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1. Assess O2 (normal: 80-100 for arterial blood*) Does the client have hypoxemia? 2.

Assess for acidosis (pH <7.35) or alkalosis (pH >7.45). 3. Assess for Respiratory (pCO2) or Metabolic (HCO3) components.

. Evaluation
Normal*** Respiratory Acidosis Respiratoty Alkalosis Metabolic Acidosis Metabolic Alkalosis

7.35-7.45 <7.35 >7.45 <7.35 >7.45

35-45 >45 <35 WNL WNL

22-28 WNL WNL <22 >28


The "Seesaw" effect Respiratory acidosis . Respiratory Respiratory alkalosis

The "Elevator" effect

Metabolic acidosis


Metabolic alkalosis

4. Assess for compensation (the body's ability to correct acidosis or alkalosis). Compensation is present if the pH is normal even though the pCO2 and/or the HCO3 are abnormal. 5. If compensation is present, assess which is the primary component causing the imbalance and which is the compensatory component correcting the imbalance.

. a. Is the pH in the acid range (7.35-7.40) or in the alkaline range (7.41-7.45)? b. The component in the same direction as the pH is the primary component. c. The component in the opposite direction as the pH is the compensatory

. Evaluation ph pCO2 HCO3

>28 <22 <22 >28

Compensated Respiratory Acidosis 7.35-7.40 >45 Compensated Respiratoty Alkalosis 7.41-7.45 <35 Compensated Metabolic Acidosis Compensated Metabolic Alkalosis 7.35-7.40 <35 7.41-7.45 >45