In this video we're diving into arterial blood gas interpretation, specifically talking about
how to tell if an ABG is fully compensated, partially compensated, or uncompensated.
Let's do it.
Hello again friend, Christina here with nursingschoolofsuccess.com
and today we're talking all about abg's or arterial blood gases and
how to interpet them.
This is a MUST know for nursing school, so I'm going to break it down really easy for
you so you can finally understand it.
And before we get started, subscribe to this channel so you never miss out on any other
nursing school tips that I've got for you.
So you have these 3 main components to look at when solving ABGs: the pH (which tells
you if the blood is more acidic or more alkaline), the PaCO2 (which tells you how much carbon
dioxide is in the blood.
Carbon dioxide is an ACID) and the HCO3 (which tells you how much bicarbonate is in the blood,
and bicarbonate is a BASE).
Now if you haven't already, make sure to check the other video we have on ABG interpretation,
where I walk you through the easy, step-by-step process I use when solving ABGs.
We're going to use that same process here, so if you want a deep dive on how to do it,
make sure to check that video out.
So like we talked about in that previous video, the pH will tell you if the blood is acidic
or basic.
If the pH is less than 7.4, it's acidic.
If the pH is greater than 7.4, it's more alkaline or basic.
A normal pH value is between 7.35 and 7.45.
The PaCO2 level tells you how much carbon dioxide there is in the blood, and the HCO3
level tells you how much bicarbonate is in the blood.
A normal PaCO2 is between 35-45 millimeters mercury, and a normal HCO3 is between 22-26
miliEquivalents per liter.
Let's throw up an example problem to walk through as we do this.
Let's say the pH is 7.32, the PaCO2 is 31, and the HCO3 is 16.
The first thing you need to do is determine if the pH is acidic or basic - is it lower
than 7.4 or above 7.4?
In this case, the pH is acidic because it's lower than 7.4, and it's also lower than the
normal range.
So once you've decided that the pH is acidic or basic , you'll look at the PaCO2 and the
HCO3 values to determine which one caused the problem in the first place.
There are only 2 options: the lungs or the kidneys.
The lungs control the PaCO2, and the kidneys control the HCO3.
If the pH is acidic and the PaCO2 is higher than normal, that means that the lungs are
holding onto too much acid, and they are the problem.
If the pH is BASIC and the HCO3 level is higher than normal, that means the kidneys are making
too much base, and they are the problem.
Whoever the problem is, we call them the party pooper.
So determine if the lungs are the problem or if they kidneys are the problem.
Remember, if you need a deeper dive on how to determine this, watch the previous video
where I walk you through it step by step.
We're just doing a general overview here.
So here in our example, the pH is acidic, but the PaCO2 value is lower than normal,
so the lungs are not the problem.
The lungs are not bringing too much acid.
So let's look at the kidneys.
And here we see that the HCO3 value is low, so the kidneys aren't making enough bicarbonate,
causing the blood to be acidic.
So the kidneys are the problem here.
So in this example ABG problem, the kidneys are the party poopers.
And that makes this example metabolic acidosis.
So now that we've got that figured out, we need to decide if the other guy (I call him,
the "Life of the Party") if he's helping or not.
In this case, the "Life of the Party" is the lungs.
And we see here that the PaCO2 value is lower than normal range, which means YES!
The lungs know there's a problem, they know the kidneys aren't making enough base, so
they've decided to get rid of more CO2 to help bring the acid level down in the body.
Since the kidneys are causing the problem, the lungs are trying to help by getting rid
of their acid - that CO2.
And this is where we really get into ABG compensation.
If the Life of the Party is trying to help, then we call this either partially or fully
compensated.
It's partially compensated if the helpers value is changing but the pH isn't quite back
within normal range, and it's fully compensated if the helpers value is changing and the pH
is back to normal.
So in our example, since the kidneys are the party poopers, they're causing the problem
in the first place.
And the lungs are the Life of the Party, they're trying to help, and their value is changing,
that means that this example is some sort of compensated.
So we just need to look back at the pH to determine if it's partially compensated or
fully compensated.
If the pH is within normal range, it's FULLY compensated.
If the pH is outside normal range, but the Life of the Party's value is changing (in
this case it's the lungs, and yes, the lungs ARE trying to help), then it's partially compensated.
Partially compensated means that the pH isn't quite yet back to normal range, but the Life
of the Party is working on it to make it happen.
It's value is changing.
If the lungs hadn't noticed anything was wrong and their value wasn't changing, that would
make this example UNCOMPENSATED.
So in our ABG example here, it's partially compensated metabolic acidosis.
Uncompensated means that the "Life of the Party" hasn't noticed anything is wrong, it's
value is still within normal range, and the pH is still messed up.
Partially compensated means that the "Life of the Party" HAS noticed that the party pooper
is being a party pooper, but they haven't had enough time to help.
(the pH is still out of wack, even though the "Life of the Party's" value is changing
to compensate)
And full compensation happens when the "Life of the Party" has noticed something is wrong,
their value has changed and the pH has gone back within normal range.
If this ABG example helped you understand arterial blood gases better, write LOVE in
the comments below.
And like I said before, if you want a step-by-step guide for interpreting arterial blood gases,
make sure to check that video out, the link is down below in the description.
And I've also got a free ABG cheat sheet for you to download too if you'd like.
That link is also in the description.
Thanks for watching friend!
Now go become the nurse that God created only YOU to be.
And I'll catch you in the next video.