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Arterial blood gases Rafiq Suleman BScN (Post RN)

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Arterial blood gases Rafiq Suleman BScN (Post RN)

  1. 1. Arterial Blood Gases Made Easy Prepared by: Rafiq Suleman BScN
  2. 2. Purpose of ABG  Assess degree to which  Lungs are able to provide adequate O2 & remove CO2 and  Kidneys are able to reabsorb or excrete HCO3 . 2 Rafiq Suleman BScN Feb 1st, 2014.
  3. 3. You Must Know What is Normal to be Able to Know What is Abnormal pH = 7.35 to 7.45 PaC02 = 35 to 45 mm Hg PaO2 = 80 to 100 mm Hg HCO3 = 22 – 26 mEq/l 3 Rafiq Suleman BScN Feb 1st, 2014.
  4. 4. What You Must Look At To Interpret ABGs 4 Rafiq Suleman BScN Feb 1st, 2014.
  5. 5. Look at Your pH Is it normal? Is it high ? Is it low? 5 Rafiq Suleman BScN Feb 1st, 2014.
  6. 6. Examples pH = 7.36 pH = 7.23 pH = 7.47 A high pH indicates alkalosis. A low pH indicates acidosis. 6 Rafiq Suleman BScN Feb 1st, 2014.
  7. 7. Look at Your PaCO2 Is it normal ? Is it high ? Is it low ? This is the respiratory component. An 7 abnormality in the PaCO2 will indicate Rafiq Suleman BScN a respiratory problem. Feb 1st, 2014.
  8. 8. Examples PaCO2 = 40 mm Hg PaCO2 = 23 mm Hg PaCO2 = 48 mm Hg A high PaCO2 indicates acidity. 8 A low PaCO2 indicates alkalosis.eb 1st, 2014. F Rafiq Suleman BScN
  9. 9. PaCO2 Lungs will increase or decrease ventilation to remove the appropriate amount of CO2 . Lung compensation begins quickly. 9 Rafiq Suleman BScN Feb 1st, 2014.
  10. 10. Now Look at Your HCO3 Is it normal ? Is it high ? Is it low ? This is the metabolic component. An abnormality in the HCO3 indicates a metabolic problem. 10 Rafiq Suleman BScN Feb 1st, 2014.
  11. 11. Examples HCO3 = 25 mEq/l HCO3 = 19 mEq/l HCO3 = 32 mEq/l A low HCO3 indicates acidity. 11 A high HCO3 indicates alkalosis. Rafiq Suleman BScN Feb 1st, 2014.
  12. 12. HCO3 The kidneys excrete Hydrogen (acid) & retain bicarbonate (base) to help maintain pH. Renal compensation is slow. 12 Rafiq Suleman BScN Feb 1st, 2014.
  13. 13. Let’s Look at the 4 Situations that Can Occur 13 Rafiq Suleman BScN Feb 1st, 2014.
  14. 14. Acidosis Develops when: Excess accumulation of acid Decreased amount of alkali. Can be respiratory or metabolic. 14 Rafiq Suleman BScN Feb 1st, 2014.
  15. 15. Metabolic Acidosis ABGs: Low pH (below 7.35). Decreased HCO3 (below 22) PaCO2 will be normal. 15 Remember both the pH & HCO3 will be low. Rafiq Suleman BScN Feb 1st, 2014.
  16. 16. Metabolic Acidosis Caused by too much acid in the body or loss of bicarbonate. Diarrhea (loss of HCO3). Diabetic ketoacidosis. Renal failure. 16 Rafiq Suleman BScN Feb 1st, 2014.
  17. 17. Respiratory Acidosis ABGs: Low pH (below 7.35) Increased PaCO2 (above 45) HCO3 will be normal. Remember the pH will be low & PaCO2 will be elevated (opposite). 17 Rafiq Suleman BScN Feb 1st, 2014.
  18. 18. Respiratory Acidosis Caused by acid buildup due to lungs not eliminating CO2 . Anything that decreased. respirations can cause respiratory acidosis. Chronic respiratory disease. CNS depression. 18 Rafiq Suleman BScN Feb 1st, 2014.
  19. 19. Alkalosis Develops when: Excess accumulation of bicarbonate. Loss of acid. 19 Rafiq Suleman BScN Feb 1st, 2014.
  20. 20. Metabolic Alkalosis ABGs: Increase in pH (greater than 7.45)  Increased HCO3 (greater than 26) PaCO2 will be normal. Remember both the pH & the HCO3 will be elevated. 20 Rafiq Suleman BScN Feb 1st, 2014.
  21. 21. Metabolic Alkalosis Loss of acid or increase in HCO3 Vomiting or NG drainage (loss of Hydrogen). Excessive use of antacids. 21 Rafiq Suleman BScN Feb 1st, 2014.
  22. 22. Respiratory Alkalosis ABGs: Increase in pH (greater than 7.45) Decrease in PaCO2 (less than 35) HCO3 will be normal. Remember the pH will be high & PaCO2 will be low (opposite). 22 Rafiq Suleman BScN Feb 1st, 2014.
  23. 23. Respiratory Alkalosis Caused by too much CO2 being excreted by the lungs. Hyperventilation. 23 Rafiq Suleman BScN Feb 1st, 2014.
