ABG help

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Hi everyone,

I am a new LPN to RN nursing student and I am having a hard time with ABG's. Can anyone help me please. I have a case study with the following ABG...

pH 7.30, Pa0270, PC0247, HC0320mEq/L

I am interpreting this as Compined Respiratory and Metabolic Acidosis. Can anyone recheck my work please. Thanks so much! :up:

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Specializes in Pedi.
Hi everyone,

I am a new LPN to RN nursing student and I am having a hard time with ABG's. Can anyone help me please. I have a case study with the following ABG...

pH 7.30, Pa0270, PC0247, HC0320mEq/L

I am interpreting this as Compined Respiratory and Metabolic Acidosis. Can anyone recheck my work please. Thanks so much! :up:

Ok, let's look at what you have:

pH of 7.30- what does this indicate? Acidosis, right?

PCO2 47- what does this mean? CO2 is an acid with normal range of 35-45. So you have too much acid which produces an acidotic state.

HCO3 20- what does this mean? HCO3 is a base with a normal range of 22-26, so you have lost base which also gives you an acidotic state.

So, overall, I'd have to agree with you that you're looking at acidosis in both systems but I will admit that I am not too familiar with the real world implications of such a thing.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

moved to for best response

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Specializes in ER trauma, ICU - trauma, neuro surgical.

Don't forget to say compensated or uncompensated. Your ABG would be uncompensated b/c the Ph is abnormal. The rest looks good.

A pt in acute renal failure would have an ABG like this. The co2 is high, but the kidneys, which would normally be pumping out bicarb to compensate for the acidosis, is unable to make bicarb because the kidneys are shot. The only thing that would help would be to fix the respiratory issue, and put the pt on a bicarb gtt. However, in the real world, a bicarb of 20 is not too bad. Fixing the resp issue might normalize the ph enough. But, for arguments sake, you would address the metabolic acidosis with some type of bicarb.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

ROME:

Respiratory= Opposite:

- pH is high, PCO2 is down (Alkalosis).

- pH is low, PCO2 is up (Acidosis).

Metabolic= Equal:

- pH is high, HCO3 is high (Alkalosis).

- pH is low, HCO3 is low (Acidosis)

and......ABG tic tac toe......

VickyRN I've attached a "tic-tac-toe" type handout I made for my students when I teach ABG's. Hope this helps :)

paperclip.png Attached Files

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Specializes in Hospital Education Coordinator.

Per the ABGStat app on my phone it is mixed resp. and Met Alkalosis

The pH is normal. The CO2 and bicarb are only slightly elevated, so one system is not working harder than the other (resp vs. metabolic).

I mention the app because it is free but does NOT replace thinking. If you double-check the numbers with the app you will begin to see patterns and will be able to learn how to interpret ABG's faster. At least, I did.

Do not cheat in school with it. That would be the day your phone or the app died. Murphy's law.

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Thanks for the abg worksheets Esme.....was just doing some today and said I needed some more practice problems

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