Nurses role in arterial puncture and abg analysis
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Nurses role in arterial puncture and abg analysis
- 2. Acid base status Degree of oxygenation of blood and adequacy of alveolar ventilation Continous arterial blood pressure monitoring in an emergency
- 3. 1ml or 2 ml disposable syringe 20 gauge disposable needles Heparin1;1000 Alcohol swab disposable gloves Arterial catheter for continous pressure monitoring Tegaderm
- 4. Identify patient by name and explain procedure Temperature Heparinize 2 ml syringe Wash hands wear gloves Palpate the radial,brachial or femoral artery
- 5. perform allen test
- 6. palpate for maximum pulsation at 45-60 degreee angle once the artery is punctured ,arterial pressure will push up the piston of the syringe and a pulsating flow of blood will fill the syringe.
- 7. apply firm pressure -for 5 mins. air is removed and cap the syringe needle and keep it in a container of ice.
- 8. Arterial blood gas analysis is an essential part of diagnosing and managing a patient’s oxygenation status and acid-base balance
- 9. pH = Pka + log base/acid Acidemia – H+ conc in plasma is greater than normal Alkalemia – H + conc in plasma is less than normal
- 10. Excess heparin : low pH, PCO2 & HCO3 Contamination with room air : PaO2, pH, PaCO2 Delayed analysis : By 10 mts – pH decreases by 0.01 PCO2 increases by 1 mmHg O2 conc decreases by 0.001
- 11. Normal PH : 7.35 – 7.45 acidosis< 7.35 alkalosis > 7.45
- 12. Normal PaCO2- 35-45 High PaCO2 > 45 PH low Resp acidosis Low PaCO2 < 35 PH high Resp alkalosis
- 13. Normal HCO3 – 22-28 meq/L PH low HCO3 low Metabolic acidosis PH high HCO3 high Metabolic alkalosis
- 14. Determine if there is a compensatory, mechanism working to try to correct the pH. Values of HCO3 and CO2
- 15. Analyse the partial pressure of oxygen and saturation
- 16. Normal Values (At sea level) Range: pH 7.35--‐7.45 pCO2 35--‐45 mmHg pO2 80--‐100 mmHg O2 Saturation 95--‐100% HCO3 Base Excess 22--‐26 mEq/L +or--‐2
- 17. ABG's: pH 7.31 PCO2 55 mm Hg HCO3 - 28 mEq/L
- 18. Ans uncompensated respiratory acidosis
- 19. ABG's: pH 7.31 PCO2 55 mm Hg HCO3- 35 mEq/L
- 20. Compensated respiratory acidosis
- 22. Ph- 7.30 Pco2 -30 Po2-68 O2 sat- 92% HCO3-14
- 23. Compensated metabolic acidosis
- 24. Ph -7.18 Pco2 44 Po2-92 O2 sat-95% Hco3-16
- 25. Uncompensated metabolic aciosis
- 26. Ph- 7.27 Pco2-53 Po2-50 O2 sat-79% HCO3-24
- 27. Uncompensated respiratory acidosis with hypoxemia