82yo male on bipap FIO2 90% with diagnosis of pneumonia. o2 sats WNL. ph 7.54 pco2 51 p02 64 hco3 43.6 BE 18.5 I am a relatively new ICU nurse and ABG's aren't my strong point. Charge RN... Read More

1. It looks like he is hypoxic so why would you think his O2 is WNL? What were his resps like? It looks like he was metabolic alkalosis and respiratory acidosis (compensation) dt his pnuemonia. The lasix was to clear his lungs, doesnt sound like his kidneys were failing but could be dt to his hypoxia.
2. Quote from gwenith
Look at the Nomogram for ABG's in the following text

http://umed.med.utah.edu/ms2/renal/W...0Disorders.htm

Nomograms are absurdly simple to use and will give you a more accurate insight into what is happening than those silly up down arrows.

Use one for a while and it will not be too long before reading the gas will come more easily

3. just remember these quick and easy to learn formulas....
these are what should be the maximal compensations...

the compensation from metabolic system for respiratory problems
an acute acidosis HCO3= [(PaCO2-40)/15)]+24 +-2
a chronic acidosis HCO3= [(PaCO2-40)/10)]4 +24 +-2

an acute alkalosis HCO3= 24 - [(40-PaCO2)/5)] +-2
a chronic alkalosis HCO3= 24 - [(40-PaCO2)/10)]5 +-2

the compensation from the respiratory system for metabolic problems
acidosis PaCO2 = 1.5HCO3+8 +-2
alkalosis PaCO2 = 0.7HCO3+20

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