hello nurses today we are going to discuss enlex RN ABG interpretation ABG M arterial blood gases acid or base and system it's related to pH system so I'm not sure if you guys are aware like stach l as you can see here numb it's all acidic and normal and alkaline so the more the pH is the more it's alkaline so acidic and alkaline so let's discuss acid base balance the body likes the pH to be 7.35 to 7.40 7.35 to 7.45 so J 7.35 let's say 730 7.25 acidic situation J pH 7.45 let's say it's 750 7.55 on and on situation body it's basic base or alkalosis so base and acidic that's what we need to learn if pH is base or acid if it gets higher or lower than this it tries to bring it back into normal range this is called compensation up body automatically compensation acid base imbalance the which is ABG am35 automatically compensate and ver let's say it's more than 7.45 it's 7.60 just as an example that means body base amount it's alosis situationally cre situation cre bring it back to the normal so 7.60 down I hope this makes sense so now metabolic and respiratory kidneys make bicarbonate bicarbonates H3 and it is called base but H3 or base is related to metabolic situation H3 that means it's related to metabolic situation [Music] bbs3 situation more BB more alkalotic pH goes higher because as we discussed before pH level 7.45 situation lower than 7.35 only acidic situation so one thing is clear alal situation acid situation below 7.35 alkalosis more than 7.45 next is respiratory respiratory system pH Bas balance depb Dio it will be acidotic situation acidotic situation pH lower it will go below than 7.35 less carbon dioxide situation opposite more carbon dioxide more acidotic less carbon dioxide more more you need to remember these normal values these these normal values should be on your tips RN exam pass you will get at least one question on abgs make sure values you remember these values 7.35 45o 5 45 so same H it's CO2 is between 35 to 45 So Below 35 inversely propor but carbon Dio inversely proportion it will be acidotic and 35 carbon dioxide body then it will be alkalosis but this is just for carbon dioxide otherwise bicarbonates pH this will work in the same direction the lower the number it will be acidotic the higher the number it will be alkalosis I hope this makes sense so remember these normal values sobs this is called base which is related to metabolic system carbon dioxide is acid it's related to respiratory system so now when you need to solve ABG practice questions we will do this in steps the lower the ph it will be acidotic the higher the pH it will be alkalotic so 7.35 to a 7.45 but there is a normal value which is neutral this is 7.40 35 45 it's mid 7.40 is normal pH Next Step number two is there's a respiratory problem or there's a metabolic problem the easiest way once you get to know your pH first it's acidotic or alalo so as all of you guys know discuss CO2 respir H3 metabol let's say as an example pH pH AO it's 7.20 that means it's acidotic CO2 that means it's a respiratory problem and J to H3 the value acidotic on that means it's a metabolic acidosis one more time pH check is it acidotic or alkalotic okay let acidotic is CO2 acidotic or H3 is acidotic but CO3 alkal so you get two numbers pH A3 a number then your problem is metabolic acidosis we will come back later so example check question one is a client presents with the following ABG results what is the correct interpretation so patient the pH it's 7.35 37 so 7 37 it's in the middle so that means pH it's already normal and CO2 Carbono L 42 so 42 this side is higher this side is lower but 42 is in the middle so carbon dioxide we normal H3 y b carbs are 25 so 25 that means it's higher than 22 lower than 28 it's in the middle so 25 that means patient carbs normal now what would you do in this situation question usually document the results and keep monitoring option because patient ABG levels completely normal then what would you do as a nurse you will document that the patients ABG results are within range not need to do anything I will keep monitoring so the answer is it's normal you do not need to do anything okay next question a client presents with the following ABG results what is the correct inter interpretation so pH a patient that it's 7.20 as you can see 7.20 is lower than 7.35 so it's acidotic so this is the acidotic situation CO2 CO3 is acidotic let's find out CO2 is 58 CO2 58 so it's more than 45 that means CO2 is acidotic so this is acidotic that means up problem already solve but still we will still check the figure it's CO3 H3 value 26 26 is within this range it's normal so what is the problem it's CO2 respiratory acidosis so this is respiratory acidosis now next problem is is this compensated uncompensated partially compensated or fully compensated respiratory acidosis let's learn that so in this situation this is uncompensated respiratory acidosis now we will learn uncompensated First Step acidosis or alkalosis it was acidosis this situation is acidosis second is is it respiratory or metabolic pH a you need to find out acido H3 acidotic that means metabolic acidosis just CO2 acidotic that means respiratory acidosis but here we got CO2 acidotic so this is respiratory acidosis second problem solve third problem is compensation so CO2 is causing the problem because respiration it's related to respiratory system patient that's why the CO2 number is really high that's why it's causing respiratory acidosis but now we need to find out H3 is H3 trying to help to solve the problem let's find out H3 normal it is not helping because when H3 is normal that means body acidotic carbon dioxide increase H3 simply doesn't care it's normal that means it's uncompensated I hope this makes sense situation OPP situation completely normal this is uncompensated respiratory alkalosis because H3 third number it's normal next is question three a client presents with the following ABG results what is the correct interpretation so here the pH is 7.38 which is right here it's normal but still it's