Acid Base

Given a normal HCO3, what is the expected pH for a PaCO2 of 15 mmHg?

7.65

For every _____ mmHg rise in PaCO2, the HCO3 will naturally increase by 1 mEq/L

10 mm Hg

The femoral artery is the least preferred arterial sampling site because

It is a relatively deep artery. It lies adjacent to the femoral nerve and vein. It does not have collateral blood flow.

The most commonly used arterial sampling sites include:

Radial artery Brachial artery Femoral artery

A nurse checks the arterial blood gas (ABG) results of an older adult and finds that the patient's pH is 7.34, PaCO2 is 46 and if compensated then the HCO3 is 27. What is the nurse's interpretation of the patient's condition by looking at these values.

Respiratory acidosis RATIONALE: The given scenario confirms that the patient has developed respiratory acidosis. ABG results for respiratory acidosis are pH <7.35 and PaCO2 >45. If compensated, then the HCO3 >26 meq/L

This patient has smoked for over 40 years and has advanced lung disease. What acid-base imbalance would the nurse anticipate seeing with the arterial blood gases?

Respiratory acidosis. RATIONALE: Respiratory acidosis is seen in the patient with lung disease.

After releasing occlusive pressure on the ulnar artery while performing a modified Allen's test, you should notice a flushing of the hand within.

15 seconds.

What is the normal HCO3 level in blood?

22 to 26 mEq/L RATIONALE: The normal HCO3 level in blood is 22 to 26 mEq/L

What is the normal PaCO2 level in blood?

35-45 mm Hg

For every _____ mmHG decline in PaCO2 the HCO3 will naturally decrease by 1 mEq/L

5 mm Hg

Given a normal HCO3, what is the expected pH for a PaCO2 of 85 mm Hg?

7.13

Given a normal HCO3, what is the expected pH for a PaCO2 of 65 mm Hg?

7.25

Which of the following items will you need to perform a radial artery puncture?

Gloves A 20 to 22 gauge, short beveled needle Sterile gauze

Which of the following is the most common complication associated with the puncture of an artery?

Hematoma

The nurse is caring for a patient with an acid-base imbalance. Which respiratory condition can cause respiratory alkalosis? **Consider if CO2 is retained or released**

Hyperventilation. RATIONALE: Hyperventilation causes respiratory alkalosis from the body blowing off CO2

Which is true regarding uncompensated arterial blood gas? select all that apply. **Do not confuse uncompensated with partially or fully compensated.**

In uncompensated ABG, PaCO2 or HCO3 is abnormal. RATIONALE: PaCO2 or HCO3 is abnormal in uncompensated ABG In Uncompensated ABG, there is no indication that the renal or respiratory system has tried to correct the imbalance. RATIONALE: When there is a condition of uncompensated ABG, indications of the renal or respiratory systems trying to correct the imbalance are absent. In uncompensated ABG, pH is abnormal. RATIONALE: The pH is abnormal in uncompensated ABG.

The radial artery is the preferred arterial sampling site because:

It has collateral blood flow.

Respiratory modalities that pertain to ventilation and oxygenation include:

Oxygen therapy Mechanical ventilation Positive end expiratory pressure Continuous positive airway pressure.

The nurse is caring for a patient with a low PaO2 level. Which is correct regarding oxygenation and PaO2? select all that apply. **PaO2 stands for partial pressure arterial oxygen.**

PaO2 value indicates the arterial pressure of oxygen in arterial blood and is the most important factor in determining how oxygen binds to hemoglobin. RATIONALE: PaO2 measures the partial pressure of oxygen in arterial blood and is the most important factor in determining how oxygen binds to hemoglobin. PaO2 values, when high, indicate more oxygen in able to bind with hemoglobin. RATIONALE: When PaO2 is high, more oxygen is able to bind with hemoglobin. PaO2 values, when low, indicate less oxygen is able to bind with hemoglobin. RATIONALE: When PaO2 is low, less oxygen is able to bind with hemoglobin.

A nurse is providing a non-pulmonary treatment to a patient who has developed respiratory acidosis postsurgery. Which treatment is an example of nonpulmonary treatment? **Differentiate between pulmonary treatments and nonpulmonary treatments.

Providing heart failure treatment like diuretics for decreasing fluid in the lungs. RATIONALE: When a nurse provides heart failure treatment like diuretics for decreasing fluid in the lungs, it is an example of possible nonpulmonary treatment.

Which of the following best explains the reason for not squeezing the sampling site when obtaining a capillary blood gas sample?

Squeezing the sampling site may de-arterialize the sample.

Which of the following will occur if a blood gas sample is analyzed at a temperature that is below 37 degrees C

The PaO2 and PaCO2 will be falsely decreased.

Which of the following will occur if a blood gas sample is analyzed at a temperature that is higher than 37 degrees C

The PaO2 and PaCO2 will be falsely increased

Which of the following may occur if there is a delay in icing a blood gas sample

The PaO2 may decrease The PaCo2 may increase

Which of the following may occur if air or air bubbles are not removed from a blood gas sample?

The PaO2 may increase The PaO2 may decrease The PaCO2 may decrease

Arterial blood provides information about:

The adequacy of ventilation The adequacy of oxygenation The acid-base status of the blood.

A negative modified Allen's test is one in which

The hand does not flush within the specified time period.

Which statement is incorrect regarding the characteristics of a renal buffer? **Do not confuse renal buffers with respiratory buffers**

The renal buffer is the least effective, yet fastest acting, buffer system. RATIONALE: The renal buffer is the most effective, yet the slowest acting, buffering system.

A negative modified Allen's test means that:

There is not collateral blood flow supplying the hand.

The reason for waiting a specific time interval before obtaining an arterial blood gas sample after a change in oxygen therapy has been made is:

To allow a steady state to be reached.

Which of the following best explains the reason for placing a metal flea into the capillary tube containing a capillary blood gas sample and running the flea up and down the sides of the capillary tube?

To mix the blood with heparin which will prevent clotting of the sample.

Which of the following best explains the reason for mixing heparin with a blood gas sample?

To prevent clotting of the blood

Before obtaining an arterial blood gas sample, the practitioner should:

Verify that an order has been written for the procedure. Ensure that the patient is on the correct respiratory modality Gather all supplies that will be needed for the procedure.

Hazards associated with the puncture of an artery include:

Vessel obstruction Infection Arteriospasm

A nurse is checking the arterial blood gas (ABG) results of an older adult who has developed postsurgical acid-base imbalance. Which ABG result confirms that the patient has developed metabolic acidosis? **Do not confuse with respiratory acidosis**

pH <7.35 and HCO3 <22 if compensated, then the PCO2 <35 mm Hg RATIONALE: ABG results for metabolic acidosis are pH <7.35 and HCO3 <22. If compensated, then the PCO2 <35 mm Hg