Arterial Blood Gases

Components
 pH, PaCO2, PO2, HCO3
 pH:
 expression of Hydrogen ion concentration (H+)
 pH & H+ are related inversely
 normal pH = 7.35-7.45
 PaCO2:
 reflects partial pressure of carbon dioxide in blood
 influenced solely by respiratory factors
 normal PaCO2 = 35-45
Components continued
 HCO3:
 measure of bicarbonate ion
 influenced solely by renal (metabolic) factors
 normal HCO3 =22-26mEq/L
 PO2:
 reflects partial pressure of oxygen in blood
 influenced by ventilation & perfusion
 normal PO2 = 80-100mmHg
Assessing ABGs
 1. Examine pH:
 pH < 7.35 acidosis; pH > 7.45 alkalosis
 2. Is 10 problem respiratory or metabolic:
examine PCO2 & HCO3
 if only the pH & one other value are abnormal the
ABGs indicate an acute primary disorder
 *if pH & PCO2 change in opposite directions a
respiratory disorder is present
 * if pH & HCO3 change in same direction a
metabolic disorder is present
Assessing ABGs continued
 3. Is there compensation:
 body’s attempt to normalize pH
 system not responsible for 10 problem attempts to
bring pH back towards normal
 respiratory changes lead to renal compensation
 metabolic changes lead to respiratory compensation
 compensation may be:
 Partial: pH does not return to normal; PCO 2 & HCO3
change in same direction: pH:7.30 PCO 2: 25 HCO3:12
 Full: restoration of normal pH;
 pH:7.42 PCO2:50 HCO3:32
Assessing ABGs continued
 4. Always assess the patient:
 physiological signs, lab data, objective &
subjective assessment of symptoms
 5. Treat the imbalance
 6. Assess the PaO2:
 < 80 mmHg: hypoxemia
 < 60 mmHg: severe hypoxemia
 7. Document assessment, intervention, &
outcomes