Has the body tried to fix the problem? The CO2 is outside its normal ranges. By the time your test comes up you should be an ABG interpretation expert. It is the dedication of healthcare workers that will lead us through this crisis. If not, then: a. 3) Acid-base balance or imbalance in extra-cellular fluid (ECF). A deficit of bicarbonate and other bases indicates metabolic acidosis. This is higher than normal, so we have an alkalosis. Normal is considered to be from 22 to 26 mmol/L. 4. However, low carbon dioxide levels in the blood also have a number of physical effects, including: The treatment for respiratory alkalosis depends on the underlying cause. Ultimately, the body is yet to fix the problem or has been unable to fix the problem. This is also called respiratory failure or ventilatory failure. If the pH is not within or close to the normal ranges, then a partial-compensation exists. Is the patient receiving enough oxygen? Once you’ve determined whether there is too much acid or too much base, you can move on to determine the cause of it. Metabolic acidosis is when there is a decrease in bicarbonates and a buildup of lactic acid occurs. Interpret the results as follows: Lastly, we need to determine the compensation to accomplish our goal #3. However, the pH is not yet back within normal ranges so a partial compensation exists. So the body is trying to fix this problem. For  pH, the normal range is 7.35 to 7.45. Since we started in 2010, Nurseslabs has become one of the most trusted nursing sites helping thousands of aspiring nurses achieve their goals. 4. Base excess or BE value is routinely checked with HCO3 value. Kaufman, DA 2020, Interpretation of ABGs, American Thoracic Society, viewed 20 April 2020. These can include: If you need to practice your new skills acquired here, check out our Arterial Blood Gas Interpretation for NCLEX (40 Questions). The pH is 7.50. Following are the steps one should follow when reading the Arterial Blood Gas and interpreting the values simultaneously: 1. ABGs Made Easy for Nurses w/ Tic Tac Toe Method for Arterial Blood Gas Interpretation - YouTube ABGs Tic Tac Toe Method for Nurses with QUIZ: … Swelling in the lower legs (peripheral edema). Interpretation of ABG Gas exchange Acid Base Status 12. 1. Respiratory acidosis is typically caused by an underlying disease or condition. Respiratory acidosis occurs when breathing is inadequate (alveolar hypoventilation) and the lungs are unable to excrete enough CO2 causing PaCO2 or respiratory acid builds up. The third step of this technique is to determine the acidity or alkalinity of the blood with the given value of the pH as our determining factor. The goals are as follows: We need to keep these goals in mind as they’ll come up later in the steps for the ABG interpretation technique. Our ultimate goal is to help address the nursing shortage by inspiring aspiring nurses that a career in nursing is an excellent choice, guiding students to become RNs, and for the working nurse – helping them achieve success in their careers! To assess how well it has been able to do this, we need to refer back to the pH. The “6 Easy Steps to ABG Analysis” are listed below for easy reference and will be explained in … Determine if PaCO2 is under NORMAL, ACIDOSIS, or ALKALOSIS. MINT Merch: https://teespring.com/stores/mint-nursing (Thank you for the support)Hey Guys!You are watching an educational video about interpreting ABGs. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire nursing students. Normal values for pH range from 7.35 - 7.45. November 27, 2018 August 3, 2019 Staff 0 Comments. ABG interpretation made easy So you are an intelligent RT student or RN who wishes to learn more about how to interpret ABGs. Deliver the blood sample immediately to the laboratory. An ABG Calculator, like the one above, is a piece of software that can be used to quickly calculate the interpretation of a sample set of ABG results. History 2. For instance, a pH of 3 is severely acidotic and requires emergency intervention. She graduated with an Associates degree in Nursing from Mercyhurst College Northeast in 2007 and lives in Erie, Pennsylvania in the United States. This site complies with the HONcode standard for trustworthy health information: Verify here. ABG Equipment 3 electrode system that measures three fundamental variables - pO2, pCO2 and pH All others parameters such as HCO3 - computed by software using standard formulae 11. Once you’ve determined whether the pH is under the ACIDOSIS or ALKALOSIS, plot it on your tic-tac-toe grid under the appropriate column. The normal ABG level for pH is 7.35 to 7.45. 