below 7.40 disc because 40 is the mid number so complicated situation then we will go precisely into the normal values so 7.40 is normal but it's slightly low than 7.40 so it will come under acidosis so pH is acid CO2 is 48 so it's higher than 45 that means it's acidotic as well so problem solve first this is respiratory acidosis now next step we need to find out if this is compensated uncompensated fully compensated or partially compensated H3 is 37 37 means it's way too high it's way too high 37 that means H3 is trying to help how it's trying to help H increased so that problem so hc3 is trying to help moreover it's already helped that's why J PHR it's closed to normal it's 7.38 so we found out that it's fully compensated respiratory acidosis so fully compensated fully compensated amount so that it will bring bring it back to the normal situation bring it back to the normal situation so both help each other so H3 that means it's trying to bring it back to the normal but fully compensated because it's already close to normal it's 7.38 and the normal is 7.40 that means already fully compens that's why let's go to the next question a client presents with the following ABG results what is the correct interpretation so pH is 7.62 which is way higher it's higher than 7.45 that means it's alkalotic now CO2 so CO2 is 49 49 is this side so that means it's acidotic so no this is not a respiratory problem H3 is 35 35 is on the higher side on the alkalotic side that means it's metabolic alkalosis now we need to find out if if this is compensated partially compensated fully compensated what that is how you would find find out CO2 so CO2 is acidotic this is 49 that means CO2 opposite direction because these two are on the same direction but CO2 opposite direction it's trying to help remember2 completely normal it's uncompensated metabolic acidosis because CO2 it's normal but now it's on the opposite side that means CO2 is trying to help it's compensated but if it's fully partially compensated pH J pH normal range that means it's fully compensated J pH normal range that means it's partially compensated so pH it's not normal it's 7.62 it's on the alkalotic side that means it's partially compensated metabolic alcalosis right here another question a L presentence with the following ABG results what is the correct interpretation so pH it's 7.57 which is on alkalotic side it's more than 7.45 next is CO2 CO2 is 17 which is also on alkalotic side because it's less than 35 and then H3 is 16 which is on the acid side because it's less than 22 so now we know that here pH it's alkalotic now we need to find out who becomes friend with ph so pH is alkalotic let's say who else is alkalotic so we already discussed CO2 a alkalotic side there so it's going to be respiratory Al Colossus first problem is solved second problem is it's uncompensated compensated fully compensated or partially compensated we already discuss this we will check H3 so H3 is going on the opposite side and these two are this side so those both became friend and H3 opposite side that means ho3 is trying to help now it's fully or partially normal like within this range that means it's fully compensated respiratory alkalosis but our pH is alkalotic side it's this side that means it's partially compensated respiratory alkalosis partially compensated let's say a pH is 7.42 then we would have said number see fully compensated respiratory alkalosis because it's within the range so we already discussed everything about abgs but one more time One Last Time uncompensated Value let's say you team up pH is acidotic CO2 AV acidotic so this become a pair they both become friends so now we have respiratory acidosis because pH o acidic carbon dioxide V acidic so both becomes friends it's respiratory acid acidosis now we are left with H3 the opposite party so J opposite party if opposite party value is normal that means he doesn't care so this is uncompensated now the next is when the problem is fully compensated let's say pH and CO2 becomes friends that means already pH this is acidotic carbon dioxide v acidotic h so those both becomes friends so we have a respiratory acidosis problem now but3 uncompensated H3 was normal he doesn't care but fully compensated opposite part which is H3 it's working it's working to bring these back to normal to bring those both back to normal how it's working the H3 will be in opposite direction that means acid3 it will be alkalosis and most important thing j pH it will be on acidotic side but it will be within normal range that means pH will be in between 7.35 to 7.45 then it becomes fully compensated acid base imbalance then the last one when the problem will be partially compensated so same example let's see say pH and CO2 becomes friends and this is acidic situation so this is respiratory acidosis but H3 this is trying to help how it's helping it's going in opposite direction it's going towards alkalosis side opposite party in opposite direction and the pH is in abnormal range remember fully compensated the opposite party is going in opposite direction but pH normal range but partially compensated opposite party is going in opposite direction but pH it's still abnormal because it's partially compensated it's still working now the most favorite question of anx RN K problems respiratory acidosis Alat respiratory acidosis so too much CO2 first is hypoventilation that means patient Carbono rain patient will go in respiratory acid second is drug overdose drug overdose patient will go in respiratory acidosis do not forget that COPD coronary OB obstructive pulmonary disease so coronary obstructive pulmonary disease patient will have hard times maintaining their oxygen saturation because carbon dioxide rain which so in this situation too patient will go in respiratory acidosis last one is asthma so basically lungs patient is unable to breathe that means the patient will go in respiratory acidosis next is respiratory alkalosis patient this situation is totally opposite from this that means not enough