Question

Group 2-ABGs

You are the R.N. caring for a 72-year-old woman with severe emphysema. Today she was walking at a mall when she suddenly grabbed her right side and gasped, “Oh, something just popped.” She whispered to her walking companion, “I can't get any air.” Her companion yelled for someone to call 911 and helped her to the nearest bench. By the time the rescue unit arrived, she was stuporous and in severe respiratory distress. She was intubated, started on intravenous lactated Ringer's at KVO (keep vein open), and transported to the nearest emergency department (ED). On arrival at the ED, you auscultate muffled heart tones, no breath sounds on the right, and faint sounds on the left. She is stuporous, tachycardiac, and cyanotic. The paramedics inform you that it was difficult to ventilate her. A portable chest x-ray (CXR) examination shows an 80% pneumothorax on the right.

Arterial Blood Gases (ABGs) on 100% O2:

pH	7.25
PaCO2	92 mm Hg
HCO3	27 mEq/l
PaO2	32 mm HG
SpO2	53%

1. Interpret the ABGs and explain the reason for the ABG results? (USLO 1, 6)

Answer 1

The patient is suffering from respiratory acidosis because pH is less than 7.35 and pco2 is 92 mm of Hg. Normal value of pH is 7.35-7.45 and pco2 is 35-45 mm of Hg.
Hco3 is in normal range.

Respiratory acidosis is a condition that occurs when the lungs cannot remove all of the carbon dioxide the body produces. This causes body fluids, especially the blood, to become too acidic.

Respiratory acidosis involves a decrease in respiratory rate and/or volume (hypoventilation). Common causes include impaired respiratory drive (eg, due to toxins, CNS disease), and airflow obstruction (eg, due to asthma, COPD [chronic obstructive pulmonary disease], sleep apnea, airway edema).