6 Easiest Steps of ABGs interpretation. Arterial Blood Gas Interpretation for NCLEX (40 Questions), Creative ways to teach arterial blood gas interpretation, A Graphical Tool for Arterial Blood Gas Interpretation using Standard Bicarbonate and Base Excess, Assessing and interpreting arterial blood gases and acid-base balance, The interpretation of arterial blood gases, Nursing Test Bank and Nursing Practice Questions for Free, NCLEX Practice Questions Test Bank (2021 Update), Nursing Pharmacology Practice Questions & Test Bank for NCLEX (500+ Questions), Select All That Apply NCLEX Practice Questions and Tips (100 Items), IV Flow Rate Calculation NCLEX Reviewer & Practice Questions (60 Items), EKG Interpretation & Heart Arrhythmias Cheat Sheet. Metabolic alkalosis may not show any symptoms. All articles are developed in consultation with healthcare professionals and peer reviewed where necessary, undergoing a yearly review to ensure all healthcare information is kept up to date. In this guide, we’ll help you understand the concepts behind arterial blood gas and teach you the easiest and most fun way to interpret … pH is under ACIDOSIS, therefore solving for goal #1, we have ACIDOSIS. To determine the type of arterial blood gas the key components are checked. We need to look at the other component, being HCO3- in this case. The HCO3- is 32, which is high. From this baseline, you can then begin to recognise significant variations in a patient’s results, which could indicate clinical deterioration. The first test that should come to mind in a deteriorating patient is an ABG (Arterial Blood Gas). The following sources are used as references for this guide. Unlike other blood samples obtained through a vein, a blood sample from an arterial blood gas (ABG) is taken from an artery (commonly on radial or brachial artery). If the cause is respiratory in nature, the PaCO2 will be out of the normal range, whereas for metabolic problems the HCO3- will be abnormal. Determine if pH is under NORMAL, ACIDOSIS, or ALKALOSIS. It is used to determine the extent of the compensation by the buffer system and includes the measurements of the acidity (pH), levels of oxygen, and carbon dioxide in arterial blood. Carbon dioxide (CO2) cannot escape when there is damage in the alveoli, excess CO2 combines with water to form carbonic acid (H2CO3) causing an acidotic state. What are the components of arterial blood gas? Please use the diagram below to help you visualize whether the normal value is ACIDOSIS or ALKALOSIS. People with this type of alkalosis more often complain of the underlying conditions that are causing it. Alkalosis is the opposite. Remember that the normal range for PaCO2 is from 35 to 45: Next, we need to interpret if the value of HCO3 is within the NORMAL range, ACIDIC, or BASIC and plot it under the appropriate column in the tic-tac-toe grid. Remember in step #1 that the normal pH range is from 7.35 to 7.45. An arterial blood gas (ABG) is a test that measures the blood levels of oxygen and carbon dioxide as well the level of acid-base (ph) in the body. The best (and fun) way of interpreting arterial blood gas is by using the tic-tac-toe method below: For the purpose of this guide, we have set three (3) goals that we need to accomplish when interpreting arterial blood gases. So the body is trying to fix the problem. Creating an account is free, easy, and takes about 60 seconds. What is the primary disorder present? This happens in diarrhea, ketosis, and kidney disorders. If the blood is basic, the HCO3 level is considered because the kidneys regulate bicarbonate ion levels. Arterial Blood Gas Interpretation Made Easy This poster offers a basic level of understanding of ABGs for medical students. We can investigate this by looking at the opposing component of the problem. Acidotic 7.35 pH 7.45 Alkalotic. The first value is the pH, which measures how many hydrogen ions (H+) are in the sample. For PaO2, the normal range is 75 to 100 mmHg, SO2 or oxygen saturation, measured in percentage, is the amount of oxygen in the blood that combines with hemoglobin. pH of 7.26 ABNORMAL and under ACIDOSIS, so we place pH under ACIDOSIS. Common sites for drawing arterial blood are the radial and brachial artery. 