MLS LESSON 11

the arterial puncture

is used to collect blood specimen for arterial blood gas (ABG) analysis to manage cardiopulmonary disorders and maintain the acid-base balance of the body.

arterial blood

is ideal specimen for the respiratory function evaluation due to the consistency of its composition and high oxygen content.

respiratory disorders

The evaluation of the Arterial Blood Gas (ABGs) is performed to diagnose?

(1) oxygenation, (2) ventilation, and (3) acid-base balance

The testing (evaluation of the arterial blood gas) provides information about the _____ _____ ______ which helps in the management of the disease.

preanalytical error

The accuracy of the results is easily affected by?

7.35-7.45

pH normal range

pH

A measure of acidity or alkalinity of blood (acidosis or alkalosis)

80-100 mm Hg

PaO2 normal range

PaO2

Partial pressure of O2 dissolved in arterial blood

35-45 mm Hg

PaCO2 normal range

PaCO2

Partial pressure of CO2 dissolved in arterial blood

22-26 mEq/L

HCO2 normal range

HCO2

A measure of bicarbonate in blood

97%- 100%

normal range of O2 saturation

O2 saturation

Percent O2 bound to hemoglobin

-2 to +2 mEq/L

Base excess normal range

base excess

a calculation of non respiratory part of acid-base balance

portable ultrasound instrument or by modified Allen test.

how can The potential site can be evaluated in arterial puncture?

accessible and large

The artery should be ______ and _____ in size so it is easy puncture.

more than one artery

There is collateral circulation or the site gets its blood supply from_____________

little risk of being injured

The surrounding tissue of the puncture site should have ___________ during the procedure

rolling , after the procedure.

The area should also help in keeping the artery from _____ and the pressure can be applied easily in the area _____ ____ _______.

inflammation, irritation, edema, hematoma, lesion, and wound.

The area should be free from __ __ __ ______ ______ ____ _____.

AV shunt

There should be no _ _ near the site or there are no recent arterial puncture.

scalp and hair for infants and the dorsalis pedis arteries for adults

Other sites that could be used for arterial puncture include the?

antiseptic

for site cleaning

Local anesthetic

to numb the site (optional)

Sharp, short-bevel

___ ______ _____ hypodermic needle with safety feature

1- to 5-mL

self-filling syringe (mL)

Luer-tip normal or bubble removal cap

to cover the end of the needle after needle removal

Coolant (when applicable)

to maintain the temperature of the specimen

2- by 2-inch gauze squares

to hold pressure

Self-adhering gauze bandage

to wrap the site

Puncture-resistant

sharps container for proper disposal

current body temperature, respiratory rate, ventilation status, fraction of inspired oxygen (FIO2), and prescribed flow rate in liters per minute.

required requisition information for ABG test results

the modified allen test

To determine if the patient has collateral circulation, the ____ _______ _____ is performed prior to collection.

(+)

if hand flushes pink allens test

(-)

if hand does not flush pink; allens test

Arteriospasm

involuntary contraction or twitching of an artery

Artery damage

Results from repeated punctures on the same site

Discomfort

can be avoided by using local anesthesia as ordered by the physician

infection

observe proper preparation in the pre-analytical phase.

Hematoma

avoid multiple puncture on a single site

numbness

should be addressed and reported immediately to the nurse or physician

thrombus formation

must be reported to the nurse or physician immediately

- the development of a blood clot (thrombus) inside a vessel

vasovagal response

Remove the needle, activate the safety device, maintain pressure over the site, and follow the syncope procedure

- a common, generally benign, reflex that causes a sudden drop in heart rate and blood pressure, often resulting in fainting (syncope).