Nurses role in arterial puncture and abg analysis
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Transcript of Nurses role in arterial puncture and abg analysis
NURSES ROLE IN ARTERIAL PUNCTURE AND ABG ANALYSIS
STEPHY STANLY
Acid base status
Degree of oxygenation of blood and adequacy of alveolar ventilation
Continous arterial blood pressure monitoring in an emergency
Purposes
1ml or 2 ml disposable syringe 20 gauge disposable needles Heparin1;1000 Alcohol swab disposable gloves Arterial catheter for continous pressure
monitoring Tegaderm
Articles
Identify patient by name and explain procedure
Temperature
Heparinize 2 ml syringe
Wash hands wear gloves
Palpate the radial,brachial or femoral artery
Procedure
perform allen test
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.
apply firm pressure -for 5 mins.
air is removed and cap the syringe needle and keep it in a container of ice.
Arterial blood gas analysis is an essential part of diagnosing and
managing a patient’s oxygenation status and acid-base balance
ABG ANALYSIS
pH = Pka + log base/acid
Acidemia – H+ conc in plasma is greater than normal
Alkalemia – H + conc in plasma is less than normal
Buffer
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
ABG ERRORS
Normal PH : 7.35 – 7.45 acidosis < 7.35 alkalosis > 7.45
STEP 1 - ASESS PH
Normal PaCO2- 35-45
High PaCO2 > 45 PH low Resp acidosis
Low PaCO2 < 35 PH high Resp alkalosis
STEP 2 – ASSESS PaCO2
Normal HCO3 – 22-28 meq/L
PH low HCO3 low Metabolic acidosis
PH high HCO3 high Metabolic alkalosis
STEP 3 – HCO3
Determine if there is a compensatory, mechanism working to try to correct the pH. Values of HCO3 and CO2
Step 4:
Analyse the partial pressure of oxygen and saturation
Step 5
Normal Values(At sea level)
Range:
pH 7.35--‐7.45
pCO2 35--‐45mmHg
pO2 80--‐100mmHg
O2Saturation 95--‐100%
HCO3
Base Excess
22--‐26mEq/L
+or--‐2
ABG's: pH 7.31 PCO2 55 mm Hg HCO3
- 28 mEq/L
Qiuz 1
Ans
uncompensated respiratory acidosis
ABG's: pH 7.31 PCO2 55 mm Hg HCO3- 35 mEq/L
Compensated respiratory acidosis
Ph- 7.30 Pco2 -30 Po2-68 O2 sat- 92% HCO3-14
Compensated metabolic acidosis
Ph -7.18 Pco2 44 Po2-92 O2 sat-95% Hco3-16
Uncompensated metabolic aciosis
Ph- 7.27 Pco2-53 Po2-50 O2 sat-79% HCO3-24
Uncompensated respiratory acidosis with hypoxemia