Christina Rafano teaches how to read arterial blood gases by identifying whether they're fully compensated, partially compensated, or uncompensated. She uses a "life of the party" versus "party pooper" metaphor to track which organ is causing the problem and which is trying to fix it. A worked example shows pH 7.32 with low PaCO₂ and HCO₃⁻, revealing partial metabolic acidosis compensation.
In this video we're diving into arterial blood gas interpretation, specifically talking about how to tell if an ABG is fully compensated, partially compensated, or if it's uncompensated. Let's do it. Hello again, friend Christina here with nursingschoolofsuccess.com and today we are talking all about ABGs or arterial blood gases and how to interpret them. This is a must know for nursing school, so I'm gonna break it all down really easy for you so you can finally understand it for nursing school. Before we get started, make sure you're subscribed to this channel so you never miss out on any other nursing school tips or tricks that I've got for you. So you have these three main components to look at when solving ABGs. The pH, which tells you if the blood is more acidic or more alkaline. The Paco 2, which tells you how much carbon dioxide is in the blood. Carbon dioxide now is an acid. And the HCO3, which tells you how much bicarbonate is in the blood. And bicarbonate is a base. Now if you have not already, make sure to check out the other video that we've got for you on ABG interpretation where I walk you through the easy step by step process that I use when solving ABGs. We're going to use that same process here in this video. So if you want to deep dive into how to do that step by step process, make sure to check that video out. So like we talked about in that previous video, the PH will tell you if the blood is acidic or basic, and if the PH is less than 7.4, it's acidic. If the pH is greater than 7.4, it's more basic or alkaline. A normal PH value is between 7.35 and 7.45. The Paco 2 levels tell you how much carbon dioxide there is in the blood, and the HCO3 level tells you how much bicarbonate is in the blood. Now, a normal Paco 2 is between 35 and 45 ML mercury and a normal HCO3 value is between 22 to 26 milli equivalents per liter. Let's throw up an example problem here to walk through as we do this. So let's say The PH is 7.32, the Paco 2 is 31 and the HCO 3 is 16. Now the first thing you need to do is determine if the PH is acidic or if it's basic. Is it lower than 7.4 or above 7.4 in this case, The PH is acidic because it's lower than 7.4 and it's also lower than the normal range. So once you've decided that that PH is acidic or basic, you'll look at the PACO2 and the HCO values to determine which one caused the problem in the first place. There are only two options, the lungs or the kidneys. Now, the lungs, they control the PACO2 and the kidneys control the HCO3. If the pH is acidic and the PACO2 is higher than normal, that means that the lungs are holding on to way too much acid and they are the problem. Now if the PH is basic and the HCO3 level is higher than normal, that means that the kidneys are making way too much base and they are the problem. Whoever the problem is, we call them the party pooper. So determine if the lungs are the problem or if the kidneys are the problem. Remember, if you need a deeper dive into this step by step process and how to determine this, watch that previous video where I walk you through this step by step here in this video. We're just going to do a general overview of it here to help you figure out if the ABG is compensated or uncompensated. So here in our example, the PH is acidic, but the Paco2 value is lower than normal. So the lungs, not the problem. The lungs are not bringing too much acid. So let's take a look at the kidneys. And here we can see that the HCO3 value is low. So the kidneys are not making enough bicarbonate, which causes the blood to be more acidic. So the kidneys here are the problem. So in this example, ABG problem, the kidneys are the party poopers. And that makes this example metabolic acidosis. So now that we've got that figured out, we need to decide if the other guy, I like to call him the life of the party, if he's helping or not. Now in this case, the life of the party is the lungs. And we see here that the Paco2 value is lower than normal, lower than the normal range, which means that the lungs, they know that there's a problem, they know that the kidneys are not making enough base, so they've decided to get rid of more CO2 to help bring that acid level down in the body. Now since the kidneys are causing the problem, the lungs are trying to help by getting rid of their acid, that CO2. And this is where we really get into ABG compensation. If the life of the party is trying to Help, then we call this either partially compensated or fully compensated. It's partially compensated if the helper's value is changing but the PH still isn't quite back within normal range. And if it's fully compensated, the helper's value is changing and the PH now is back to normal. So in our example, since the kidneys are the party poopers, they're causing the problem in the first place and the lungs are the life of the party, they're trying to help and their value is changing. That means that in this example is some sort of compensated. So we just need to look back at the PH level to determine if it's partially compensated or if it's fully compensated. If the PH is within normal range, it's fully compensated. But if the PH is outside of normal range but the life of the party's value is still changing. In this case it's the lungs and yes, the lungs are trying to help, then it's partially compensated. So partially compensated means that the PH isn't quite back to normal range, but the life of the party is working on it to help make it happen. Its value is changing. If the lungs hadn't noticed anything was wrong and their value wasn't changing, that would make this example uncompensated. So in our ABG example here, it's partially compensated metabolic acidosis. Uncompensated means that the life of the party has not noticed anything is wrong, its value is still within normal range and the PH is still messed up. Partially compensated means that the life of the party, like we said, has noticed that the party pooper is being a party pooper, but they haven't had enough time to help out. That peach is still out of whack and even though the life of the party, their value is changing to compensate. Now full compensation of ABGs happens when that life of the party, that helper, their value has started to change, they've noticed something's wrong, their value is changing and the PH now has gone back within normal range. Now if this ABG example helped you to understand arterial blood gases better, write love in the comments below. And like I said before, if you want a step by step guide for interpreting arterial blood gases or ABGs, make sure to check out that video that we've got for you. That link is down below in the description and I've also got a free ABG cheat sheet for you to download too as well if you'd like. That link is also in the description below. Thank you so much for watching friend. Now go become the nurse that God created only you to be. And I will catch you in the next video.