2017). pH of 7.44 is NORMAL but leaning towards ALKALOSIS, therefore solving for goal #1, we have ALKALOSIS. This can occur in excessive vomiting, dehydration, or endocrine disorders. Dialysis for chronic renal failure. What is the Oxygenation status 3. Nurse Salary 2020: How Much Do Registered Nurses Make? Gaines, K 2020, ‘Know Your ABHs - Arterial Blood Gases Explained’, Nurse.org, viewed 20 April 2020. For PaCO2, the normal range is 35 to 45 mmHg (respiratory determinant). The control of metabolic acidosis in hemodialysis is mainly focused on the supply of bicarbonate during the dialysis sessions. Let’s give ourselves another reference point that will help to prevent confusion later. The normal range for ABGs is used as a guide, and the determination of disorders is often based on blood pH. Usefulness. We need to look at the other component, in this case, what is the CO2? To determine acid-base imbalance, you need to know and memorize these values to recognize what deviates from normal. 7. ABG interpretation is easy Break it down into steps The first priority for the respiratory system is pH If partial pressure of carbon dioxide (pCO2) goes down, partial pressure of … The pH is 7.30. What is the pH? Note: ABGs should be thought of as a snapshot of how the body is interacting with its environment at a particular time. Log In Create Account. Signs and symptoms of respiratory acidosis are as follows: Medical and nursing management of an arterial blood gas of respiratory acidosis includes the following: Respiratory alkalosis can result from hyperventilation since the lungs excrete too much carbonic acid which increases pH. If pH is under the ALKALOSIS column, it is ALKALOSIS. This self-learning packet will examine the made no attempt to help normalise the pH. If the pH is back within normal ranges then a full-compensation has occurred. It can be measured indirectly by calculating the PAO2 and pH Or measured directly by co-oximetry. The normal range for PaCO2 is 35 to 45 mmHg. Yes, normal HCO3- is between 22-28. It’s 47, which is high. The kidneys activate its compensatory process (albeit slow, often 24 hours or more) by increasing the excretion of metabolic acids through urination, which increases blood bicarbonate. Students can work around the table, looking at pH, then CO2 and then HCO3- … pH is NORMAL, therefore solving for goal #3, we have a FULLY COMPENSATED ABG. The usefulness of this diagnostic tool is dependent on being able to correctly interpret the results. If the other level (or component) is within normal ranges, then the problem is non-compensated or uncompensated. A non-compensated or uncompensated abnormality usually represents an acute change occurring in the body. So we have metabolic alkalosis. Put the syringe with arterial blood in an ice-water bag to minimize the metabolic activity of the sample. This might seem counterintuitive, but let’s start with what we’ve memorized. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics. Second, we need to determine if values define METABOLIC or RESPIRATORY. PaCO2 or partial pressure of carbon dioxide shows the adequacy of the gas exchange between the alveoli and the external environment (alveolar ventilation). PaCO2 (Partial Pressure of Carbon Dioxide), Interpreting Arterial Blood Gas Imbalances, Steps in ABG analysis using the tic-tac-toe method. What else is acidotic? You may find them interesting for your additional reading: Nurseslabs.com is an education and nursing lifestyle website geared towards helping student nurses and registered nurses with knowledge for the progression and empowerment of their nursing careers. Arterial blood is usually drawn via the brachial or radial artery. pH of 