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ABG Interpretation
ABG Interpretation
ABG Interpretation
I.
Introduction:
Arterial Blood Gases: gives us information about:
--- acid-base balance (pH 7.4)
--- alveolar ventilation
--- oxygenation
Includes:
--- pH (Hydrogen ion concentration)
--- Pa02: partial pres. of 02 in arterial blood
--- PaC02: partial pres. of C02 in arterial blood
--- HC03 (bicarbonate)
--- 02 saturation: % of hgb. in the arterial blood that is saturated with 02
(normal: 95-100%)
pH: hydrogen ion concentration:
Acids: donate H ions
Bases: accept H ions
If increased numbers of Hydrogen ions: acidic with a lower pH
If decreased numbers of Hydrogen ions: alkalotic with a higher pH
Normal pH of the blood: 7.35-7.45
If less than 7.35: acidic
If more than 7.45: alkalotic
II.
Maintaining Acid/Base Balance: balance between amt. of acids and bases in the blood.
To maintain pH between 7.35-7.45
A. Chemical buffers in the serum
Bicarbonate: carbonic acid
B. Lungs: control C02
(C02 is an acid)
RESPIRATORY
C. Kidneys: can excrete H ions or conserve bicarbonate.
Act slowly.
METABOLIC
III.
Normal ABG's
Again, ABG's indicate acid base balance, ventilation, and oxygenation.
pH: 7.35-7.45 (7.4)
PaC02: 35-45
Pa02: 80-100
HC03: 22-26
Types of ABG abnormalities
A. Respiratory alkalosis
B. Metabolic acidosis
C. Metabolic alkalosis
IV.
2. Partial: if the value that DOES NOT MATCH the pH is above or below the
normal range and the pH is also above or below the normal range, then partial
compensation exists.
3. Complete: This exists when the value that DOES NOT MATCH the pH is above
or below normal range and the pH is within the normal range (7.35-7.45). This
tells you that one of the systems (respiratory or metabolic) has compensated for
problems in the affected system.
V.
Abnormalities
A. Respiratory acidosis
pH < 7.35; PaC02 > 45
(too much C02 = too much acid = acidosis)
1. Causes
Resp. failure, resp. arrest, pulmonary edema, COPD, pneumonia, pneumothorax,
atelectasis, overdose, aspiration
2. s/s:
a. if sudden onset: Increased HR, decreased LOC; feeling of fullness in head;
dysrhythmias
b. if chronic: weakness, dull HA
3. tx
a. Improve ventilation (CPT, TCDB, suction, 02)
b. assess v/s, BS
c. monitor ABG
B. Respiratory alkalosis
pH > 7.45; PaC02 < 35
too little C02 = too little acid = alkalosis
1. Causes: HYPERVENTILATION
pain, anxiety, hypoxemia, ventilators
2. s/s:
lightheadedness, unable to concentrate; numbness, tingling: tinnitus
3. tx: the cause
a. slow breaths
b. use paper bag
C. Metabolic acidosis
pH < 7.35; HC03 < 22
Too little HC03 = too little base = acidosis
1. causes
diabetic ketoacidosis (DKA); starvation (ketoacidosis), lactic acidosis (arrest);
renal failure; diarrhea; ASA poisoning
2. s/s
Step 2:
Step 3:
Step 4:
The increased HCO3 indicates compensation but the pH is below 7.35 so it's only
Partial Compensation.
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3/2014