This ABG is an example of a partially compensated respiratory acidosis. This is higher than normal, so we have an alkalosis. ABGs Tic Tac Toe Method for Nurses with QUIZ: This video tutorial is on how to set-up arterial blood gas problems using the tic tac toe method. Yes, normal HCO3- is between 22-28. And note - The term partial or fully-compensated is used to describe the level of compensation and does not necessarily mean the patient’s ABG is normal or that they are healthy. Let’s do it. This test is commonly performed in the ICU and ER setting; however, ABGs can be drawn on any patient on any floor depending on their diagnosis. This article has been reviewed by our panel of experienced registered nurses: An ABG is a blood test that measures the acidity, or pH, and the levels of oxygen (O2) and carbon dioxide (CO2) from an artery.² The test is used to check the function of the patient’s lungs and how well they are able to move oxygen into the blood and remove carbon dioxide. When interpreting arterial blood gas (ABG) results, it is essential to know what ABG values are considered ‘normal’. PO 2 values compare poorly. This question provides a scenario about arterial blood gas results. You know all nursing jobs aren’t created (or paid!) Below is a step-by-step guide to taking an arterial blood gas sample in an OSCE setting, with an included video demonstration. 2017). If ∆AG/∆ [HCO 3 -] > 2.0, then a concurrent metabolic alkalosis is likely to be present. pH: 7.35-7.45. Published information on the errors of ABG sampling arising from the presence of air bubbles comes from Biswas et al (1982). Medlineplus 2018, Blood Gases, viewed 20 April 2020. ABG’s vs VBG’s in the Emergency Department. So the first thing an arterial blood gas can tell is the pH of the blood. The bicarbonate buffering system is the method by which the body controls pH and is crucial to understand arterial and venous blood gas results. The CO2 is 50, which is high. Name / date of birth 2. Usefulness. There are many different ways to remember how to analyze arterial blood gas. To assess how well it has been able to do this, we need to refer back to the pH. Once you’ve determined whether there is too much acid or too much base, you can move on to determine the cause of it. Collection of arterial blood for arterial blood gas (ABG) test. The radial artery on the wrist is most commonly used to obtain the sample. Arterial blood gasses, or ABGs, are among the more complex assessments performed by clinical healthcare professionals. Arterial blood gas test is the common test of blood gas analysis. As a side note, remember the [HCO 3–] value obtained from an arterial blood gas (ABG) is calculated. Metabolic Equal -- In metabolic disorders, the PH and CO2 arrows will move in the same direction. Copyright © 2021 Full Beaker, Inc | 866-302-3888 | [email protected] | Do Not Sell My Personal Information, 6 Steps to Becoming a Forensic Nurse | Salary & Programs, Career Advancement: Registered Nurse to Medical Doctor, National Center for Biotechnology Information, Journal of Clinical and Diagnostic Research, Physiology, Respiratory Alkalosis - Joshua E. Brinkman; Sandeep Sharma, Interpretation of Arterial Blood Gases (ABGs) - David A. Kaufman, MD, Kathleen Coduvell Gaines, BSN, RN, BA, CBC, Chronic Obstructive Pulmonary Disease (COPD), To check if lung condition treatments are working, Partial pressure of carbon dioxide (PaCO2). If the pH is back within normal ranges then a full-compensation has occurred. And even with a normal pH level, acidosis or alkalosis may still be present, as the body can compensate to balance the pH.⁶. The PaO2 is low so it is possible that it is a venous sample. ... then it is likely to be some sort of compensation! National Center for Biotechnology Information, 3. Alkalosis is the opposite. This method is simple, easy and can be used for the majority of ABGs. However, the femoral artery and brachial artery can be used if necessary. Respiratory Opposite -- In respiratory disorders, the pH and CO2 arrows move in opposite directions. Arterial blood gases (ABG’s) – blood sample taken directly from an artery used to gauge the metabolic environment, oxygenation, and ventilation status. Chang, E, Daly, J & Elliot, D 2006, Pathophysiology Applied to Nursing Practice, 2nd edn, Mosby Australia, Port Melbourne, VIC, Australia. Note: ABGs should be thought of as a snapshot of how the body is interacting with its environment at a particular time. ABGs are drawn for a variety of reasons. Normal is considered to be from 22 to 26 mmol/L. Arterial blood gas (ABG) analysis is an important laboratory method that provides reliable information about the patient’s metabolic status and respiratory physiology. The key difference between arterial and venous blood gas is that arterial blood gas test uses a small blood sample drawn from an artery while venous blood gas test is a comparatively less painful test that uses a small blood sample drawn from a vein.. Arterial Blood Gases (ABG) can be difficult and confusing to understand at first. When sticking the artery you will see pulsatile flow which indicates you are in the artery. It also measures your body’s acid-base (pH) level, which is … Finally, bicarbonate ions, or HCO3-, will tell you if the problem is related to metabolic changes in your patient and refers to the renal system (Berman et al. If the cause is respiratory in nature, the PaCO2 will be out of the normal range, whereas for metabolic problems the HCO3- will be abnormal. Arterial blood gas (ABG) testing is a diagnostic test performed on blood taken from an artery that provides a glimpse of how much oxygen and carbon dioxide are in your blood, along with your blood's pH level. The next value is the carbon dioxide level, and this will tell you if the problem is respiratory in origin, as CO2 is regulated by the lungs (Berman et al. Some hospitals allow specially trained nurses or phlebotomists to perform this skill but only after an intense training program. Assessment of electrolyte levels. According to the National Institute of Health, typical normal values are: The first value a nurse should look at is the pH to determine if the patient is in the normal range, above, or below. Partial pressure of carbon dioxide (PaCO2): 35-45 mmHg. No, the pH is not within normal ranges, so there is partial compensation occurring. So we have respiratory acidosis. The pH is 7.30. If the results are not understood right, or are wrongly interpreted, it can result in wrong diagnosis and end up in an inappropriate management of the patient. This is an NCLEX practice question on partially compensated vs fully compensated ABGs. It is also used to assess integrity of the ventilatory control system and to determine the acid-bas level of the blood. Asking the help of more senior clinical nurses and respiratory therapists will allow novice nurses to master this skill. Use a metabolic profile (BMP, CMP) to determine the measured [HCO 3–] when performing detailed acid-base assessments. ABG Quick Interpretation Parameter Acidosis Normal Alkalosis Reflects pH < 7.35 7.35-7.45 > 7.45 Acid/Base Status of Body pCO2 > 45 35-45 < 35 Respiratory Component HCO3 < 22 22-26 > 26 Metabolic Component Facts: Body will not overcompensate when it comes to acid/base balance so: pH midpoint is … Key Components to an ABG. © 2021 Ausmed Education Pty Ltd (ABN: 33 107 354 441), https://nurse.org/articles/arterial-blood-gas-test/, https://www.healthline.com/health/blood-gases, https://www.thoracic.org/professionals/clinical-resources/critical-care/clinical-education/abgs.php, https://medlineplus.gov/ency/article/003855.htm. However, it's a crucial skill for nurses, physicians, respiratory therapists, and nursing students to learn.