7.1 is ABNORMAL and ACIDOSIS, therefore, we place pH under the ACIDOSIS column in the tic-tac-toe grid. If the blood is acidic, the PaCO2 or partial pressure of carbon dioxide in arterial blood is assessed because the lungs regulate the majority of acid. Q2) Is the problem of a respiratory or metabolic nature? If the blood pH is between 7.35 to 7.39, the interpretation is NORMAL but SLIGHTLY ACIDOSIS, place it under the NORMAL column. Treating the condition is a matter of rising carbon dioxide levels in the blood. Patients with arterial blood gas indicating metabolic acidosis are managed and treated by: Metabolic alkalosis occurs when bicarbonate ion concentration increases, causing an elevation in blood pH. Solve for goal #2: METABOLIC or RESPIRATORY. Test your knowledge on the web's most interactive blood gas learning tool. Since respiratory alkalosis occurs quickly, the kidneys do not have time to compensate. This calculator only differentiates between acute (pH abnormal) and compensated (pH normal). Note if the client is receiving oxygen therapy (flow rate, type of administration device), and the client’s current temperature. Is the pH back within normal ranges? Compensation can be seen when both the PCO 2 and HCO 3 rise or fall together to maintain a normal pH. Lastly, we need to determine the compensation if it is: FULLY COMPENSATED, PARTIALLY COMPENSATED, or UNCOMPENSATED. Step 2: Remind Yourself of pH. ABG Interpretation Made Easy Shawna LeBouthillier Fall 2019. A base excess of less than –2 is acidosis and greater than +2 is alkalosis. ABG = 7.50/34/90/21/95 → pH is high, HCO3 is low & CO2 is low (but it doesn’t matter that HCO3 is low because in alkalosis, HCO3 is supposed to be … An arterial blood gas is a laboratory test to monitor the patient’s acid-base balance. Put simply, when the numbers in an ABG result fall outside of these ranges, you can then determine what type of problem the patient is experiencing. The extra CO2 combines with water to form carbonic acid, causing a state of acidosis — a common occurrence in emphysema. 5. They should always be interpreted as part of a wider assessment of a patient’s respiratory function and in line with your organisation’s policies. If it outside range, then it is uncompensated or partially compensated. ABG Interpretation. I’ve also got a bonus cheat sheet for you to help walk you through each of these steps. It explains each component in turn followed by clinical examples to work through. On the other hand, when there is alveolar hyperventilation (e.g., hyperventilation), the PaCO2 is decreased causing respiratory alkalosis. Has the body done a good job at fixing the problem? Hydration for diabetic ketoacidosis. This test will give you an instant view of the patient’s physiology. There are eight (8) steps simple steps you need to know if you want to interpret arterial blood gases (ABGs) results using the tic-tac-toe technique. Interpreting ABGs (Arterial Blood Gases) Made Easy | Ausmed. Part 1: Arterial Blood Gas Interpretation Practice Quiz (20 Items) Part 2: Arterial Blood Gas Interpretation Practice Quiz (20 Items) Guidelines. That in mind, and based on popular demand, here is ABG interpretations made easy (For simplicity reasons I will only refer to the three basic ABG values in this post: pH (acid base balance), CO2 (carbon dioxide) and HcO3 (bicarbonate). Arterial blood gasses, or ABGs, are among the more complex assessments performed by clinical healthcare professionals. Arterial Blood Gas Interpretation: ABGs made easy! Using a heparinized needle and syringe, collect 1 to 5 mL of arterial blood. See whether pH is within normal range or not. 2. Approach To Interpretation of ABG. Looking back again on the tic-tac-toe grid, determine if pH is under the same column as PaCO2 or HCO3 so we can accomplish our goal #2 of determining if the ABG is RESPIRATORY or METABOLIC. HCO3 or bicarbonate ion is an alkaline substance that comprises over half of the total buffer base in the blood. If pH is under the NORMAL column, determine whether the value is leaning towards ACIDOSIS or ALKALOSIS and interpret accordingly. One type of acid-base imbalance is acidosis wherein the blood is relatively