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ANALYZING ARTERIAL BLOOD GAS RESULTS

POINTS TO REMEMBER:
1. In ACIDOSIS, the pH is DOWN. 2. In ALKALOSIS, the pH is UP. 3. The RESPIRATORY FUNCTION indicator is the PCO2. 4. The METABOLIC FUNCTION indicator is the HCO3.

STEPS:
STEP 1 Look at the blood gas report. Look at the pH. Is the ph UP or DOWN? If Up=ALKALOSIS, Down= ACIDOSIS.

STEP 2
Look at the PCO2. Is it up or down? If the PCO2 reflects an opposite response to the pH, then you know that the condition is a RESPIRATORY IMBALANCE. If the PCO2 does not reflect an opposite response to the pH, then move to step 3.

STEP 3
Look at the HCO3 concentration. Does the HCO3 concentration reflect a corresponding response with the pH? If it does, then the condition is a METABOLIC IMBALANCE.

EXAMPLE:
pH = 7.37 PaCO2 = 52 HCO3= 29mmHg Answer:

ANSWER: pH = 7.37 ACID PaCO2 = 52 Acid HCO3= 29mmHg Alkalosis Answer: METABOLIC ACIDOSIS Complete Compensatory

STEP 4
Remember: COMPENSATION has OCCURRED if the pH is in a normal range of 7.35-7.45. if the pH is NOT within NORMAL range, look at the respiratory or metabolic function indicators.

RESPIRATORY IMBALANCES:
If a condition is a respiratory imbalance, look at the HCO3 concentration to determine the state of compensation. If the HCO3 is NORMAL, then the condition is UNCOMPENSATED. If the HCO3 is ABNORMAL, then the condition is PARTIAL COMPENSATION.

EXAMPLE:
pH = 7.30 PaCO2 = 56 HCO3= 29mmHg

Answer:

ANSWER:
pH = 7.30 PaCO2 = 56 HCO3= 29mmHg
Answer:

RESPIRATORY ACIDOSIS (P.COMPENSATORY)

METABOLIC IMBALANCE
If the condition is a METABOLIC IMBALANCE, look at the PCO2 to determine the state of compensation. If the PCO2 is NORMAL, then the condition is UNCOMPENSATED. If the PCO2 is ABNORMAL, then the condition is a PARTIAL COMPENSATION.

EXAMPLE
pH = 7.30 PaCO2 = 43 HCO3= 21mmHg Answer:

ANSWER
pH = 7.30 PaCO2 = 43 N HCO3= 21mmHg Answer: UNCOMPENSATED METABOLIC ACIDOSIS

DRILL

GROUPING
Ferolin, Selina C. Almanzor, Viloan, Dan Kessa Marie Louie M. D. Beglilio, Eramis Army Ortega, Rey Jamie B. Joy A. Mart P. Paderes, Anna Tess B. Paciente, Kyle T.

Amualla, Bolivar, May Marife Julia Rozel M. A. Gomez, Erwin S. Bantala, Abdel Haq D.

Ceriales, Sanogal, Joanne Fe Alene Joy T. C. Sanang, Almira M.

Velos, Queenie Kaye B.

Solayman, Larisma, Farisha Bea Mae D. Andrea R. Quionez, V.

Vallejo,Ar pha Omar F.

Verano, Salcedo, Karen Joy Ralph Elton F. S. Bagsican, Mae A. Aquino Jr., Arnold L.

Parnes, Maniquis, Jonalie P. Irene M.

Pagaduan, Lady Anne M.

Mostrales, Kelvin Doyle C.

Bisabis, Michel B.

Demerin, Herma Grace B.

Nazaire, Rose A.

Parcon, Krystyl Myca C.

PRACTICE QUESTIONS:
1. A nurse plans care for a client with Chronic Obstructive Pulmonary Disease, knowing that the client is most likely to experience what type of imbalance? a. Respiratory Acidosis b. Respiratory Alkalosis c. Metabolic Acidosis d. Metabolic Alkalosis

ANSWER

a. Respiratory Acidosis
b. Respiratory Alkalosis c. Metabolic Acidosis d. Metabolic Alkalosis

2. A nurse reviews the blood gas results of a client with Guillain-Barr syndrome. The nurse analyzes the results and determines that the client is experiencing respiratory acidosis. Which of the following validates the nurses findings? 1. pH 7.50, Pco2 52 mmHg 2. pH 7.35, Pco2 40 mmHg 3. pH 7.25, Pco2 50 mmHg 4. pH 7.50, Pco2 30 mmHg

