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how our instructor taught us to determine if it was respiratory or metabolic:
if the ph goes down the paco2 goes up.
if the ph goes up the paco2 goes down.
like a see-saw its respiratory.
if the ph goes down and the hco3 goes down.
if the ph goes up and the hco3 goes up.
like a elevator its metabolic.
that was hard to put into words but i hoped it helped. otherwise you just have to learn the normals, sorry i don't have an easy way to remember them. just when i get to the test i write them down quickly first thing so i don't confuse myself later on.
ROME
Respiratory
Opposite
Metabolic
Equal
Example:
Normal Values:
pH 7.35-7.45 PaCO2 35-45 mm Hg PaO2 80-95 mm Hg HCO3 22-26 mEq/L
Lets say pH is 7.50 CO2 32 CO3 24
THE PH is elevated and Alkaline
THE CO2 is decreased
THE CO3 is normal
So the pH and CO2 are going in opposite directions which = Respiratory Opposite so this would be Respiratory alkalosis
Now lets say the pH was 7.32 (decreased and acidic) and the CO2 is 33 (decreased) since there both going in the same direction (decreasing) = Metabolic Equal and you would have Metabolic Acidosis
So basically take the Ph and determine if its acidic or alkaline then take the abnormal CO2 or CO3 value and determine which direction they are going (elevated or decreased) and apply ROME.
Good luck, hope this is not confusing.
there is all kinds of information on how to interpret abgs on post #43 of this sticky thread:
https://allnurses.com/nursing-student-assistance/pathophysiology-p-microbiology-145201.html pathophysiology/ a & p/ microbiology/ fluid & electrolyte resources
how our instructor taught us to determine if it was respiratory or metabolic:
if the ph goes down the paco2 goes up.
if the ph goes up the paco2 goes down.
like a see-saw its respiratory.
if the ph goes down and the hco3 goes down.
if the ph goes up and the hco3 goes up.
like a elevator its metabolic.
that was hard to put into words but i hoped it helped. otherwise you just have to learn the normals, sorry i don't have an easy way to remember them. just when i get to the test i write them down quickly first thing so i don't confuse myself later on.
our instructor gave us the term metro (like the train) to remember which goes together and which does not. "metabolic equals together respiratory opposite" like the see-saw or the elevator.
If there is full compensation, the pH will be normal. Example:
pH 7.35 (low side, but still within normal limits)
CO2 52 (high-acid)
HCO3 30 (high-alkaline)
The above would be compensated respiratory acidosis. The bicarbonate is elevated as it is compensating for the low pH, which is now WNL.
Partially compensated respiratory acidosis:
pH 7.32 (still acidic)
CO2 52 (high-acidic)
HCO3 30 (high-alkaline)
Uncompensated metabolic alkalosis:
pH 7.55 (alkaline)
CO2 37 (normal)
HCO3 35 (high-alkaline)
In this one the CO2 is normal, it has not elevated in an effort to bring the pH down.
Partially compensated metabolic alkalosis:
pH 7.5 (alkaline)
CO2 60 (high-acid)
HCO3 35 (high-alkaline)
In this one the pH is still alkaline, the bicarb is high, yet the CO2 is now elevated, too, in an effort to restore the pH, though it has not yet succeeded.
I hope this helps.
please go to the sticky thread i gave you. open, copy and use this document: arterial blood gases basic principles.doc. it addresses compensated and partially compensated abgs. also do the tutorials instead of continually asking for help. then, if you still have questions--ask. you have to put some effort into this. interpreting abgs is not easy and requires effort to learn.
This website is a lifesaver for a nursing student http://danibanani.wordpress.com/ on the right side there is a column for ABG's with practice tests and tutorials, it really helped me.
lder0426
6 Posts
We are just learning how to read ABGs, i wanted to see if anyone know some tricks to figuring them out ( websites, pneumonics, hints or your way to understand them)
Thanks!