let's go over how to determine compensation whenever you're solving arterial blood gas problems so this is a source of confusion for some people whenever they're trying to solve ABG problems they don't usually have problems trying to determine if it's a respiratory or metabolic problem where acidosis are osis but whenever they get to this part it's like I don't know how do I do this so I'm going to give you a simple way on how to figure this out so here's our problem we got a pH of 7.34 a P2 of 36 this represents respiratory and a B carb of 20 which represents metabolic system I'm going to use Tic Tac Toe to help us do this what I'm looking for is a vertical three in a row if I don't have an up and down three in a row I know I'm dealing with full compensation so that's one of the great things about this method our pH is acidic so we're going to put it under here under acid our pH CO2 is normal so I'm going to put it here under normal let's see where this B carbs to fall it is 20 that is on the acid side so I'm going to put it under here under acid and I have a three in a row right here so I know I have metabolic acidosis now I got to determine what kind of compensation do I have do I have have full compensation and my pH is abnormal so the body hasn't compensated and done its thing however I'm left with these two so in order to figure out if I have uncompensated or partial compensated I have to look at the system that is not causing mybalance the system that's causing mybalance is a metabolic system so I'm going to look at this respiratory value a little bit deeper it's 36 a normal is about 35 to 45 so Falls within range that tells me this respiratory system isn't doing a thing about about this acid base imbalance I have going on so it's uncompensated so that's what this would be metabolic acidosis uncompensated now let's change up things a little bit I have the same exact problem but I have changed the pac2 to 29 so now this P2 is not normal it is on the basic side so we're just going to put it over here so now what do I have I still have metabolic acidosis CU I have this vertical three in a row here so I know I don't have full compensation however I'm trying to go between these two uncompensated or partial compensated so let's take a further look at that system that's not causing our imbalance which is the respiratory system and I notice that now it doesn't fall in normal range it's less than 35 cuz 35 to 45 was normal it's 29 so because of that this system has thrown itself into an alkalotic hence Basic Value in order to try to fix this Blood pH so it's partially trying to compensate it hasn't done it fully yet because our pH is still abnormal now let's take that same exact problem and just change up that pH now it's 7.37 so we know that a normal pH is 7.35 to 7.45 so our pH just became normal and I have bells going off in my head telling me oh full compensation our pH is normal plus if you're using the Tic Tac Toe method you don't have a vertical three in a row so that's another thing so we know we have full compensation now whenever we have full compensation a lot of times where people get confused is how to determine is this a respiratory or metabolic problem or is this acidosis or alkalosis so when this happens what you have to do is you have to take a further look at that blood pH so let's go over this for a second an absolute normal blood pH is about 7.40 so remember 7.35 to 7.45 is our normal range so anything that's 7.35 but less than 7.40 is considered acid a normal acid okay now anything that is greater than 7.40 but to 7.45 is considered a normal alkalic So based on our blood pH of 7.37 it's normal but it's on the acidic side so we go and look at the system that's also acidic and it's the metabolic system so we know that that's where we've been hanging out because our blood pH has trended up from that acid part so we know we have metabolic acidosis and it's fully compensated now if you want to dive deeper into this topic you can check out my comprehensive acid base balance video on my YouTube channel register nurse RN