Arterial Blood Gases (ABGs)

ABG Definition
 Blood gases measure the pH (acidity),
oxygen content, and carbon dioxide
content of the blood. Usually, blood gases
are used to analyze the arterial blood. In
rarer cases, venous blood may be used.
 Why do ABGs
 The test is used to evaluate respiratory
diseases and conditions that affect the
lungs. It is used to determine the
effectiveness of oxygen therapy. The acid-
base component of the test also gives
information on how well the kidneys are
functioning.
 How is the test performed
The test is performed by collecting a sample of blood
from an artery. Using a small needle, the sample may be
collected from the radial artery in the wrist, the femoral
artery in the groin, or the brachial artery in the arm.

Before blood is drawn, the circulation to the hand may

be tested (if the wrist is the site). After the blood is
drawn, pressure must be applied to the puncture site for
at least 5 minutes to completely stop the bleeding.

The test must be sent to the laboratory for analysis

immediately, or the accuracy of the results cannot be
guaranteed
Obtaining the specimen
 Normal Values
 pH of 7.35 to 7.45
 Partial pressure of oxygen (PaO2) - 80 to
100 mm Hg
 Partial pressure of carbon dioxide (PaCO2)
- 35 to 45 mm Hg
 Bicarbonate - (HCO3) - 22 to 26 mEq/liter
 Oxygen saturation (SaO2) - 94% to 100%
 pH
 pH – Measures the relationship between acids
and bases in the blood.

 7.35 – 7.45 (mean 7.40)

 If pH is low = more acid in blood (<7.35)

 If pH is high = more base in blood (>7.45)

 PaO2
 Reflects the lungs ability to oxygenate the
blood

 80-100
 PaCO2
 A true measure of alveolar ventilation

 Regulated by the rate and depth of respiration

 35 – 45

 < 35 = Resp. alkalosis

 >45 = Resp. acidosis
 HCO3
 Indicates the amount of bicarbonate in the
blood
 Abnormal level reflects a metabolic
problem or the patient may be
compensating for a respiratory problem
 22 -26
 < 22 = Metabolic acidosis
 > 26 = Metabolic alkalosis
 Base Excess (BE)
 Difference between the acid-base levels in
the blood
 Respiratory Acidosis
 pH = < 7.35

 PaCO2 = > 45

 Alveolar hypoventilation

 S/S – diminished respiration, HA, confusion

 Treatment – Improve ventilation

 Respiratory Alkalosis
 pH = > 7.45

 PaCO2 = < 35

 Hyperventilation

 S/S – Hyperventilation, tetany, confusion

 Treatment – Correct ventilation

 Metabolic Acidosis
 pH = < 7.35

 HCO3 = < 22

 Excess loss of bicarbonate

 Treatment – Give IV bicarbonate

 Metabolic Alkalosis
 pH = > 7.45

 HCO3 = > 26

 Retained bicarbonate

 Treatment – Hydrogen & Chloride

replacement
 Care Plan
 Ineffective breathing pattern

 Ineffective airway clearance

 Impaired gas exchange

 Pain

 Anxiety
 Practice Problems
 Apply your principles

 Assess pH
 Label pH = Acidosis or Alkalosis
 Assess PaCO2 & HCO3
 Find the gas that matches
 Treat symptoms and cause to correct
Questions?