ABGs Respiratory Acidosis pH < 7.35, PaCO2 > 45 Respiratory Opposite (pH & CO2 move in opposite direction ↓↑) Notice: Opposite Directions STEP #1: ↓ pH STEP #2: HIGH PaCO2 (>45) STEP #3: LOW HCO3- (<22) -> Respiratory Acidosis HIGH HCO3- (>26) -> Metabolic Alkalosis LOW PaCO2 (<35) -> Metabolic Acidosis HIGH PaCO2 (>45) -> Respiratory Acidosis Causes: Hypoventilation Respiratory depression (e.g., narcotics, head injury) Respiratory muscle weakness (e.g., ALS) COPD Pneumonia Pulmonary Edema Drowning Treatments: Reposition the patient Maintain patent airway Ventilation as needed to remove excess CO2 Signs/Symptoms: Bradycardia Hypotension Agitation Confusion Combativemess Lethargy Coma Think altered mental status, respiratory issues, retaining CO2 VS. Respiratory Alkalosis pH > 7.45, PaCO2 < 35 Respiratory Opposite (pH & CO2 move in opposite direction ↑↓) Notice: Opposite Directions STEP #1: ↑ pH STEP #2: LOW PaCO2 (<35) STEP #3: HIGH HCO3- (>26) -> Metabolic Alkalosis LOW HCO3- (<22) -> Metabolic Acidosis HIGH PaCO2 (>45) -> Respiratory Acidosis LOW PaCO2 (<35) -> Respiratory Alkalosis Causes: Hyperventilation Hypometabolic states Fever Anxiety (Think: tachypnea) Hypoxia (Think: breathing faster to get oxygen) Sepsis (Think: breathing faster to get oxygen) Flailing Fear Pain Pneumothorax Treatments: Control breathing Sedatives PRN Rebreather mask Correct for metabolic causes Signs/Symptoms: Tachycardia Anxiety Confusion Diaphoresis Dizziness Lightheadedness

Respiratory (ABG) Cheat Sheets

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