REVIEW OF NURSING PROCEDURES

ABGs: MADE EASY

Dominic E. Del Rosario, RN, MANc Lecturer

ABG ANALYSIS
Arterial blood gas (ABG) analysis is used to measure the partial pressures of oxygen (PaO2) and carbon dioxide (pacO2)' and the pH of an arterial sample.

A blood sample for ABG analysis may be drawn by percutaneous arterial puncture or from an arterial line.

Purpose:
To evaluate gas exchange in the lungs. To assess integrity of the ventilatory control system. To determine the acid-base level of the blood. To monitor respiratory therapy.

SITES: Radial Brachial Femoral

REMEMBER:
Look for the:
Compensated

First Names

Uncompensated

Middle Name

Respiratory Metabolic

Last Name

Acidosis
Alkalosis

STEPS IN ABG READING!

Step 1 Look at the pO2 ( if less than 60 mmHg your patient is on ACUTE RESPIRATORY FAILURE) This is often forgotten when reading the ABG result! It will indicate HYPOXEMIA (low level of oxygen)

STEPS IN ABG READING!

Step 2 Look at the pH to determine the First Name and Last Name
Compensated

First Name

Uncompensated Acidosis

Last Name

Alkalosis

NO higher or lower term ( it should be acidotic or alkalotic)

COMPENSATED Anything less than 7.40 is ACIDOSIS, Anything greater than 7.40 is ALKALOSIS WITHIN THE NORMAL RANGE

Anything less than 7.35 is UNCOMPENSATED ACIDOSIS

Anything greater than 7.45 is UNCOMPENSATED ALKALOSIS

STEPS IN ABG READING!

Step 3 Look at the pCO2 (Carbon Dioxide) and HCO3 (Bicarbonate) to match the FIRST NAME and LAST NAME pCO2 is an ACID = RESPIRATORY

HCO3 is not ( Its a BASE!) = METABOLIC

VALUES UNCOMPENSATED ACIDOSIS pH UNCOMPENSATED ALKALOSIS

7.35 7.45

RESPIRATORY ALKALOSIS

CO2 (CARBON DIOXIDE)

RESPIRATORY ACIDOSIS

35 - 45 METABOLIC ACIDOSIS HCO3 (BICARBONATE) METABOLIC ALKALOSIS

23 - 27

EXAMPLE # 1
pH pCO2 7.49 40 Alkalosis Normal

EXAMPLE #2
pH 7.10 Acidosis

pCO2
HCO3

25
7

Alkalosis
Acidosis

HCO3

29

Alkalosis

First Name: Uncompensated Last Name: Alkalosis Middle Name: Metabolic Interpretation: Uncompensated Metabolic Alkalosis (Patient is losing ACID in the body Ex. VOMITING)

First Name: Uncompensated Last Name: Acidosis Middle Name: DKA: Give INSULIN Metabolic Instead of Bicarbonate!!!

Interpretation: Uncompensated Metabolic Acidosis ( Patient with DIARRHEA, SHOCK, BLEEDING, DKA)

EXAMPLE #
pH pCO2 7.42 18 Normal Alkalosis

HCO3

29

Alkalosis
NOTE: METABOLIC Fluid goes UP: Alkalosis Fluid goes DOWN: Acidosis Respiratory Acidosis: Ex. COPD

First Name: Compensated Last Name: Alkalosis Middle Name: Respiratory Interpretation: Compensated Respiratory Alkalosis (Patient is HYPERVENTILATING)

FOOD FOR THE BRAIN!!!

Remember ROME Respiratory OPPOSITE DIRECTION Metabolic EQUAL DIRECTION
pH pCO2 7.49 40 Normal pH pCO2 HCO3 7.42 18 29 (Normal)

HCO3
pH pCO2 HCO3

29
7.10 25 7

If the pH goes DOWN the PaCO2 goes UP. If the pH goes UP the PaCO2 goes DOWN. Like a see-saw its respiratory. If the pH goes DOWN and the HCO3 goes DOWN. If the pH goes UP and the HCO3 goes UP. Like a elevator its metabolic.