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ABG's Tic Tac Toe
ABG's Tic Tac Toe
and
carbon dioxide in the blood. Blood for an ABG test is taken from an artery whereas most other blood
tests are done on a sample of blood taken from a vein. This test is done to monitor several conditions
that can cause serious health complications especially to critically ill individuals.
Every day, a lot of nursing and medical students assigned in acute areas encounter ABG results, which
they may not necessarily be able to interpret with its knotty aspect. They struggle over the
interpretation of its measurements, but they are not especially complicated nor difficult if you
understand the basic physiology and have a step by step process to analyze and interpret them.
There may be various tips and strategies to guide you, from mnemonics, to charts, to lectures, to
practice, but this article will tell you how to interpret ABGs in the easiest possible way. And once you
have finished reading this, you’ll be doing actual ABG analysis in the NCLEX with fun and excitement!
Steps:
Contents
Know the normal and abnormal ABG values when you review the lab reports.
The first thing you need to determine when checking ABG results is the acidity of the blood which is
determined by the value of the pH. The pH level in a healthy human should be between 7.35 to 7.45.
Your body is constantly striving to keep pH in balance.
pH level below 7.35 is Acidosis
pH level above 7.45 is Alkalosis
Next thing you need to determine is whether the acid base is Respiratory or Metabolic.
paCO2 = Respiratory
HCO3 = Metabolic
4. Remember ROME
Respiratory Opposite
Metabolic Equal
5. Tic-Tac-Toe
And yes, ABG problems work using the Tic-Tac-Toe method. All you have to do is make a blank chart a
bit like a tic-tac-toe chart.
6. Mark the Chart
Using the lab result values, mark them on your Tic-Tac-Toe chart. Now begin with this given example.
In this step, look at which column matches up with the pH. In this case HCO3 goes with pH. HCO3 is
considered Metabolic (shown in step 3), and both are under Acid, so this example implies Metabolic
Acidosis.
8. Determine Compensation
The last step is to determine if the ABG is Compensated, Partially Compensated, or Uncompensated.
In this case PACO2 goes with pH. PACO2 is considered Respiratory (shown in step 3), and both are under
Basic, so this example implies Respiratory Alkalosis. The HCO3 is also abnormal. When pH is NORMAL
and PaCO2 and HCO3 are both ABNORMAL, it indicates FULL COMPENSATION.