3: 27 mEq PaO2: 78 mmHg a. b. c. d. Respiratory Alkalosis Respiratory Acidosis Metabolic Alkalosis Metabolic Acidosis ANSWER: Respiratory Acidosis Correct Feedback Step one: look at the pH. Is the pH high or low? The patient’s pH is 7.29. This is lower than normal; therefore your patient has some type of acidosis. Is the acidosis related to a breathing problem (respiratory acidosis) versus a body/kidney problem (metabolic acidosis)? Proceed to the next step to determine what type of acidosis the patient has. Step two: Look at the CO2. Is the CO2 high or low? The patient’s CO2 is high. The pH is low and the CO2 is high. This appears to be respiratory acidosis. Proceed to step three to check the HCO3. Step three: look at the HCO3. Is the HCO3 high or low? The HCO3 is very close to normal; it’s not low and is one point above normal. This patient appears to have respiratory acidosis. Proceed to step four to match the pH, HCO3 and CO2. Material protected by copyright Step four: Match the pH, CO2 and HCO3 Match the pH, HCO3 and CO2: Using the acronym R.O.M.E or the analysis table, we also know that when the movement of pH is opposite to the movement of CO2 (R=Respiratory and O= Opposite), the disorder is respiratory in nature. From step one, we determined that this imbalance is an acidosis. From step 4 we confirm that the disorder is respiratory. We thus have a respiratory acidosis. R.O.M.E method 2. pH 7.37 PCO2 57 HCO3 32 a. b. c. d. Respiratory acidosis without compensation Respiratory acidosis with compensation Metabolic Alkalosis acidosis with compensation Metabolic Acidosis without compensation ANSWER: Respiratory acidosis with compensation Correct Feedback The patient has a low pH (acidemia) • The PCO2 is high (respiratory acidosis) and the bicarbonate is high (metabolic alkalosis). The low pH in combination with the high PCO2 tells us that the respiratory acidosis is the primary process. • The metabolic alkalosis is the compensatory process. • Summary: A chronic respiratory acidosis with a compensatory 3. pH: 7.25 CO2: 50 mmHg HCO3: 26 mEq PaO2: 150 mmHg a. b. c. d. Respiratory Alkalosis Respiratory Acidosis Metabolic Alkalosis Metabolic Acidosis ANSWER: Respiratory Acidosis Correct Feedback Step 1: pH is 7.25. Is the pH normal? No- this pH indicates acidosis. Step 2: CO2 is 50 mmHg. Is the CO2 normal? No – it is high, this must be respiratory acidosis. Step 3: HCO3 is 26 mEq. Is the HCO3 normal? Yes- It is within normal limits; therefore this is NOT a metabolic disorder. Step 4: Match the pH, HCO3 and CO2. Using the acronym R.O.M.E. or the analysis table we can confirm that this is a respiratory disorder, since the movement of the pH is opposite to the movement of CO2 (R=O). The movement of the pH was down, but the movement of the CO2 was up. Step 5: PaO2 is 150 mmHg. Is the PaO2 normal? No - it’s too high and needs correction. 4. pH 7.45 PCO2 49 HCO3 - 34. a. b. c. d. Respiratory Alkalosis with compensation Respiratory Acidosis Metabolic Alkalosis with compensation Metabolic Acidosis ANSWER: Metabolic Alkalosis with compensation Correct Feedback The patient has a high pH (alkalemia) • The PCO2 is high (respiratory acidosis) and the bicarbonate is high (metabolic alkalosis). The high pH and the high bicarbonate tell us that the metabolic alkalosis is the primary process. • The anion gap is 10. This is a normal value • The respiratory acidosis is the compensatory process • The delta gap is 10 – 12 = -2. The delta delta is -2 + 34 = 32. This value is above 26 and tells us that a metabolic alkalosis is present. This is the same process that was identified in the second step above. • Summary: A primary metabolic alkalosis with respiratory compensation 5. pH 7.25 PCO2 68 HCO3 - 31. a. b. c. d. Respiratory Alkalosis with compensation Respiratory Acidosis with compensation Metabolic Acidosis with compensation Metabolic Acidosis ANSWER: Respiratory Acidosis with compensation Correct Feedback The patient has a low pH (acidemia) • The patient has a high PCO2 (respiratory acidosis) and a high bicarbonate (metabolic alkalosis). The combination of the low pH and the high PCO2 tells us that the respiratory acidosis is the primary process. • The metabolic alkalosis is the compensatory process. The pH is still low despite this metabolic compensation • Summary: Primary respiratory acidosis with compensatory metabolic alkalosis. 6. pH: 7.76 CO2: 55 HCO3: 28 a. b. c. d. Respiratory Alkalosis with compensation Respiratory Acidosis with compensation Metabolic Alkalosis with compensation Metabolic Acidosis ANSWER: Metabolic Alkalosis with compensation Correct Feedback: Partially Compensated Metabolic Alkalosis 7. pH: 7.46 CO2: 31 HCO3: 17 a. b. c. d. Respiratory Alkalosis without compensation Respiratory Acidosis with compensation Metabolic Alkalosis with partial compensation Metabolic Acidosis ANSWER: Respiratory Alkalosis without compensation Correct Feedback:Acute (uncompensated) primary respiratory alkalosis 8. pH: 7.41 CO2: 47 HCO3: 34 a. b. c. d. Respiratory Alkalosis Respiratory Alkalosis with compensation Metabolic Alkalosis with compensation Metabolic Acidosis with compensation ANSWER: Metabolic Alkalosis with compensation 9. On the normal oxyhemoglobin curve, if the O2 saturation is 88%, it would correlate with a PaO2 of ? a. 60 mm Hg b. 80 mm Hg c. 90 mm Hg d. 100 mm Hg ANSWER: 60 mm Hg: ABG interpretation is the definitive tool for respiratory disorders? True/False:This statement is true