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Stuff for Nurses

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  1. 1. Blood GasesBLOOD GASES Normal ValuesArterial (Sea Level) pH 7.35-7.45 PaO2* 80-100 mm Hg PaCO2 32-48 mm Hg HCO3 22-26 mEq/L O2 saturation > 95%*In a patient > 60 years old, PaO2 is equal to 80 mm Hg minus 1 mm Hg for every year over 60.Expected PaO2 = FIO2 × 5.Interpreting Arterial Blood Gases (ABGs)1 Check pH ↑ = Alkalosis; ↓ = acidosis 2 Check PaCO2 ↑ = CO2 retention (hypoventilation); respiratory acidosis or compensating for metabolicalkalosis ↓ = CO2 blown off (hyperventilation); respiratory alkalosis or compensating for metabolicacidosis3 Check HCO3 ↑ = Nonvolatile acid is lost; HCO3 gained (metabolic alkalosis or compensating forrespiratory acidosis) ↓ = Nonvolatile acid is added; HCO3 is lost (metabolic acidosis or compensating forrespiratory alkalosis)4 Determine imbalancesDefinition and Sources of Variation in ECG Waveforms and Intervals* Description Normal Duration(sec) Source of Possible VariationDefinition and Sources of Variation in ECG Waveforms and Intervals* Description Normal Duration (sec)Source of Possible VariationP wave Represents time for the passage of the electrical impulse through the atrium causing atrialdepolarization (contraction); should be upright 0.06-0.12 Disturbance in conduction within atriaPR interval Measured from beginning of P wave to beginning of QRS complex; represents time taken forimpulse to spread through the atria, AV node and bundle of His, the bundle branches, and Purkinjefibers, to a point immediately preceding ventricular contraction 0.12-0.20 Disturbance in conductionusually in AV node, bundle of His, or bundle branches but can be in atria as well QRS interval Measured from beginning to end of QRS complex; represents time taken for depolarization(contraction) of both ventricles (systole) < 0.12 Disturbance in conduction in bundle branches or inventriclesST segment Measured from the S wave of the QRS complex to the beginning of the T wave; representsthe time between ventricular depolarization and repolarization (diastole); should be isoelectric (flat)0.12 Disturbances usually caused by ischemia or infarction
  2. 2. T wave Represents time for ventricular repolarization; should be upright 0.16 Disturbances usuallycaused by electrolyte imbalances, ischemia, or infarctionQT interval Measured from beginning of QRS complex to end of T wave; represents time taken for entireelectrical depolarization and repolarization of the ventricles 0.34-0.43 Disturbances usually affectingrepolarization more than depolarization and caused by drugs, electrolyte imbalances, and changes inheart rate