too acidic (low pH). paO 2 <0.8 = hypoxia. Acidemiaor Alkalemia? Medlineplus 2018, Blood Gases, viewed 20 April 2020. Note if the client is taking anticoagulant therapy or aspirin as this may affect results. The body produces two types of acid, therefore, there are two types of acidosis: respiratory acidosis and metabolic acidosis. pH is NORMAL but is leaning towards ALKALOSIS, therefore under the same column as PaCO. If the ABG results reveal pH numbers are not within the normal range, the patient’s pH level is either acidotic or alkalotic. Table of Contents Arterial blood gas (ABG) interpretation is something that can be difficult to grasp initially (we’ve been there). When there is hypoventilation in the alveolar level (for example, in COPD), the PaCO2 is elevated, and respiratory acidosis results. When interpreting arterial blood gas (ABG) results, it is essential to know what ABG values are considered ‘normal’. Hyperventilation is a sign that respiratory alkalosis is most likely to occur. Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. PaO2 or partial pressure of oxygen or PAO2 indicates the amount of oxygen available to bind with hemoglobin. Check the PaCO2 – to rule out if it’s respiratory or metabolic (Respiratory Opposite). Despite their popular use, a lot of nurses still struggle to interpret an ABG. Arterial Blood Gas (ABG) interpretation for medical students, OSCEs and MRCP PACES This section presents how to interpret arterial blood gases. Arterial blood gas analysis is an essential part of diagnosing and managing a patient’s oxygenation status and acid-base balance. It only addresses acid-base balance and considers just 3 values. The pH plays a role in the combining power of oxygen with hemoglobin: a low pH means there is less oxygen in the hemoglobin. When acid-base imbalances occur, the body activates its compensatory mechanisms (the lungs and kidneys) to help normalize the blood pH. Interpret the results as follows: Let’s solve for the ABG interpretation with the examples below: Practice Problem #1:pH=7.26 | PaCO2=32 | HCO3=18, The answer to Practice Problem #1:Metabolic Acidosis, Partially Compensated, Practice Problem #2:pH=7.44 | PaCO2=30 | HCO3=21, The answer to Practice Problem #2:Respiratory Alkalosis, Fully Compensated, Practice Problem #3:pH=7.1 | PaCO2=40 | HCO3=18, The answer to Practice Problem #3:Metabolic Acidosis, Uncompensated. Just a reminder, it should be used for learning and practicing only and is not intended to be used in a real-life clinical setting. Any blood pH above 7.45 (7.46, 7.47, 7.48, and so on…) is ALKALOSIS, place it under the ALKALOSIS column. Neurological symptoms such as confusion, paresthesias, and cell membrane excitability occur when the blood pH, CSF, and ICF increases acutely. There are six components of arterial blood gas (ABGs): The pH is the concentration of hydrogen ions and determines the acidity or alkalinity of body fluids. It is PARTIALLY COMPENSATED if all three (3) values are abnormal. Easy Way on How to Interpret Arterial Blood Gases ABGs with Tic Tac Toe First, we need to lay the foundation and talk about what three lab values you need to look at when trying to figure out ABGs, how to determine if that value is consider normal, an acid, or basic (alkalotic), and what fancy terms are used once the ABG is figured out. So here are 3 steps to help you get ABG questions right in nursing school. Lynda is a registered nurse with three years experience on a busy surgical floor in a city hospital. After you’ve determined whether the sample is acidic or alkaline, you need to work out if it’s due to respiratory or metabolic causes. Upon Arterial Blood Gas ABG Interpretation Analysis, you could come to know, 1) Oxygenation of blood through gas exchange in the lungs. 