Arterial Blood Gas Interpretation

Topics: PH, Carbon dioxide, Bicarbonate Pages: 18 (4893 words) Published: July 17, 2015
Arterial Blood Gas Interpretation
(ABG) Arterial Blood Gas Analysis is used to measure the partial pressures of oxygen (PaO2), carbon dioxide (PaCO2), and the pH of an arterial blood sample. Oxygen content (O2CT), oxygen saturation (SaO2), and bicarbonate (HCO3-) values are also measured. A blood sample for ABG analysis may be drawn by percutaneous arterial puncture from an arterial line. The ABG analysis is mainly used to evaluate gas exchange in the lungs. It is also used to assess integrity of the ventilatory control system and to determine the acid-bas level of the blood. The ABG analysis is also used for monitoring respiratory therapy (again by evaluating the gas exchange in the lungs). Nursing considerations:

Your first look at an ABG result might prove to be confusing. Any patient who is critically ill might be given this test at regular intervals. Arterial blood gas determinations will indicate two basic bodily functions: 1. acid-base balance of the blood

2. oxygenation status of the blood
ABG's will also indicate other important facts about a patient's status. However, the two functions above are the most important. In a clinical situation, most nurses need only to understand these two basic concepts. When the results of an ABG are abnormal, most hospitals today will have a lab procedure for notification of the MD or to the ICU staff. But if you should be one of those "lucky" nurses who is floated to a critical care area or a respiratory care area, you may have to interpret the results by yourself. If you are able to do this, and fast, it may mean that the patient will get help fast. Hypoxemia, acidemia, and alkalemia are important concepts which should be understood before beginning. Hypoxemia is a term which refers to a lowered blood oxygen content. This term and the term hypoxia are probably quite familiar to most nurses. They both will be used as meaning exactly the same. Hypoxia is the basis of one part of interpretation process. From above, we know that oxygenation status of the patient can be critical during certain disease states. Acidemia or acidosis is a term which refers to excessive amounts of acid in the blood. Acids are produced naturally in the body as a product of metabolism and other specific body processes. If our blood acid levels rise too high, it will interfere with the health of the individual. This will be in addition to the disease which is already present causing the acidosis. Alkalosis, or alkalemia is the term which refers to the condition of excessive bicarbonate ions (bases) in the blood. As we mentioned above, this imbalance in the blood pH will then cause further problems as the normal body recovery mechanism may also be interrupted. On the next pages you will find an explanation of what the ABG test is all about. We will also present the nursing considerations surrounding their interpretation. Read each section of the following text in order. The text builds up from the simpler concepts to the more complex concepts so each nurse will be able to easily follow the interpretation process. When you fully understand one section, then go on to the next section until you finally are able to interpret the ABG with the fullest understanding. Since this course is very clinically oriented, we will concentrate on the aspects of ABG interpretation that apply to direct patient care. The clinical uses of ABG studies will be listed on the following pages. ABG studies may be helpful to diagnose and treat the following: (Brunner 1994) 1. unexplained tachypnea, dyspnea (esp. in patients with cardiopulmonary disease) 2. unexplained restlessness and anxiety in bed patients

3. drowsiness and confusion in patients receiving oxygen therapy 4. assessment of surgical risk
5. before and during prolonged oxygen therapy and during ventilator support of patients 6. progression of cardiopulmonary disease
Collecting the ABG specimen
The ABG is performed on a sample of arterial blood. The specimen is then...
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