carbon dioxide in lungs carbon dioxide o am in hyperventilation Pati hyperventilate Sal he's nervous he's anxious then he will go in respiratory alkalosis or panic attack like they will breathe fast so body Oyo patient will go in respiratory alkalosis now the next one is when your patient will go in metabolic acidosis metabolic acidosis bicarbonates bicarbs enough h3s problem problem on Ral disease loss of bicarbs or diarrhea diarrhea renal disease patient metabolic acidosis and when your patient will go in metabolic alkalosis totally opposite diarhea vomiting patient an acids use use then also patient will go in metabolic alkalosis so how does this work like contents it's acidic but patient ands vomit mechanically the patient is in metabolic alkalosis if he's having vomit again and again Jo ant acidsa that means patient he's trying to kill the acid by taking an acids so same situation and either one of them will go higher alkal B one of them will be higher that means patient is going in metabolic alkalosis here acid base balance problems that cause metabolic acidosis disc kidney disease Ral dysfunctions naturally patient metabolic AOS diabetic keto acidosis so in a situation the which your patient will be in metabolic acidosis so you can remember this keto acidosis metabolic acidosis di discuss it will work inversely it's inversely proportionate vomit the patient is in metabolic alosis so he will go in alkalosis but he will go in metabolic acidosis and problems that cause metabolic alkis problems takings vomits increas gastric suction suctioning so that cont so same situation like vomiting but vomiting naturally expel contents gastric suction manually expel both ways patient will be in metabolic alkalosis next is when your patient will go in respiratory acidosis first thing respiratory acidosis acidosis hypoventilation but less oxygen in the body in the lungs overdose of medication drug overdose COPD asthma so LSA problem respiratory acidosis problems that cause respiratory alkalosis hyperventilation that means less carbon dioxide more oxygen panic attack now let's practice one more question the nurse is caring for a client recovering from clonazepam overdose which of the following ABG results would be expected so just key patient is patient hadam overdose colam overdose that means drug overdose overdose patient will go in respiratory acidosis that's what we learned soes respiratory acidosis K so let's see first is pH 7.4 7.4 that means it's within the normal range so this is we will cancel this out second is pH 7.42 this is also in normal range so this is not acidotic we will cancel this one out to we are looking for respiratory acidosis PhD then we will look the other findings further see the pH is 7.56 7.56 is on the alkal alkalotic side that means it's totally opposite we will cancel this option too now we only left with one aab you will say that it's D but still let's learn this pH is 7.25 7.25 that means it's right here sorry 7.25 it's less than 7.35 that means this is the only situation which is acidotic carbon dioxide is 74 it's it is also on the higher side so acidotic H3 is 36 36 36 is higher so this is the right option disc a respiratory acidosis but is it compensated uncompensated or what let's do that too so the answer is this D but let's say um just for fun let's say if it's uh compensated or what discuss pH and carbon dioxide became friends see hc3 if it's trying to help or not the H3 normal hagga that means it's not trying to help he doesn't care at all that means it's uncompensated respiratory acidosis but J hc3 opposite direction toia that means it's trying to help so let's say H3 is 36 yes it's going in opposite direction it's more than 28 it's 36 it's trying to help that means it's compensated now we need to find out if it's fully compensated or partially compensated pH J it's in between 35 to 45 that means it's fully compensated respiratory acidosis jjd pH it's on either side abnormal merite there that means it's partially compensated respiratory acidosis so pH is 7.25 so this is on abnormal side so we are here with partially compensated respiratory acidosis last question of this topic the nurse is caring for a client with the following ABG results a patient the ABG results which of the following conditions are possible causes for the client's acid base imbalance select all that apply so the pH is 7.31 J pH of 7.31 that means it's on the acidotic side so one W J CO2 it's 32 CO2 is 32 that means co22 is alkalotic side so this is opposite H3 is 19 that means it's on this side so two Vols on acidic side one is pH one is uh metabolic bicarbs so this is metabolic acidosis so now we need to find out problems metabolic acidosis disc but still we need to learn this so first is a five-day history of severe diara this is metabolic acidosis metabolic Al metabolic acidosis that means we will choose this option metabolic acid acidosis patient will go in this situation second is hyperemesis gravidarum hyperemesis gravidarum emesis related to vomiting every nurse knows emesis is vomiting that means just for you no like I'm not going to go deep into this topic this is related to pregnancy but let's says be a lay manting metabolic Alis so this is totally opposite we will cancel this one out end stage renal disease yes we discussed this metabolic as um acidosis the problem kidney failure end stage renal disease is a kidney problem so next is a diabetic keto acidosis discuss acidosis metabolic acidosis so diabetic keto acidosis the which we metabolic acidosis so we will choose this option too so we choose a CD let's see chronic obstructive pulmonary disease this is related to respiration this is not metabolic this is respiratory acidosis so we will cancel this Hy hypoglycemic hyperosmolar nonketotic syndrome so this is also not that so we are left with a c and d and let's see if this is the correct option yes a c and d is metabolic acidosis because metabolic acidosis happen in diarrhea kidney disease diabetic keto acidosis okay guys this was all about abgs