ANSWER
1. pH 7.50, Pco2 52 mmHg 2. pH 7.35, Pco2 40 mmHg

3. pH 7.25, Pco2 50 mmHg


4. pH 7.50, Pco2 30 mmHg

3. A nurse reviews the arterial blood gas results of a client and notes the following: pH 7.45, Pco2 of 30mmHg and HCO3 of 22 meQ/L. The nurse analyzes these results as indicating: a. Metabolic Acidosis, compensated b. Metabolic Alkalosis, uncompensated c. Respiratory Alkalosis, compensated d. Respiratory Acidosis, uncompensated

ANSWER
a. Metabolic Acidosis, compensated b. Metabolic Alkalosis, uncompensated

c. Respiratory Alkalosis, compensated


d. Respiratory Acidosis, uncompensated

4. A client is scheduled for blood to be drawn from the radial artery for ABG determination. Before the blood is drawn, an Allens test is performed to determine the adequacy of the: a. Popliteal circulation b. Ulnar circulation c. Femoral circulation d. Carotid circulation

ANSWER

a. Popliteal circulation

b.Ulnar circulation
c. Femoral circulation d. Carotid circulation

5. A nurse is caring for a client with Nasogastric tube that is attached to a low suction. The nurse monitors the client knowing that the client is at risk for which acid-base disorder? a. Respiratory Acidosis b. Respiratory Alkalosis c. Metabolic Acidosis d. Metabolic Alkalosis

ANSWER
a. Respiratory Acidosis b. Respiratory Alkalosis c. Metabolic Acidosis

d. Metabolic Alkalosis

6. A nurse caring for a client with an ileostomy understands that the client is at most risk for developing which acidbase disorder? a. Respiratory Acidosis b. Respiratory Alkalosis c. Metabolic Acidosis d. Metabolic Alkalosis

ANSWER
a. Respiratory Acidosis b. Respiratory Alkalosis

c. Metabolic Acidosis
d. Metabolic Alkalosis

7. A nurse is caring for a client with diabetic ketoacidosis (DKA) and documents that the client is experiencing Kussmauls respirations. Based on this documentation, which of the following did the nurse observe? a. Respirations that are abnormally deep, regular & increase in rate. b. Respirations that are regular but abnormally slow. c. Respirations that are labored and increased in depth and rate d. Respirations that cease for several seconds.

ANSWER
a. Respirations that are abnormally deep, regular & increase in rate.
b. Respirations that are regular but abnormally slow. - bradypnea c. Respirations that are labored and increased in depth and rate hyperpnea d. Respirations that cease for several seconds. - apnea

8. A nurse understands that excessive use of oral antacids containing bicarbonate can result in which acid-base disturbance? a. b. c. d. Respiratory alkalosis Respiratory acidosis Metabolic acidosis Metabolic alkalosis

ANSWER a. Respiratory alkalosis b. Respiratory acidosis c. Metabolic acidosis

d. Metabolic alkalosis

9. A nurse is caring for a client with renal failure. Blood gas results indicate a pH of 7.30, a pC02 of 32mmHg and a bicarbonate concentration of 20 mEq/L. The nurse has determined that the client is experiencing metabolic acidosis. Which of the following laboratory values would the nurse expect to note? a. Sodium level of 145 mEq/L b. Magnesium level of 5.2 mEq/L c. Potassium level of 5.2 mEq/L d. Phosporus level of 4.0 mg/dL

ANSWER
a. Sodium level of 145 mEq/L N b. Magnesium level of 5.2 mEq/L - N

c. Potassium level of 5.2 mEq/L


d. Phosporus level of 4.0 mg/dL - N

10. A nurse is caring for a client who is on mechanical ventilator. Blood gas results indicate a pH of 7.50 and pC02 of 30 mmHg. The nurse has determined that the client is experiencing respiratory alkalosis. Which laboratory value would mist likely be noted in this condition? a. Sodium level of 145 mEq/L b. Potassium level of 3.0 mEq/L c. Magnesium level of 2.0 mg/dL d. Phosporus level of 4.0 mg/dL

ANSWER
a. Sodium level of 145 mEq/L - N

b. Potassium level of 3.0 mEq/L


c. Magnesium level of 2.0 mg/dL - N d. Phosporus level of 4.0 mg/dL - N

-END OF DRILL

GRADE EQUIVALENT (CLASS STANDING)


SCORE GRADE

1- 5 6 7 8 9 10

= = = = = =

65 75 80 85 90 95

CONGRATULATIONS!