partially compensated? uncompensated? compensated?

ckh23, BSN, RN · Apr 11, 2011

I have got the respiratory vs metabolic alkalosis vs acidosis down but I'm struggling with uncompensated vs partially compensated. Anyone have a quick tip. I can get 6 out of 8 right when I'm doing them but I'm not sure why I am getting the other two wrong and it's frustrating me. Example:
pH 7.48, pCO2 30, HCO3- 23
I answered this as partially compensated respiratory alkalosis
The answer key says it's uncompensated
considering the ph is normalizing wouldn't this be an indication of partial compensation?
Now, I got this next one right:
pH 7.62, pCO2 47, HCO3- 30
I answered this as partially compensated metabolic alkalosis because the pco2 is normalizing.
So why is the first one wrong and the second one right? What am I doing wrong here?
HELP!!

The first one is uncompensated because the PH is above 7.45 and the bicarb is still in the normal range. If this were partially compensated the PH would still be above 7.45, but the bicarb would be BELOW normal. This is why in the second one it is partially compensated because the CO2 is higher than normal.

Check out this website it gives a pretty good rundown about ABG's. Slide 42 talks about compensation.

http://www.scribd.com/doc/6386357/Arterial-Blood-Gases-Made-Easy

yayforme · Apr 11, 2011

ckh23 is right so always remember to check your levels of CO2. When you are looking at these case studies remember what fully compensated, partially compensated and uncompensated means. If someone is fully compensated it means their bicarb or CO2 level is out of norm (high) trying to bring the pH back to norm. When we are talking about Resp alkalosis we want to see higher levels of CO2. If the levels are higher it is compensating, now you need to see if it is fully or partially. what is the actual pH? Is it within normal levels? it is fully comp. meaning the pH is 7.35 to 7.45. The pH not in normal levels, but a higher CO2 means partially comp. Since the patients pH level is high it is Alk and since the CO2 and Bicarb are in normal ranges they are not trying to compensate yet. So, uncompensated Resp alkalosis. Once you get it down it is a cake walk but getting it down sometimes feels like you are running around in circles. Hope that helps.

savagetrojan · Apr 11, 2011

Thanks a million. I just couldn't get it to sink in. I believe I finally got it! and you are right yay.... I felt like a dog chasing its tail, the more I read the more confused I got but once it hit me it was like a lightbulb.

kgh31386, BSN, MSN, RN · Apr 11, 2011

Be careful when you say normalizing. The question doesn't say what the values were prior to any moment in time. Your Ph in #1 may have been 7.46 before, you don't know. Look at the current values and whether they're above or below the normal limit. The only time you worry about something within the normal limit is when it's fully compensated and the PH is above or below 7.40