ABGs and ME NEED HELP

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Hello all I am a 2nd semester 1st yr student who has no clue about abg interpretation and would like some assistance. Need help with understanding compensation(partial and full) and what compensation means. Thanks in advance

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http://www.ed4nurses.com/abgtoday.htm

$10 download, WELL worth the money!!!!!!!!! Mr. Woodruff saved my butt second semester!

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Specializes in Med-Surg, Tele, Vascular, Plastics.

hello,

I will help break it down for you; it gets confusing but when have the actual numbers and do some exercises you will get it. I will explain the definitions first and then at the bottom I will give practice exercises.

1st: look at the pH this will tell you if you have acidosis or alkalosis

7.45 is alkalemia

if normal pH it is euphemia

2nd: look at the pCO2 this will tell you if it is respiratory

>45 acidotic or

if normal pCO2 then it is not respiratory (so it must be metabolic)

3rd: look at the Bicarb (HCO3) this will tell you if it is metabolic

26 is alkalotic

if normal Bicarb then it is not metabolic so it must be respiratory

4th: if there is an increase or decrease in both the pCO2 and the Bicarb then there is compensation present.

Partial compensated state= some compensatory effect is present but blood is not returned to normal

Completely compensated state= compensatory effect is present and blood pH is returned to normal.

*now go back to your pH

If the pH is less than normal it is acidotic

if the pH is greater than normal it is alkalotic

you then determine if it is respiratory or metabolic by the one that caused the change in pH;

when the other is either increased or decreased in the opposite direction from that which caused the pH to change this indicates partial compensation.

*example: 7.48 pH is alkalosis; 47 pCO2 is acidotic; 34 Bicarb is alkalosis = so you have metabolic alkalosis with partial compensation

*( in english: always start by looking at the pH; you know the pH is alkalosis; and since the bicarb is alk too then you have a metabolic alkalosis; you know that it is not respiratory cuz the CO2 is acid; now since the CO2 was not in normal range you also have compensation going on... in other words, the CO2 is trying to make up for the change in PH so it is going to go more acid in an attempt to get the blood back to normal and away from alkalosis )

a normal pH with either an increase or decrease of the pCO2 or the HCO3 will indicate full compensation ( in english: once the blood is restored to normal pH you then have had full compensation )

since normal pH is 7.35-7.45 the neutral is 7.40

now if it is 7.45 that is still normal but it is on the alkalotic side...

if it is 7.38 that is still a normal pH but it is toward the acidotic side...

So the pH will tell you which caused the compensation...

if your ph was 7.38 it is normal indicating full compensation... and it is towards the acidotic side.... and your pCO2 was 55 that is acid.... and your Bicarb is 28 that is alkalotic... you would know that you have respiratory acidosis with complete compensation cuz your pH will lean towards the one that caused the compensation.

In some cases you can have a mixed condition... for example the pH is acidotic and it is respiratory and also metabolic acidosis. usually seen in critically ill patients.

Now here are some examples:

pH pCO2 HCO3

7.26 52 24 respiratory acidosis without compensation

7.24 44 18 metabolic acidosis without compensation

7.55 24 23 respiratory alkalosis without compensation

7.46 45 40 metabolic alkalosis without compensation

7.48 22 18 respiratory alkalosis with partial compensation

7.46 72 50 metabolic alkalosis with partial compensation

7.10 25 8 metabolic acidosis with partial compensation

7.25 90 38 respiratory acidosis with partial compensation

7.44 63 41 metabolic alkalosis with complete compensation

7.38 31 17 metabolic acidosis with complete compensation

7.41 28 16 respiratory alkalosis with complete compensation

Hope this all makes sense, if you need further clarification let me know. I tried as best I could to explain it. Good luck,

Angie

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Specializes in Med-Surg, Tele, Vascular, Plastics.

I could have saved your butt $10 bucks.... sheesh! LOL

http://www.ed4nurses.com/abgtoday.htm

$10 download, WELL worth the money!!!!!!!!! Mr. Woodruff saved my butt second semester!

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this site really helped me understand it well. also provides some practice links. Just scroll down the frame and click on "ABGs".

http://realnurseed.com/

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I could have saved your butt $10 bucks.... sheesh! LOL

Really? Were you willing to sit in my car giving me a 60 minute lecture as I drove to school?

Seriously, I learn by hearing things. My instructors each taught us a different way to interpret ABGs and they really messed me up (one drew this bullseye, one drew arrows and I am NOT a visual learner). Now it makes sense.

The OP asked for suggestions and I gave her one. That was the best $10 I spent in a long time.

Ali

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Specializes in Med-Surg, Tele, Vascular, Plastics.
Really? Were you willing to sit in my car giving me a 60 minute lecture as I drove to school?

Seriously, I learn by hearing things. My instructors each taught us a different way to interpret ABGs and they really messed me up (one drew this bullseye, one drew arrows and I am NOT a visual learner). Now it makes sense.

The OP asked for suggestions and I gave her one. That was the best $10 I spent in a long time.

Ali

Sheesh, you are sensitive. Was just teasing. :p well if i couldnt save you the 10 bucks then atleast mayble i'll save someone new that money.

Anybody who needs help or practice problems... let me know, ive got bunches.

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Specializes in Gerontological, cardiac, med-surg, peds.

Great post, Nrs_angie Have you considered going into Nursing Education someday? You really have a wonderful knack for teaching. I am attempting to attach some exercises I developed for my students (one is entitled, "ABG Tic-Tac-Toe.") Hope this will be of help also.

ALLNURSES ABG Tic-Tac-Toe Part One.doc

ALLNURSES ABG Tic-Tac-Toe Part Two.doc

ABG Practice Quiz.doc

ANSWERS to ABG Practice Quiz.doc

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i am graduating may 25!!!! yhea!!! but i remember how confusing abgs can be. there is an excellent article i used from rn january 1995 turn abgs into childs play if your school library does not have it let me know and i will scan it and send it to you, it made the whole concept very easy and understanding---really!!:chuckle

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very helpful thanks for the explanation

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i am graduating may 25!!!! yhea!!! but i remember how confusing abgs can be. there is an excellent article i used from rn january 1995 turn abgs into childs play if your school library does not have it let me know and i will scan it and send it to you, it made the whole concept very easy and understanding---really!!:chuckle
thanks to everyone for the tips and wish me luck on monday
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Specializes in Med-Surg, Tele, Vascular, Plastics.
Great post, Nrs_angie Have you considered going into Nursing Education someday? You really have a wonderful knack for teaching. I am attempting to attach some exercises I developed for my students (one is entitled, "ABG Tic-Tac-Toe.") Hope this will be of help also.

thank you RNVICKY, actually when I decided about school I was between nursing and teaching as majors. haha. Eventually someday I would like to be a Nursing Instructor. ( after I finish nursing school o' course :specs: ) :)

Are you a post moderator? how does one get to become a moderator?

Thanks,

Angie

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