An arterial blood gas (ABG) is a blood test that measures the acidity (pH) and

the levels of oxygen and carbon dioxide in the blood. Blood for an ABG test is
taken from an artery whereas most other blood tests are done on a sample of
blood taken from a vein. This test is done to monitor several conditions that can
cause serious health complications especially to critically ill individuals.
Every day, a lot of nursing and medical students assigned in acute areas
encounter ABG results, which they may not necessarily be able to interpret with
its knotty aspect. They struggle over the interpretation of its measurements, but
they are not especially complicated nor difficult if you understand the basic
physiology and have a step by step process to analyze and interpret them.
There may be various tips and strategies to guide you, from mnemonics, to
charts, to lectures, to practice, but this article will tell you how to interpret ABGs

in the easiest possible way. And once you have finished reading this, youll be
doing actual ABG analysis in the NCLEX with fun and excitement!
Steps:
Contents [show]

1. Know the Normal Values

Know the normal and abnormal ABG values when you review the lab reports.

2. Check for Acidosis or Alkalosis

The first thing you need to determine when checking ABG results is the acidity
of the blood which is determined by the value of the pH. The pH level in a
healthy human should be between 7.35 to 7.45. Your body is constantly striving
to keep pH in balance.
pH level below 7.35 is Acidosis
pH level above 7.45 is Alkalosis

3. Determine If the Acid Base is Respiratory or

Metabolic

Next thing you need to determine is whether the acid base is Respiratory or
Metabolic.
paCO2 = Respiratory
HCO3 = Metabolic

4. Remember ROME
Still, it all boils down to mnemonics. The mnemonic RO-ME.
Respiratory Opposite
When pH is up, PaCO2 is down = Alkalosis
When pH is down, PaCO2 is up = Acidosis
Metabolic Equal
When pH is up, HCO3 is up = Alkalosis
When pH is down, HCO3 is down = Acidosis

5. Tic-Tac-Toe
And yes, ABG problems work using the Tic-Tac-Toe method. All you have to do is
make a blank chart a bit like a tic-tac-toe chart.

6. Mark the Chart

Using the lab result values, mark them on your Tic-Tac-Toe chart. Now begin with
this given example.
pH 7.26, PaCO2 32, HCO3 18
pH is LOW = ACID so place pH under Acid
PaCO2 is LOW = BASE so place PaCO2 under Base
HCO3 is LOW = ACID so place HCO3 under Acid
Your chart should go like this:

7. Match It up
In this step, look at which column matches up with the pH. In this case
HCO3 goes with pH. HCO3 is considered Metabolic (shown in step 3), and both
are under Acid, so this example implies Metabolic Acidosis.

8. Determine Compensation
The last step is to determine if the ABG is Compensated, Partially Compensated,
or Uncompensated.
If pH is NORMAL, PaCO2 and HCO3 are both ABNORMAL = Compensated
If pH is ABNORMAL, PaCO2 and HCO3 are both ABNORMAL = Partially
Compensated
If pH is ABNORMAL, PaCO2 or HCO3 is ABNORMAL = Uncompensated
Therefore this ABG is METABOLIC ACIDOSIS, PARTIALLY COMPENSATED .
By applying the steps above, interpret the following ABGs.
pH 7.44, PaCO2 30, HCO3 21

pH is NORMAL = NORMAL so place pH under Normal

PaCO2 is LOW = BASE so place PaCO2 under Base
HCO3 is LOW = ACID so place HCO3 under Acid
*Since the acidity of the blood is determined by the value of the pH, determine
whether the normal pH is SLIGHTLY ACIDIC or SLIGHTLY BASIC. In this example,
pH is NORMAL but SLIGHTLY BASIC therefore it is ALKALOSIS.
Your chart should go like this:

In this case PACO2 goes with pH. PACO2 is considered Respiratory (shown in
step 3), and both are under Basic, so this example implies Respiratory Alkalosis.
The HCO3 is also abnormal. When pH is NORMAL and PaCO2 and HCO3 are both
ABNORMAL, it indicates FULL COMPENSATION.
Therefore this ABG is RESPIRATORY ALKALOSIS, FULLY COMPENSATED.

pH 7.1, PACO2 40, HCO3 18

pH is LOW = ACID so place pH under Acid
PaCO2 is NORMAL = NORMAL so place PaCO2 under Normal
HCO3 is LOW = ACID so place HCO3 under Acid
Your chart should go like this:

In this case HCO3 goes with pH. HCO3 is considered Metabolic (shown in step 3),
and both are under Acidic, so this example implies Metabolic Acidosis. The
PaCO2 is normal. When pH is ABNORMAL, PaCO2 or HCO3 is ABNORMAL, it
indicates UNCOMPENSATION.
Therefore this ABG is METABOLIC ACIDOSIS, UNCOMPENSATED.