uncompensated vs partially compensated

BeachieRN84 · 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:

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:

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!!

Here is an easy way to remember how to interpret an ABG quickly.

Look at your pH. You already know that the normal pH is 7.35-7.45 and that if your pH is less than 7.35, you are acidic and if you are greater than 7.45 you are alkaline.

So now, don't worry about the Resp vs Metabolic yet. Look at the pH again. If the pH is NOT normal, you are NOT compensated. If your pH is greater than 7.45 or less than 7.35, you are uncompensated.

I always go with the mneumonic ROME-- Respiratory opposite, Metabolic equal. If the ABG shows for example, that your pH is low, and your CO2 is high, then you are opposite--the failure is from the respiratory system. If your pH is high and your Bicarb is also high, then you are equal--the failure is from the renal system.

To figure out partial compensation....If BOTH systems, along with the pH are abnormal, you are partially compensating. Your respiratory system will compensate for your renal system and vice versa.

So for the example you posted: pH 7.62, pCO2 47, HCO3- 30

Your pH is high and your Bicarb is high, so you equal.. metabolic. Your pH is high so you are alkalotic. Look at your CO2 and that is also high. Your CO2 *is* rising, the lungs are trying their best to compensate for the kidneys... but since your pH is still too high, you are only partially compensated right now. In this ABG, you have abnormal numbers in the respiratory value, the metabolic value and the pH.

The next example: pH 7.48, pCO2 30, HCO3- 23

Your pH is high and your CO2 is low, so you are opposite..respiratory. Your pH is high, so you are alkaline. Your bicarb is *normal*. If the bicarb was lower than 23, it would be partially compensated. But because the Bicarb is WNL, and the pH is still too high, you are completely uncompensated. In this ABG, the only abnormal value besides the pH is the CO2--the respiratory value.

I hope that helps a little :-)

yasmin0518 · Jan 28, 2013

This is so great and easy to understand !!! And a big help thank you so much

logank622 · Jan 28, 2013

Beachie, you are my favorite person today! I have trouble with ABGs, and this explanation is MUCH easier than anything I've seen before. Thank you!

NiloJuniorRN · Jan 20, 2014

Thank you so much BeachieRN84. You're such a blessing to those who have trouble in ABG interpretation. Your response is a pro! Keep up and God bless.

Tcons · Feb 16, 2016

So helpful! Thank youuuuuuu SO much!

smtha620 · May 27, 2016

Thank you! You are an ABG Goddess...

TheCommuter, BSN, RN · May 28, 2016

Moved to Nursing Student Assistance forum...

la_chica_suerte85, BSN, RN · May 30, 2016

I put it in a calculator and got partially compensated, as well (ABG interpreter - calculator) - this is kind of a nifty resource because it has a table that shows under what conditions something is fully compensated and party and so on and so forth. I hope this helps!