Arterial Blood Gas Worksheet
ABG Interpretation:
Indicate the levels as or = for the Arterial Blood Gas (ABG)
values of each Acid-Base Imbalance.
ABG
Parameter
Respiratory
Acidosis
Respiratory
Alkalosis
Metabolic
Acidosis
Metabolic
Alkalosis
pH
7.35-7.45
PaCO2
35-45
HCO3
22-26
oCircle the system that will compensate for each imbalance.
Full compensation has occurred when the pH returns to normal.
Compensation occurs faster for metabolic than for respiratory. Why?
Finally, evaluate oxygenation: PaO2 (80-100) < 80 mm Hg Hypoxemia
Practice interpretation:
pH PaCO2 HCO3- PaO2
7.50 30 23 98
7.30 55 25 68
7.28 40 19 82
7.49 35 28 80
Acid-Base Imbalance Signs and Symptoms Acute or Chronic
Respiratory Acidosis
Metabolic Acidosis
Respiratory Alkalosis
Metabolic Alkalosis
Examples of Disorders that are associated with Acid-Base Imbalance
Acid-Base Imbalance Common Disorders
Respiratory Acidosis
Metabolic Acidosis
Respiratory Alkalosis
Metabolic Alkalosis
Case Study #1:
An elderly patient has a surgical repair of a hip fracture from a fall at home. The patient is alert
and oriented but complains of extreme pain in the left hip: reporting pain as 9 on a scale of one
to ten. The nurse administers morphine 5 mg intravenous (IV) push. However, the patient
continues to complain of extreme pain, so the nurse repeats a 5 mg dose of morphine 30
minutes later. One hour later, the patient is difficult to arouse, respirations are six to eight
breaths per minute and shallow. The physician orders an ABG which reveals:
pH 7.27
PaCO2 69 mm Hg
PaO2 75 mm Hg
HCO3- 26 mEq/L
#1: Which acid-base imbalance does the patient’s ABG values reveal?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
#2: The ABG results indicate hypoxemia. T or F
#3: Which intervention is the nurse's priority based on the patient’s ABG values?
A. Call results to the physician.
B. Continue to monitor and assess patient.
C. Call Rapid Response Team (RRT).
D. Administer naloxone (Narcan).
#4: Explain what caused the acid-base imbalance.
Case Study #2:
A young man is found at the scene of an automobile accident in a state of emotional distress.
He tells the paramedics that he feels dizzy, tingling in his fingertips, his heart is racing and he
does not remember what happened to his car. His respiratory rate is rapid at 34 breaths per
minute.
#1. Which acid-base imbalance is reflective of the man's assessment and clinical
manifestations?
A. Respiratory acidosis
B. Metabolic alkalosis
C. Respiratory alkalosis
D. Metabolic acidosis
#2. Interpret the ABG results after the patient arrives at the hospital:
pH 7.45
PaCO2 33 mm Hg
PaO2 85 mm Hg
HCO3- 19 mEq/L
A. Respiratory acidosis with hypoxemia
B. Respiratory alkalosis with hypoxemia
C. Respiratory alkalosis with compensation
D. Respiratory acidosis with compensation
#3. Explain what caused this acid-base imbalance.
Case Study #3:
An AA male patient is brought to the ER by his family with altered mental status (AMS). His
daughter reports a history of CRF with hemodialysis three times a week. This week the patient
did not receive all three dialysis treatments. The patient is hypertensive and breathing deeply
with a RR of 26. Significant lab results: hyperkalemia, elevated creatinine and BUN with the
following ABG:
pH 7.30
PaCO2 35 mm Hg
PaO2 80 mm Hg
HCO3 16 mEq/L
1: Which acid-base imbalance does the patient’s ABG values reveal?
2. What treatment will be ordered for this patient?
Case Study #4:
A 76 year-old female is eating lunch with friends at the Senior Center and chokes, unable to
breathe. The attendant successfully dislodges the meat obstruction using the Heimlich
maneuver. The woman was placed on oxygen via face mask. When she arrived at the ER, she
was breathing with shallow respirations and periods of apnea, confused and disoriented. ABG
results are:
pH 7.32
PaCO2 58 mm Hg
PaO2 80 mm Hg
HCO3 26 mEq/L
1: Which acid-base imbalance does the patient’s ABG values reveal?
2.What is an intervention that helps remove CO2 that is retained in the body?
3.What would be necessary if a patient continues to become acidotic?
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