Blood Gas Interpretation res 141

Identify normal acid-base balance, primary respiratory disturbances and primary metabolic disturbances as they may appear on a blood gas report
Interpret acid-base balances and classify their severity.
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Arterial blood gas monitoring provides valuable information about the adequacy of ventilation and/or oxygenation of the blood. It is also a valuable diagnostic tool used to evaluate respiratory or metabolic disorders, quantitate the effectiveness of therapeutic interventions, and monitor the progression or improvement of documented cardiopulmonary disease. This diagnostic tool is only useful if the results are interpreted correctly.

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Physicians, respiratory therapists, and other health care professionals make decisions about the care of a patient based on arterial blood gas reports; therefore, interpreting blood gases is important to appropriately treating critically ill patients.

Use the guide provided below to complete your assignment.

1) When interpreting ABG’s:
Look at your pH
Is your pH within normal range? 7.35 – 7.45. A normal pH indicates homeostasis
If your pH is below 7.35, the blood is acidotic
If your pH is above 7.45, the blood is alkalotic
This is will be your LAST NAME (Acidosis or Alkalosis?)

2) If your pH is acidotic or alkalotic, then determine the cause. Look at your 2 major organs……which is causing the problem? LUNGS or KIDNEYS
Lungs = PaCO2 (respiratory system) Normal = 35 – 45mmHg.
If the PaCO2 is less than 35, alkalotic
If the PaCO2 is greater than 45, acidotic
Kidneys = HCO3 (metabolic system) Normal = 22 – 26 mEq/L
If the HCO3- is less than 22, acidosis
If the HCO3- is greater than 26, alkalosis
This will make up your FIRST NAME (respiratory or metabolic). Which organ matches your last name?

Example #1

pH: 7.25 = acidosis
PaCO2: 53 = acidosis
Interpretation is respiratory acidosis

Example #2

pH: 7.49 = alkalosis
PaCO2: 30 = alkalosis
Interpretation is respiratory alkalosis

Example #3

pH: 7.30 = acidosis
HCO3: 18 = acidosis
Interpretation is metabolic acidosis

Example #4

pH: 7.49
HCO3: 29
Interpretation is metabolic alkalosis

3) Look at your opposite organ.
Is compensation occurring?
Is it doing the opposite of your LAST NAME?
Example #1

pH: 7.32 Acidosis
PaCO2: 49 Acidosis
HCO3: 31 Alkalosis(Basic)
Interpretation is compensated respiratory acidosis.
HCO3 is alkalotic or “compensating” for a primary respiratory acidotic problem.

4) Is it “partially” or fully compensated?
Partially: pH will be OUT OF NORMAL RANGE
Fully: pH will be WITHIN NORMAL RANGE
Example #1

pH: 7.29
PaCO2: 54
HCO3: 34
Interpretation is partially compensating respiratory acidosis.

ACUTE -vs- CHRONIC CONDITION
Acute: pH is OUTSIDE normal range

Chronic: pH is WITHIN normal range

ACUTE ON CHRONIC EPISODE
pH is OUTSIDE normal range

PaCO2 is elevated

HCO3 is elevated

A patient experiencing an acute respiratory episode on top of a chronic respiratory condition.

Referred to as “exacerbation of COPD”

An example is a low pH, high PaCO2 and high HCO3.

Prompt
Provide the full interpretation (acid-base, ventilation, oxygenation status, anion gap) for each individual arterial blood gas results below. Provide the standard statements for ABG interpretations and provide a detailed explanation for your interpretation of each ABG values.
Identify the system that is causing the acid-base disturbance and the one that is doing the compensating(fixing).
Quantify the level of hypoxemia, when appropriate.
Discuss the anion gap, when appropriate.
Again, be sure to explain in sufficient detail how and why you reached the ABG conclusion you did for ‘each’ example.

#1 Patient Slater
pH 7.39
PaCO2 42 mmHg
HCO3- 25 mEq/l
BE +1
PaO2 72 mmHg
SaO2 94%
Interpretation:_______

#2 Patient Fulton
pH 7.26
PaCO2 52 mmHg
HCO3- 23 mEq/l
BE – 4
PaO2 38 mmHg
SaO2 76%
K+ 4.5 mEq/L
Cl- 105 mEq/L
Interpretation:_______

#3 Patient Frey
pH 6.92
PaCO2 76 mmHg
HCO3- 15 mEq/l
BE – 17
PaO2 55 mmHg
SaO2 80%
Na+ 136 mEq/L
Cl- 100 mEq/L
Interpretation:_______

#4 Patient Blanco
pH 7.58
PaCO2 24 mmHg
HCO3- 22 mEq/l
BE + 8
PaO2 99 mmHg
SaO2 99%
Na+ 140 mEq/L
Cl- 99 mEq/L
Interpretation:_______

#5 Patient Lange
pH 7.28
PaCO2 39 mmHg
HCO3- 18 mEq/l
BE – 4
PaO2 66 mmHg
SaO2 91%
Na+ 139 mEq/L
Cl- 104 mEq/L
Interpretation:_______

Requirements:
Submit your responses, in at least 400 words on a Word document (excluding the prompt, title, cover page, citations/references, quotations). You will have to expand on your description of your understanding of ABG analysis to meet the 400 words. It is suggested you include those areas that are more challenging and also the significance and value of the anion gap. Grammar and spelling count. You must include at least one reference to defend and support your position.

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