5. We’ve created this guide, which aims to provide a structured approach to ABG interpretation whilst also increasing your understanding of each result’s relevance. Alternatively, when there is an increase in bicarbonates present, then metabolic alkalosis results. Chang, E, Daly, J & Elliot, D 2006, Pathophysiology Applied to Nursing Practice, 2nd edn, Mosby Australia, Port Melbourne, VIC, Australia. Finally, bicarbonate ions, or HCO3-, will tell you if the problem is related to metabolic changes in your patient and refers to the renal system (Berman et al. The major treatment of this condition is the initial rehydration. Gas exchange 13. If pH is under the ACIDOSIS column, it is ACIDOSIS. ABG interpretation is as easy as remembering four basic questions, and then answering them in sequence. Fortunately, there are some easy ways to remember how to decipher these important results. When interpreting ABG results, it is essential to know what ABG values are considered ‘normal’. Is the HCO3- outside its normal ranges? The first step is you need to familiarize yourself with the normal and abnormal ABG values when you review the lab results. The normal ABG values are the following: Interpreting arterial blood gases is used to detect respiratory acidosis or alkalosis, or metabolic acidosis or alkalosis during an acute illness. © 2021 Nurseslabs | Ut in Omnibus Glorificetur Deus! See Educator Profile. All three values are ABNORMAL, therefore solving for goal #3, we have a PARTIALLY COMPENSATED ABG. However, if the other component has gone outside its normal reference ranges, we can think of it as compensation occurring (the body is trying to fix the problem). Acid-base imbalances develop when a person’s normal homeostatic mechanisms are dysfunctional or overwhelmed. Whereas, in an alkalosis, to determine if the body is compensating, we’d look at what the PaCO2 is doing. Any blood pH below 7.35 (7.34, 7.33, 7.32, and so on…) is ACIDOSIS, place it under the ACIDOSIS column. The following strategies and tips are useful for respiratory alkalosis caused by over-breathing due to panic and anxiety. The kidneys compensate for respiratory acid-base imbalances while the respiratory system compensates for metabolic acid-base imbalances. ABG Quick Interpretation Parameter Acidosis Normal Alkalosis Reflects pH < 7.35 7.35-7.45 > 7.45 Acid/Base Status of Body pCO2 > 45 35-45 < 35 Respiratory Component HCO3 < 22 22-26 > 26 Metabolic Component Facts: Body will not overcompensate when it comes to acid/base balance so: pH midpoint is … The higher the pH, the more base is in the blood sample, which can disrupt the normal functioning of the body. Apply pressure to the puncture site for 5 minutes or longer. The next value is the carbon dioxide level, and this will tell you if the problem is respiratory in origin, as CO2 is regulated by the lungs (Berman et al. In her work, she took care of patients post operatively from open heart surgery, immediately post-operatively from gastric bypass, gastric banding surgery and post abdominal surgery. It has three main root causes: increased acid production, loss of bicarbonate, and a reduced ability of the kidneys to excrete excess acids. Steps to Interpret ABG 1. Interpretation of arterial blood gases (ABGs) is a crucial skill that a lot of student nurses and medical practitioners need to learn. What is an ABG? Check the pH (7.35 – 7.45) – in this part you are going to figure out if it’s acidosis (below 7.35) or alkalosis... 2. She also dealt with patient populations that experienced active chest pain, congestive heart failure, end stage renal disease, uncontrolled diabetes and a variety of other chronic, mental and surgical conditions. ABG analysis can be easy! 2017). Therefore, the “6 Easy Steps to ABG Analysis” was developed to provide nurses with an accurate and systematic method of easily interpreting arterial blood gases. Looking at the tic-tac-toe grid, determine whether in what column the pH is placed and interpret the results: In this step, we can accomplish goal #1 of determining ACIDOSIS or ALKALOSIS. The Arterial Blood Gas (ABG) Analyzer interprets ABG findings and values. pH of 7.1 is ACIDOSIS, therefore, solving for goal #1, we have ACIDOSIS. His situation drove his passion for helping student nurses by creating content and lectures that are easy to digest. An ABG is one of the most commonly used tests to measure oxygenation and blood acid levels, two important measures¹ of a patient’s clinical status and correct interpretation can lead to quicker and more accurate changes in the plan of care. pH of 7.44 is NORMAL