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The 6 Easy Steps to ABG Analysis!

The 6 Easy Steps to ABG Analysis!

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Published by Suresh Kumar

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Published by: Suresh Kumar on Dec 25, 2011
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01/13/2014

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www.Ed4Nurses.com ©1997-2009 Ed4Nurses, Inc.
 
E-Booklet
David W. Woodruff, MSN, RN-BC, CNS, CEN
 
6 Easy Steps to ABG Analysis©2003-2009 Ed4Nurses, Inc.www.Ed4Nurses.com 1
WELCOME TO THE 6 EASY STEPS TO ABG ANALYSIS!
BY: DAVID W. WOODRUFF, MSN, RN-BC, CNS, CEN 
Nurses often have difficulty interpreting arterial blood gases (ABGs). Confusion oftenbegins with trying to remember many random rules and lacking a standardizedapproach to ABGs. In addition, nurses often attempt to analyze too many componentsof the ABG at the same time. The result is often confusion and an incorrect diagnosis.
Therefore, the “6 Easy Steps to ABG Analysis” were developed to provide nurses with an
accurate and systematic method of easily interpreting arterial blood gases.
The “6 Easy Steps to ABG Analysis” are listed below for easy reference, and will be
explained in more detail in the sections that follow. Lastly, examples will be presentedwith a systematic review of pertinent findings.
The 6 Easy Steps to ABG Analysis:
1.
Is the pH normal?
2.
Is the CO2 normal?
3.
Is the HCO3 normal?
4.
Match the CO2 or the HCO3 with the pH
5.
Does the CO2 or the HCO3 go the opposite direction of the pH?
6.
Are the pO2 and the O2 saturation normal?
In order for our analysis to be effective, notes will have to be written next to the resultson our lab slip. Alternately, the ABG results can be transcribed onto another paper foranalysis (see example one below for the format).
 
6 Easy Steps to ABG Analysis©2003-2009 Ed4Nurses, Inc.www.Ed4Nurses.com 2
Step 1: Analyze the pH 
The first step in analyzing ABGs is to look at the pH. Normal blood pH is 7.4, plus orminus 0.05, forming the range 7.35 to 7.45. If blood pH falls below 7.35 it is acidic. If blood pH rises above 7.45, it is alkalotic. If it falls into the normal range, label what sideof 7.4 it falls on. Lower than 7.4 is normal/acidic, higher than 7.4 is normal/alkalotic.Label it.
Step2: Analyze the CO2
The second step is to examine the pCO2. Normal pCO2 levels are 35-45mmHg. Below35 is alkalotic, above 45 is acidic. Label it.
Step 3: Analyze the HCO3
The third step is to look at the HCO3 level. A normal HCO3 level is 22-26 mEq/L. If theHCO3 is below 22, the patient is acidotic. If the HCO3 is above 26, the patient isalkalotic. Label it.
Step 4: Match the CO2 or the HCO3 with the pH 
Next match either the pCO2 or the HCO3 with the pH to determine the acid-basedisorder. For example, if the pH is acidotic, and the CO2 is acidotic, then the acid-basedisturbance is being caused by the respiratory system. Therefore, we call it arespiratory acidosis. However, if the pH is alkalotic and the HCO3 is alkalotic, the acid-base disturbance is being caused by the metabolic (or renal) system. Therefore, it willbe a metabolic alkalosis.
Step 5: Does the CO2 or HCO3 go the opposite direction of the pH? 
Fifth, does either the CO2 or HCO3 go in the opposite direction of the pH? If so, there iscompensation by that system. For example, the pH is acidotic, the CO2 is acidotic, andthe HCO3 is alkalotic. The CO2 matches the pH making the primary acid-base disorderrespiratory acidosis. The HCO3 is opposite of the pH and would be evidence of compensation from the metabolic system.
Step 6: Analyze the pO2 and the O2 saturation.
Finally, evaluate the PaO2 and O2 sat. If they are below normal there is evidence of hypoxemia.

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