Abg analysis

ABG is a examination procedure test used for oxygen assessment of the body and its metabolismthis ppt can be used by the nursing students for the evaluation of the ABG report and its interpretation for better ventilatory management and for study and learning regarding abg analysis by gnm and bsc nursing students

1. ABG ANALYSIS DEPARTMENT OF MEDICAL SURGICAL NURSING

2. Learning Objectives At the end of this lecturer, students should be able to: define ABG analysis enlist the purpose of ABG analysis explain the terms related to acid and base analysis. describe the respiratory and metabolic, acidosis and alkalosis.

3. DEFINITION Measurements of blood pH and of arterial oxygen and carbondioxide tensions are obtained when managing patients with respiratory problems and in adjusting oxygen therapy as needed .

4. The arterial oxygen tension (PaO2) indicates the degree of oxygenation of the blood, and the arterial carbon dioxide tension(PaCO2) indicates the adequacy of alveolar ventilation.

5. Patients need ABG analysis Patient with severe blood loss/ hemorrage Respiratory failure/arrest COPD, ARDS, shock Asthama Patient is on VENTILATORY support Kidney failure Cardiac arrest Any drugs overdoses etc.

6. Purpose of ABG Analysis Aids in establishing a diagnosis Helps guide treatment plan Aids in ventilator management Improvement in acid/base management Acid/base status may alter electrolyte levels critical to patient status/care.

7. From where we obtain blood Arterial blood gas levels are obtained through an arterial puncture at the radial, brachial, femoral artery through an indwelling arterial catheter

8. Technical Errors Excessive Heparin Ideally : Pre-heparinised ABG syringes Syringe FLUSHED with 0.5ml 1:1000 Heparin & emptied Do Not Leave Excessive Heparin In The Syringe Heparin Dilutional Hco3 - Effect Pco2

9. Technical Errors Risk of alteration of results with: size of syringe/needle vol of sample Syringes must have > 50% blood Use only 3ml or less syringe 25% lower values if 1 ml sample taken in 10 ml syringe (0.25 ml heparin in needle)

10. Air Bubbles pO2 150 mm Hg & pCO2 0 mm Hg Contact with AIR BUBBLES Seal syringe immediately after sampling Body Temperature Affects values of pCO2 and HCO3 - only ABG Analyser controlled for Normal Body temperatures

11. WBC Counts 0.01 ml O2 consumed/ dL /min Marked increase in high TLC/ plt counts : pO2 Chilling / immediate analysis 

12. ABG component pH : measures hydrogen ion concentration in the blood, it shows blood’ acidity or alkalinity PCO2 : It is the partial pressure of CO2 that is carried by the blood for excretion by the lungs, known as respiratory parameter PO2 : It is the partial pressure of O2 that is dissolved in the blood , it reflects the body ability to pick up oxygen from the lungs HCO3 : known as the metabolic parameter, it reflects the kidney’s ability to retain and excrete bicarbonate

13. Normal values: pH = 7.35 – 7.45 PCO2 = 35 – 45 mmHg PO2 = 80 – 100 mmHg HCO3 = 22 – 28 mEq /L

14. THE TERMS: ACIDS Academia Acidosis Respiratory :  CO 2 Metabolic:  HCO 3

15. BASES Alkalemia Alkalosis Respiratory:  CO 2 Metabolic:  HCO 3

16. RESPIRATORY ACIDOSIS:  ph,  CO 2,  Ventilation Causes CNS depression Pleural disease COPD/ARDS Musculoskeletal disorders

17. RESPIRATORY ALKALOSIS:  pH,  CO 2,  Ventilation  CO 2  HCO 3 (  Cl to balance charges hyperchloremia) Causes Intracerebral hemorrhage Salicylate and Progesterone drug usage

18. Anxiety,  lung compliance Cirrhosis of the liver

19. METABOLIC ACIDOSIS:  PH,  HCO 3 Causes: diarrhea, lower intestinal fistulas, ureterostomies, and use of diuretics; early renal insufficiency; excessive administration of chloride; and the

20. administration of parenteral nutrition without bicarbonate or bicarbonate-producing solutes (e.g., lactate).

21. Summary So far we have discussed about Definition, purpose, terms of ABG analysis.

22. Bibliography Lewis et al, Medical Surgical Nursing, Mosby Elsevier,7 th edition. Joyce.M.Black et al, Medical Surgical Nursing, Saunders publication. Brunner and Siddhartha, Medical Surgical Nursing, Lippincott Williams and Wilkins.

23. Thank You