2. Purpose of ABG
īą Assess degree to which
ī§ Lungs are able to provide adequate O2 & remove
CO2 and
ī§ Kidneys are able to reabsorb or excrete HCO3 .
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Rafiq Suleman BScN
Feb 1st, 2014.
3. You Must Know What is Normal to
be Able to Know What is Abnormal
īpH
= 7.35 to 7.45
īPaC02 = 35 to 45 mm Hg
īPaO2 = 80 to 100 mm Hg
īHCO3 = 22 â 26 mEq/l
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Rafiq Suleman BScN
Feb 1st, 2014.
4. What You Must Look At To Interpret
ABGs
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Rafiq Suleman BScN
Feb 1st, 2014.
5. Look at Your pH
īIs it normal?
īIs it high ?
īIs it low?
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Rafiq Suleman BScN
Feb 1st, 2014.
7. Look at Your PaCO2
īIs it normal ?
īIs it high ?
īIs it low ?
īThis is the respiratory component.
īAn
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abnormality in the PaCO2 will
indicate
Rafiq Suleman BScN
a respiratory problem.
Feb 1st, 2014.
8. Examples
īPaCO2 = 40 mm Hg
īPaCO2 = 23 mm Hg
īPaCO2 = 48 mm Hg
īA high PaCO2 indicates acidity.
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īA low PaCO2 indicates alkalosis.eb 1st, 2014.
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Rafiq Suleman BScN
9. PaCO2
īLungs will increase or decrease
ventilation to remove the appropriate
amount of CO2 .
īLung compensation begins quickly.
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Rafiq Suleman BScN
Feb 1st, 2014.
10. Now Look at Your HCO3
īIs it normal ?
īIs it high ?
īIs it low ?
īThis is the metabolic component.
īAn abnormality in the HCO3 indicates a
metabolic problem.
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Rafiq Suleman BScN
Feb 1st, 2014.
15. Metabolic Acidosis
ABGs:
īLow pH (below 7.35).
īDecreased HCO3 (below 22)
īPaCO2 will be normal.
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Remember both the pH & HCO3 will be low.
Rafiq Suleman BScN
Feb 1st, 2014.
16. Metabolic Acidosis
īCaused by too much acid in the body or loss
of bicarbonate.
īDiarrhea (loss of HCO3).
īDiabetic ketoacidosis.
īRenal failure.
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Rafiq Suleman BScN
Feb 1st, 2014.
17. Respiratory Acidosis
ABGs:
īLow pH (below 7.35)
īIncreased PaCO2 (above 45)
īHCO3 will be normal.
Remember the pH will be low & PaCO2 will be
elevated (opposite).
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Rafiq Suleman BScN
Feb 1st, 2014.
18. Respiratory Acidosis
īCaused by acid buildup due to lungs not
eliminating CO2 .
īAnything that decreased. respirations can cause
respiratory acidosis.
īChronic respiratory disease.
īCNS depression.
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Rafiq Suleman BScN
Feb 1st, 2014.
20. Metabolic Alkalosis
ABGs:
īIncrease in pH (greater than 7.45)
ī Increased HCO3 (greater than 26)
īPaCO2 will be normal.
Remember both the pH & the HCO3 will be elevated.
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Rafiq Suleman BScN
Feb 1st, 2014.
21. Metabolic Alkalosis
īLoss of acid or increase in HCO3
īVomiting or NG drainage
(loss of Hydrogen).
īExcessive use of antacids.
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Rafiq Suleman BScN
Feb 1st, 2014.
22. Respiratory Alkalosis
ABGs:
īIncrease in pH
(greater than 7.45)
īDecrease in PaCO2 (less than 35)
īHCO3 will be normal.
Remember the pH will be high & PaCO2 will be low
(opposite).
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Rafiq Suleman BScN
Feb 1st, 2014.
25. 1st Step Look at pH
īIs it normal (7.35 to 7.45)
īDoes it reflect acidosis ( less than 7.35).
īDoes it reflect alkalosis (greater than 7.45).
īLabel accordingly.
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Rafiq Suleman BScN
Feb 1st, 2014.
26. 2nd Step Look at PaCO2
īThis is the respiratory component.
īIs it normal.
īDoes it reflect alkalosis (less than 35).
īDoes it reflect acidosis (greater than 45).
īLabel accordingly.
26
Rafiq Suleman BScN
Feb 1st, 2014.
27. 3rd Step Look at the HCO3
īThis is the metabolic component
īIs it normal.
īDoes it reflect acidosis (less than 22).
īDoes it reflect alkalosis (greater than 26).
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īLabel accordingly.
Rafiq Suleman BScN
Feb 1st, 2014.
41. You Are Doing Great
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Rafiq Suleman BScN
Feb 1st, 2014.
42. Compensation
īOccurs as the body begins to correct the acid
base imbalance
īpH will be normal or near normal if total
compensation
īpH will be abnormal if partial compensation
42
Rafiq Suleman BScN
Feb 1st, 2014.
43. Compensation
īBoth the PaCo2 & HCO3 will be abnormal
īRespiratory imbalances are compensated
for by the renal system
īMetabolic imbalances are compensated for
by the respiratory system
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Rafiq Suleman BScN
Feb 1st, 2014.
44. Example
īpH of 7.27
īPaCO2 of 27 mm Hg
īHCO3 of 10 mEq/l
īNote that both the PaCO2 & the HCO3 are low.
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Rafiq Suleman BScN
Feb 1st, 2014.
45. Letâs Break it Down
īLow pH
= Acidosis
īLow PaCO2 = Alkalosis
īLow HCO3 = Acidosis
īHCO3 corresponds with the pH
īThis is a metabolic problem
īMetabolic acidosis with partial compensation.
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Rafiq Suleman BScN
Feb 1st, 2014.
46. Problems
īpH of 7.52
īPaCO2 of 47 mmHg
īHCO3 of 36 mEq/L
īWhat does this indicate
īBreak it down
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Rafiq Suleman BScN
Feb 1st, 2014.
47. īpH
= Alkalosis
īPaCO2 = Acidosis
īHCO3 = Alkalosis
īWhich two go together?
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Rafiq Suleman BScN
Feb 1st, 2014.
48. Metabolic Alkalosis with Partial
Compensation
You are
doing great!!
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Rafiq Suleman BScN
Feb 1st, 2014.
49. Problems
īpH of 7.45
īPaCO2 of 50 mmHg
īHCO3 of 33 mEq/L
īWhat does this indicate
īBreak it down
49
Rafiq Suleman BScN
Feb 1st, 2014.
50. īpH
= Normal
īPaCO2 = Acidosis
īHCO3 = Alkalosis
īYour pH leans toward the alkalosis side.
50
Rafiq Suleman BScN
Feb 1st, 2014.