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charts, to lectures, to practice, but this article will tell you how to interpret
ABGs in the easiest possible way. And once you have finished reading this,
youll be doing actual ABG analysis in the NCLEX with fun and excitement!
Here are the steps:
4. Remember ROME
Still, it all boils down to mnemonics. The mnemonic RO-ME.
Respiratory Opposite
When pH is up, PaCO2 is down = Alkalosis
When pH is down, PaCO2 is up = Acidosis
Metabolic Equal
When pH is up, HCO3 is up = Alkalosis
When pH is down, HCO3 is down = Acidosis
5. Tic-Tac-Toe
And yes, ABG problems can be solved work using the tic-tac-toe method. All
you have to do is make a blank chart similar to this:
7. Match it up
In this step, determine at which column matches up with the pH. In the given
example, HCO3goes with pH. HCO3 is considered Metabolic (shown in step 3),
and both are under Acid, so this example implies Metabolic Acidosis.
8. Determine compensation
The last step is to determine if the ABG is Compensated, Partially
Compensated, or Uncompensated. Heres the trick:
If pH is NORMAL, PaCO2 and HCO3 are both ABNORMAL = Compensated
If pH is ABNORMAL, PaCO2 and HCO3 are both ABNORMAL = Partially
Compensated
If pH is ABNORMAL, PaCO2 or HCO3 is ABNORMAL = Uncompensated
Therefore this ABG is METABOLIC ACIDOSIS, PARTIALLY
COMPENSATED .
By applying the steps above, interpret the following ABGs:
pH:7.44, PaCO2: 30, HCO3: 21
pH is NORMAL = NORMAL so place pH under Normal
PaCO2 is LOW = BASE so place PaCO2 under Base
HCO3 is LOW = ACID so place HCO3 under Acid
*Since the acidity of the blood is determined by the value of the pH,
determine whether the normal pH is SLIGHTLY ACIDIC or SLIGHTLY BASIC. In
this example, pH is NORMAL but SLIGHTLY BASIC therefore it is ALKALOSIS.
In this case PaCO2 goes with pH. PaCO2 is considered Respiratory (shown in
step 3), and both are under Basic, so this example implies Respiratory
Alkalosis. The HCO3 is also abnormal. When pH is NORMAL and PaCO2 and
HCO3 are both ABNORMAL, it indicates FULL COMPENSATION.