Skip to content
View in the app

A better way to browse. Learn more.
allnurses

A full-screen app on your home screen with push notifications, badges and more.

To install this app on iOS and iPadOS
  1. Tap the Share icon in Safari
  2. Scroll the menu and tap Add to Home Screen.
  3. Tap Add in the top-right corner.
To install this app on Android
  1. Tap the 3-dot menu (⋮) in the top-right corner of the browser.
  2. Tap Add to Home screen or Install app.
  3. Confirm by tapping Install.
Discussion

Interpet this ABG

I know all the normal values of ABG's and I also know when it is resp or metabolic as well as acidosis or alkalosis. However I can't interpet the following, I get that it is a mixed ABG.

ph 7.46 (normal acidosis>7.35-7.45

HCO2 63 (normal Alk>35-45

HCO3 34 (normal acid>22-26

Pao2 70 (Hypoxemia)

Sao2 86% (hypoxia)

I'm confused. It starts to look like Metibolic alkalosis, but look at that Co2 level, that is dangerously high. Co2 above 50= Respitory distress and the need for mechanical ventilation. With that said does this cancel out the dx of metabolic alkalosis and the correct interpetation would be Respitory Acidosis? Help!

Featured Replies

Maybe there is compensation going on?? Sorry, I'm not too good with it myself

  • Experts

when you are interpreting abgs there is a step-by-step sequence to doing this:

  1. look at the ph to determine acidosis/alkalosis or compensation
    • ph 7.46 - this is alkalosis, no compensation

[*]look at what the co2 is doing; this is the respiratory effect. if the hco3 is within normal limits then you stop here and the problem is respiratory; if the hco3 is also abnormal you have a metabolic problem, so move on to step #3

  • hco2 63 - normal is 35-45, so it is elevated

[*]now, what is the hco3 doing; this is the metabolic effect

  • hco3 34 - normal is 22-26, so it is also elevated, so this is metabolic alkalosis

you can verify this using the rome mnemonic (https://allnurses.com/forums/2016253-post25.html)

r
espiratory
o
pposite

  • ph
    elevated
    pco2
    diminished
    =
    respiratory alkalosis


  • ph
    diminished
    pco2
    elevated
    =
    respiratory acidosis


m
etabolic
e
qual

  • ph
    elevated
    hco3
    elevated
    =
    metabolic alkalosis


  • ph
    diminished
    hco3
    diminished
    =
    metabolic acidosis


when assessing abgs the pao2 and sao2 have no significance. you know compensation is occurring when the ph falls within normal range while the co2 and/or the hco3 remains out of balance.

you can get weblinks to sites on abg interpretation including several sites that have practice problems on this post of one of the sticky threads: https://allnurses.com/forums/2488838-post46.html

I read it as metabolic alkalosis with partial respiratory compensation. The respiratory system is just starting to compensate, it is not fully compensated because the PH is not in normal limits. It depends how your instructor wants you to read the ABG. Mine wanted us to list every possible detail we could. If she wants it basic, then it is metabolic alkalosis. Do you have any S & S's of the pt.?

Guest
This topic is now closed to further replies.
Go to topic listing

Currently Reading 0

  • No registered users viewing this page.

Account

Navigation

Search

Search

Configure browser push notifications
Chrome (Android)
  1. Tap the lock icon next to the address bar.
  2. Tap Permissions → Notifications.
  3. Adjust your preference.
Chrome (Desktop)
  1. Click the padlock icon in the address bar.
  2. Select Site settings.
  3. Find Notifications and adjust your preference.