ABG Course (Arterial Blood Gas) Introduction
The Arterial Blood Gas (ABG) Course takes the often confusing topic of Acid-Base Balance broken it down into manageable chunks of information. In this course you will learn the basics of ABGs and how to interpret them quickly and easily! We’ll show you how to identify any abnormalities in the ABG results and how to […]
Base Excess & Deficit
Overview Definition → The level of excess or deficiency of base present in the blood Normal value: -2.0 to 2.0 mEq/L Negative = Base Deficit Positive = Base Excess Nursing Points General Indicator of metabolic component of acid-base balance Very often a base deficit indicates a poor perfusion state Limitations: Chronic Acid-Base Imbalance Renal Failure […]
Lactic Acid
Overview Normal Value 0.5 – 1.0 mmol/L In critically ill → normal = <2.0 mmol/L Most common form of metabolic acidosis in hospitalized patients Anion Gap acidosis Nursing Points General Possible causes of elevated levels Anaerobic metabolism Strenuous exercise Temporary Hypoxemia Poor perfusion Shock states Hypotension Sepsis Released with catecholamine response Renal Failure Decreased excretion […]
ABG (Arterial Blood Gas) Oxygenation
Overview Oxygenation Values on an ABG PaO2 – Partial Pressure of Oxygen Amount of oxygen dissolved in arterial blood How well the lungs are working to get O2 INTO the arterial blood SaO2 – Arterial Oxygen Saturation Percentage of hemoglobin molecules fully saturated with oxygen in arterial blood How well is the blood carrying/transporting O2 […]
Metabolic Alkalosis
Overview Lab Values HIGH pH HIGH HCO3 Nursing Points General Causes Loss of Acids Excessive vomiting NG Tube Suctioning Diuretics Loss of potassium Retention of Alkaline substances Excessive use of antacids Renal Failure Retention of sodium and bicarb Loss of potassium and hydrogen Hypokalemia Causes hydrogen ions to shift into the cells to trade with […]
Metabolic Acidosis (interpretation and nursing diagnosis)
Overview Lab Values LOW pH LOW HCO3 Nursing Points General Causes Increase in metabolic acids Diabetic ketoacidosis Lactic acidosis (sepsis or shock) Toxins/poisons Renal failure Retention of acidic toxins Loss of alkaline substances Diarrhea Renal failure Loss of HCO3 Assessment Symptoms Altered LOC Confusion Drowsiness Headache Nausea/Vomiting Trying to get rid of acids Increased Respirations […]
Respiratory Alkalosis
Overview Lab Values HIGH pH LOW PaCO2 Nursing Points General Causes Hyperventilation Anxiety Fear Fever Hypoxemia Alveolar hemorrhage Pulmonary Embolism Mechanical ventilation Rate too fast Volumes too large Assessment Symptoms Signs of the cause Lightheaded Numbness/Tingling Chest discomfort Dyspnea Confusion Therapeutic Management Address the cause Correct hypoxemia Treat PE Decrease anxiety, fear Reassurance Paper bag […]
Respiratory Acidosis (interpretation and nursing interventions)
Overview Lab Values LOW pH (< 7.35) HIGH PaCO2 (> 45 mmHg) May also see low oxygenation LOW PaO2 LOW SpO2 Nursing Points General Causes Hypoventilation – slow or shallow respirations Sedative or narcotic overdose Brain injury Airway obstructions Asthma COPD Aspiration Lung collapse Atelectasis Pneumo/Hemothorax Assessment Symptoms Signs of the cause Decreased LOC Confusion […]
ABGs Tic-Tac-Toe interpretation Method
Overview The ABG Tic Tac Toe method uses visual placement of values for evaluation. Nursing Points General Setup Three columns: Acidosis Normal Alkalosis Two rows under the headers Left blank Process For each value, determine if it represents acidosis, alkalosis, or a normal value. Write “pH”, “pCO2” and HCO3” under their correct columns Whichever […]
ROME – ABG (Arterial Blood Gas) Interpretation
Overview Interpretation of ABGs is all about determining the SOURCE of the abnormality Three basic steps regardless of method Determine acidosis, alkalosis, or normal: pH CO2 HCO3 Which is the source? Is there compensation? Nursing Points General ROME Blood Gas: Respiratory Opposite Metabolic Equal Assessment Respiratory Acidosis pH ↓ pCO2 ↑ HCO3 (n) […]