  24. 24. Interpreting ABGs 24 Rafiq Suleman BScN Feb 1st, 2014.
  25. 25. 1 Step Look at pH st Is it normal (7.35 to 7.45) Does it reflect acidosis ( less than 7.35). Does it reflect alkalosis (greater than 7.45). Label accordingly. 25 Rafiq Suleman BScN Feb 1st, 2014.
  26. 26. Next Look at PaCO2 This is the respiratory component. Is it normal. Does it reflect alkalosis (less than 35). Does it reflect acidosis (greater than 45). Label accordingly. 26 Rafiq Suleman BScN Feb 1st, 2014.
  27. 27. Next Look at the HCO3 This is the metabolic component Is it normal. Does it reflect acidosis (less than 22). Does it reflect alkalosis (greater than 26). 27 Label accordingly. Rafiq Suleman BScN Feb 1st, 2014.
  28. 28. Let’s Put It All Together 28 Rafiq Suleman BScN Feb 1st, 2014.
  29. 29. Problems pH of 7.33 PaCO2 of 40 mmHg HCO3 of 20 mEq/L What does this indicate 29 Break it down Rafiq Suleman BScN Feb 1st, 2014.
  30. 30. pH = Acidosis PaCO2 = Normal HCO3 = Acidosis An abnormal HCO3 indicates a metabolic problem. 30 Rafiq Suleman BScN Feb 1st, 2014.
  31. 31. Metabolic Acidosis Way to go!! 31 Rafiq Suleman BScN Feb 1st, 2014.
  32. 32. Problem pH of 7.59 PaCO2 of 29 mm Hg HCO3 of 24mEq/L What does this indicate Break it down 32 Rafiq Suleman BScN Feb 1st, 2014.
  33. 33. pH = Alkalosis PaCO2 = Alkalosis HCO3 = Normal An abnormal PaCO2 indicates a respiratory problem. 33 Rafiq Suleman BScN Feb 1st, 2014.
  34. 34. Respiratory Alkalosis Great Job!! 34 Rafiq Suleman BScN Feb 1st, 2014.
  35. 35. Problem pH of 7.25 PaCO2 of 61 mmHg HCO3 of 26 mEq/L What does this indicate Break it down 35 Rafiq Suleman BScN Feb 1st, 2014.
  36. 36. pH = Acidosis PaCO2 = Acidosis HCO3 = Normal An abnormal PaCO2 indicates a respiratory problem. 36 Rafiq Suleman BScN Feb 1st, 2014.
  37. 37. Respiratory Acidosis You are doing a great job !! 37 Rafiq Suleman BScN Feb 1st, 2014.
  38. 38. Problem pH of 7.51 PaCO2 of 44mmHg HCO3 of 56 What does this indicate Break it down 38 Rafiq Suleman BScN Feb 1st, 2014.
  39. 39. pH = Alkalosis PaCO2 = Normal HCO3 = Alkalosis An abnormal HCO3 indicates a metabolic problem. 39 Rafiq Suleman BScN Feb 1st, 2014.
  40. 40. Metabolic Alkalosis You have become an ABG pro!! 40 Rafiq Suleman BScN Feb 1st, 2014.
  41. 41. You Are Doing Great 41 Rafiq Suleman BScN Feb 1st, 2014.
  42. 42. Compensation Occurs as the body begins to correct the acid base imbalance pH will be normal or near normal if total compensation pH will be abnormal if partial compensation 42 Rafiq Suleman BScN Feb 1st, 2014.
  43. 43. Compensation Both the PaCo2 & HCO3 will be abnormal Respiratory imbalances are compensated for by the renal system Metabolic imbalances are compensated for by the respiratory system 43 Rafiq Suleman BScN Feb 1st, 2014.
  44. 44. Example pH of 7.27 PaCO2 of 27 mm Hg HCO3 of 10 mEq/l Note that both the PaCO2 & the HCO3 are low. 44 Rafiq Suleman BScN Feb 1st, 2014.
  45. 45. Let’s Break it Down Low pH = Acidosis Low PaCO2 = Alkalosis Low HCO3 = Acidosis HCO3 corresponds with the pH This is a metabolic problem Metabolic acidosis with partial compensation. 45 Rafiq Suleman BScN Feb 1st, 2014.
  46. 46. Problems pH of 7.52 PaCO2 of 47 mmHg HCO3 of 36 mEq/L What does this indicate Break it down 46 Rafiq Suleman BScN Feb 1st, 2014.
  47. 47. pH = Alkalosis PaCO2 = Acidosis HCO3 = Alkalosis Which two go together? 47 Rafiq Suleman BScN Feb 1st, 2014.
  48. 48. Metabolic Alkalosis with Partial Compensation You are doing great!! 48 Rafiq Suleman BScN Feb 1st, 2014.
  49. 49. Problems pH of 7.45 PaCO2 of 50 mmHg HCO3 of 33 mEq/L What does this indicate Break it down 49 Rafiq Suleman BScN Feb 1st, 2014.
  50. 50. pH = Normal PaCO2 = Acidosis HCO3 = Alkalosis Your pH leans toward the alkalosis side. 50 Rafiq Suleman BScN Feb 1st, 2014.
  51. 51. Fully Compensated Metabolic Alkalosis You have done great!! 51 Rafiq Suleman BScN Feb 1st, 2014.
  52. 52. 52 Rafiq Suleman BScN Feb 1st, 2014.

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