but slightly leaning towards ALKALOSIS, so we place pH under the NORMAL column with an arrow pointing towards the ALKALOSIS column. It’s designed to help students master ABG Interpretation. On the contrary, alkalosis is a condition wherein the blood is relatively too basic (high pH), there are also two types of alkalosis: respiratory alkalosis and metabolic alkalosis. © 2021 Ausmed Education Pty Ltd (ABN: 33 107 354 441), https://nurse.org/articles/arterial-blood-gas-test/, https://www.healthline.com/health/blood-gases, https://www.thoracic.org/professionals/clinical-resources/critical-care/clinical-education/abgs.php, https://medlineplus.gov/ency/article/003855.htm. Step 2: Is the pH acidotic, normal or alkalotic? 3. This ABG is an example of a partially compensated respiratory acidosis. Simple Method of Acid Base Balance Interpretation A FOUR STEP METHOD FOR INTERPRETATION OF ABGS. If pH is under the NORMAL column, determine whether the value is leaning towards ACIDOSIS or ALKALOSIS and interpret accordingly. This does not correct the root cause of the problem, if the underlying condition is not corrected, these systems will fail. The CO2 is 50, which is high. Healthline 2019, Blood Gas Test, viewed 20 April 2020. The most important points when assessing a patient are the history, examination and basic observations. See Educator Profile, Ausmed’s Editorial team is committed to providing high-quality and thoroughly researched content to our readers, free of any commercial bias or conflict of interest. This ABG is an example of a partially compensated metabolic alkalosis. In this guide, we’ll help you understand the concepts behind arterial blood gas and teach you the easiest and most fun way to interpret ABGs using the tic-tac-toe method. Solve for goal #1: ACIDOSIS or ALKALOSIS. The book makes the distinction between acute and chronic disorders based on symptoms from identical ABGs. This determines if the blood is acidotic or alkalotic. In this step, take note where... 3. Based on the given ABG values, determine if values interpret ACIDOSIS or ALKALOSIS. Arterial Blood Gas made easy Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Based on their values, we need to determine in which column we’ll place pH, PaCO2, and HCO3 in the grid. Interpretation of arterial blood gases (ABGs) is a crucial skill that a lot of student nurses and medical practitioners need to learn. • Partial compensation pH is still abnormal, and the ‘other’ value is abnormal in an attempt to help normalise the pH. Base excess, the normal range is –2 to +2 mmol/L. 2) Carbon dioxide (CO2) elimination through respiration. If Normal, the blood gas is compensated or not. If you continue browsing the site, you agree to the use of cookies on this website. For example: in uncompensated metabolic acidosis: pH 67.23, HCO3-6 15mmol/L, and the CO2 will be normal at 40mmHg. Where else is there an alkalosis? The Arterial Blood Gas (ABG) Analyzer interprets ABG findings and values. (Nursing) Arterial blood gas interpretation is one of the hardest subjects you’ll have to learn in nursing school. Of course then you'll have to practice, practice, practice. For example, in an acidosis, we’d look at the level of HCO3-. 6. For this step, we need to interpret if the value of PaCO2 is within the NORMAL range, ACIDIC, or BASIC and plot it on the grid under the appropriate column. Once you’ve memorized the normal values and the diagram, create a blank your tic-tac-toe grid and label the top row as ACIDOSIS, NORMAL, and ALKALOSIS. Inform that client about the procedure and that there is no food or fluid restriction imposed. Finding help online is nearly impossible. Remember that the normal range for HCO3 is from 22 to 26: Now, we will start solving for our goals. To make things simple, I will only refer to the three basic ABG values in this post Oxygen saturation, the normal range is 94–100%. ƒInvolves the combination of hydrogen ions with urinary titratable acid, particularly phosphate (HPO42- + H+ to H2PO4-) or with ammonia to form ammonium ƒAmmonium is the primary adaptive response since ammonia production from the metabolism of glutamine can be increased in the presence of an acid load