ABG ANALYSIS

and a productive cough with yellow-green

sputum. He has difficulty in communicating
because of his inability to complete a
sentence. One of his sons, Jacob, says he has
been unwell for three days. Upon
examination, crackles and wheezes can be
heard in the lower lobes; he has a
tachycardia and a bounding pulse.
Measurement of arterial blood gas shows pH
7.3, PaCO2 68 mm Hg, HCO3 28 mmol/L, and
PaO2 60 mm Hg. How would you interpret
this?
• 2. Carl, an elementary student, was rushed to the hospital due
to vomiting and a decreased level of consciousness. The
patient displays slow and deep (Kussmaul breathing), and he is
lethargic and irritable in response to stimulation. He appears
to be dehydrated—his eyes are sunken and mucous
membranes are dry—and he has a two week history of
polydipsia, polyuria, and weight loss. Measurement of arterial
blood gas shows pH 7.0, PaO2 90 mm Hg, PaCO2 23 mm Hg,
and HCO3 12 mmol/L; other results are Na+ 126 mmol/L, K+ 5
mmol/L, and Cl- 95 mmol/L. What is your assessment?
• 3. A cigarette vendor was brought to the emergency
department of a hospital after she fell into the
ground and hurt her left leg. She is noted to be
tachycardic and tachypneic. Painkillers were carried
out to lessen her pain. Suddenly, she started
complaining that she is still in pain and now
experiencing muscle cramps, tingling, and
paraesthesia. Measurement of arterial blood gas
reveals pH 7.6, PaO2 120 mm Hg, PaCO2 31 mm Hg,
and HCO3 25 mmol/L. What does this mean?
• 4. Ricky’s grandmother is suffering from persistent
vomiting for two days now. She appears to be
lethargic and weak and has myalgia. She is noted to
have dry mucus membranes and her capillary refill
takes >4 seconds. She is diagnosed as having
gastroenteritis and dehydration. Measurement of
arterial blood gas shows pH 7.5, PaO2 85 mm Hg,
PaCO2 40 mm Hg, and HCO3 34 mmol/L. What acid-
base disorder is shown?
• 5. Mrs. Johansson, who had undergone surgery in the post-
anesthesia care unit (PACU), is difficult to arouse two hours
following surgery. Nurse Florence in the PACU has been
administering Morphine Sulfate intravenously to the client
for complaints of post-surgical pain. The client’s respiratory
rate is 7 per minute and demonstrates shallow breathing.
The patient does not respond to any stimuli! The nurse
assesses the ABCs (remember Airway, Breathing,
Circulation!) and obtains ABGs STAT! Measurement of
arterial blood gas shows pH 7.10, PaCO2 70 mm Hg and
HCO3 24 mEq/L. What does this mean?
• 6. Baby Angela was rushed to the Emergency Room
following her mother’s complaint that the infant has
been irritable, difficult to breastfeed and has had
diarrhea for the past 3 days. The infant’s respiratory
rate is elevated and the fontanels are sunken. The
Emergency Room physician orders ABGs after
assessing the ABCs. The results from the ABG results
show pH 7.39, PaCO2 27 mmHg and HCO3 19 mEq/L.
What does this mean?
• 7. Mr. Wales, who underwent post-abdominal
surgery, has a nasogastric tube. The nurse on duty
notes that the nasogastric tube(NGT) is draining a
large amount (900 cc in 2 hours) of coffee ground
secretions. The client is not oriented to person,
place, or time. The nurse contacts the attending
physician and STAT ABGs are ordered. The results
from the ABGs show pH 7.57, PaCO2 37 mmHg and
HCO3 30 mEq/L. What is your assessment?
• 8. Client Z is admitted to the hospital and is to
undergo brain surgery. The client is very
anxious and scared of the upcoming surgery. He
begins to hyperventilate and becomes very
dizzy. The client loses consciousness and the
STAT ABGs reveal pH 7.61, PaCO2 22 mmHg and
HCO3 25 mEq/L. What is the ABG interpretation
based on the findings?
• 9. Three-year-old Adrian is admitted to the hospital
with a diagnosis of asthma and respiratory distress
syndrome. The mother of the child reports to the
nurse on duty that she has witnessed slight tremors
and behavioral changes in her child over the past
four days. The attending physician orders routine
ABGs following an assessment of the ABCs. The ABG
results are pH 7.35, PaCO2 72 mmHg and HCO3 38
mEq/L. What acid-base disorder is shown?
• 10. Anne, who is drinking beer at a party,
falls and hits her head on the ground. Her
friend Liza dials “911” because Anne is
unconscious, depressed ventilation
(shallow and slow respirations), rapid heart
rate, and is profusely bleeding from both
ears. Which primary acid-base imbalance is
Anne at risk for if medical attention is not
provided?
• 1. Answer: B. Respiratory Acidosis, Partially Compensated
• The patient has respiratory acidosis (raised carbon dioxide) resulting from an acute
exacerbation of chronic obstructive pulmonary disease, with partial compensation.
• 2. Answer: D. Metabolic Acidosis, Partially, Compensated
• The student was diagnosed having diabetes mellitus. The results show that he has
metabolic acidosis (low HCO3 -) with respiratory compensation (low CO2).
• 3. Answer: A. Respiratory Alkalosis, Uncompensated
• The primary disorder is acute respiratory alkalosis (low CO2) due to the painand anxiety
causing her to hyperventilate. There has not been time for metabolic compensation.
• 4. Answer: C. Metabolic Alkalosis, Uncompensated
• The primary disorder is uncompensated metabolic alkalosis (high HCO3 -). As CO2 is the
strongest driver of respiration, it generally will not allow hypoventilation as compensation
for metabolic alkalosis.
• 5. Answer: B. Respiratory Acidosis, Uncompensated
• The results show that Mrs. Johansson has respiratory acidosis because of decreased pH and
increased PaCO2 which mean acidic in nature. Meanwhile, it is uncompensated because
HCO3 is within the normal range.
• 6. Answer: C. Metabolic Acidosis, Fully Compensated
• Baby Angela has metabolic acidosis due to decreased HCO3 and slightly acidic pH. Her pH value is within the
normal range which made the result fully compensated.
• 7. Answer: B. Metabolic Alkalosis, Uncompensated
• The postoperative client’s ABG results show that he has metabolic alkalosis because of an increased pH and
HCO3. It is uncompensated due to the normal PaCO2 which is within 35 to 45 mmHg.
• 8. Answer: C. Respiratory Alkalosis, Uncompensated
• The results show that client Z has respiratory alkalosis since there is an increase in the pH value and a decrease
in PaCO2 which are both basic. It is uncompensated due to the normal HCO3 which is within 22-26 mEq/L.
• 9. Answer: B. Respiratory Acidosis, Fully Compensated
• The patient has respiratory acidosis (raised carbon dioxide) resulting from asthma and respiratory distress
syndrome, with compensation having normal pH value within 7.35to 7.45, increased PaCO2 which is acidic and
increased HCO3 which is basic.
• 10. Answer: C. Respiratory Acidosis
• One of the risk factors of having respiratory acidosis is hypoventilation which may be due to brain trauma,
coma, and hypothyroidism or myxedema. Other risk factors include COPD, Respiratory conditions such as
pneumothorax, pneumonia and status asthmaticus. Drugs such as Morphine and MgSO4 toxicity are also risk
factors of respiratory acidosis.