Arterial Blood Gas (ABG)

reveals the ability of the lungs to exchange

gases by measuring partial pressures of

oxygen (PO2) carbon dioxide (PCO2) and
evaluates the pH of arterial blood.
ordered to evaluate:
Oxygenation
Ventilation and the effectiveness of
respiratory therapy
Acid-base level of the blood

 5-ml heparinized Arterial blood samples are drawn

from a peripheral artery (e.g., radial or femoral) or

from an arterial line.
Perform the Allen test to determine patency of radial

and ulnar arteries. Instruct client to rest hands in lap

(1) Compress both the radial and ulnar arteries.
(2) Firmly compress arteries and instruct client to open
the hand.
(3) Note color of palms.
(4) Release one artery and note the color of the palm.
(5) Then steps 14 are repeated for the other artery on
the same hand. Then the procedure is performed on
the other hand. Palms should turn pink promptly

Nursing Consideration
Arterial blood gases should not be drawn

within 20 minutes after any respiratory

treatment; ensures accurate determination
of the clients actual blood gases.
Direct pressure must be applied to the

puncture site until all bleeding has

stopped, a minimum of 5 minutes.

Nsg. Consideration Cont...

Ensure that all bleeding has stopped before

releasing the pressure. Symptoms of impaired

circulation include:
Numbness and tingling
Bluish color
Absence of a peripheral pulse

Values:
pH
Normal
Values

Defined
as :

HCO3

pCO2

7.35
7.45

22-26
mmol/L

3545mmH
g

hydroge
n ion
(H+)
levels

Concentra
tion of
hydrogen
carbonate
in blood.

Carbon
dioxide
partial
pressur
e

3 steps interpretation:
1. What is the pH? Is it alkolotic

(above 7.45) or acidotic

(below7.35)?Low = Acidosis
Eg: pH= 7.25
HCO3= 20mmol/L
PCO2= 36mmHg

Step 2...
2. Whats happening with the respiratory

system (CO2) and the metabolic

systems (HCO3-)?
Eg: pH= 7.25
low =
= ACIDOSIS
Low
metabolic
HCO3= 20mmol/L normal
PCO2= 36mmHg

Metabolic
Acidosis

Uncompensated Metabolic
Acidosis

3. Is there any (if any) compensation occurring?

No compensation:

pH remains abnormal, and the

other value (where the problem
isnt occurring, i.e. CO2 or
HCO3-) will remain normal or has
made no attempt to help normalise
the pH.

Whats happening with the respiratory system (CO2) and

the metabolic systems (HCO3-)?
Eg: pH= 7.25
low = ACIDOSIS
HCO3= 20mmol/L
PCO2= 36mmHg

Low =
normal
metabolic

Metabolic
Uncompensated Metabolic Acidosis
Acidosis

Partial compensation
pH is still abnormal, and the
other value is abnormal in an
attempt to help normalise the
pH.

Example:
pH= 7.25
low = ACIDOSIS
HCO3= 20mmol/L
low=
metabolic
PCO2= 47 mmHg
high
Lungs are retaining carbon dioxide
to compensate for excess base
Partially compensated metabolic
acidosis

 Full compensation

The pH is normal, as the other

value is abnormal and has
been successful in normalising
the pH.

Example:
pH= 7.45
normal
HCO3= 20mmol/L
low=
metabolic
PCO2= 47 mmHg
high
pH becomes normal in the effort of
both the kidney and the lungs
Fully/ completely compensated
metabolic acidosis

Seatwork:
1. pH 7.38, HCO3- 15mmol/L, PaCO2

30mmHg
2. pH 7.62, PaCO2 27 , HCO3
17mmol/L
3. pH 7.23, HCO3 - 15mmol/L, PaCO2
40mmHg.
4. pH 7.33, Pa CO2 55, HCO3 29
5. pH 7.25, Pa CO2 50, HCO3 30