# Step 1: pH – ABG Interpretation (Nursing)

by Rhonda Lawes

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00:00 So now we're gonna talk about step 1.

00:03 So you've got these in order, there's six total steps but I want to show you what you already know.

00:09 Step 1, you look up the pH and label it as acidosis or alkalosis.

00:15 So look at number one, a ph of 7.54, what would you label that? Sweet! Alkalosis, right? because it's moving the direction of the blue pillow, It's a ph that's greater than 7.45 so we would label that alkalotic.

00:37 Let's look at another example.

00:39 Now hey, hey, don't just sit there and stare at the screen and wait for me to give the answer.

00:44 The way you learn how to do this is even if you need to pause a video after each example, make a guess, an educated guess before you let me give you the answer.

00:53 So let's look at number 2.

00:55 The pH is 7.20, okay so are we gonna label that acidotic or alkalotic? Right, acidotic.

01:10 A ph of 7.20 is less than 7.35 Okay so that's what's we're gonna label it as, acidosis because it's less than 7.35 Let's do another example.

01:26 pH of 7.32 Right, acidosis.

01:35 7.32 is just barely lower than 7.35 but we're gonna go with that because it is less than 7.35 - it's acidotic.

01:46 Now let's try just a couple more examples to make sure that you've got this right.

01:50 Look at number 4, pH of 7.47 That would be alkalosis because 7.47 is higher than 7.45, pushing us toward alkalosis.

02:08 Okay last example that I'm gonna give you.

02:11 7.28, so you'd label that? Right, acidosis because a ph of 7.28 is less than 7.35 In step 1 you would label the pH acidotic.

02:31 Okay, that's it.

02:32 That's essentially step 1 if you kept up with us, you're gonna be able to do ABGs without any problem.

02:40 As long as you follow these 6 simple steps and label each part as we walk through it, you're gonna do great with these.

02:51 As long as I have the right amount of CO2 and the right amount of bicarb, the body will be in homeostasis.

02:58 But look what happens if I get too much CO2.

03:01 The body will be in acidosis.

03:04 So think of CO2 in the blood as like an acid in the blood, the excess acid will make me more acidotic.

03:11 So look that the pH and label it in step 1.

03:15 You know that CO2 dissolve in the blood, is like an acid,.

03:19 Bicarb dissolve in the blood makes me more basic.

03:22 So that's really important when you're looking at that because that matters when we start looking at the next values.

03:28 So we're done with step 1 in just a minute because I want to check your understanding of this concept.

03:35 Now don't try and ovberload yourself of looking at all these words on this slide.

03:40 Just walk through it one step at a time with me and I promise it will make sense.

03:44 If I'm looking at the CO2, next column - it's greater than 45 and we consider CO2 in the blood as an acid, then what's gonna happen to the pH is it's gonna become more acidic, right? So a CO2 greater than 45, CO2 in the blood is an acid, my pH becomes less than 7.35 or more acidic because of all the extra CO2.

04:12 Now if I take the CO2 and I have a less than 35 and I know that CO2 in the blood is an acid, that means my pH will become more alkaline.

04:23 When I have less than normal amounts of acid, my pH will become more alkaline or more basic Okay, I know I'm in the repetition but I want to say that one more time.

04:34 When I have excess CO2, I become more acidic but when I don't have enough CO2, when I have a lower than normal level of CO2 and CO2 is an acid, then I become more basic or alkalotic.

04:48 Same concept applies to bicarb but in reverse.

04:51 When I have extra bicarb, I know that bicarb in the blood is a base, then my pH will become greater than 7.45 or more basic/alkalotic.

05:02 If I don't have as much bicarb as I need, I have less bicarb than normal and I know that bicarb in the blood is a base, with less base, then I need to keep a balance, my pH is going to become more acidic.

05:18 Okay, this is a slide you might want to keep going back to just to help lay those concepts down as we're going to steps 2 and 3.

The lecture Step 1: pH – ABG Interpretation (Nursing) by Rhonda Lawes is from the course Interpretation of Arterial Blood Gases (ABGs) (Nursing).

### Included Quiz Questions

1. Acidotic
2. Alkalotic
3. Homeostatic
4. Basic
1. Becoming more acidic
2. Becoming more alkaline
3. Increasing
4. Remaining unchanged
1. The ABG is more basic, and the pH will be greater than 7.45
2. The ABG is more acidic, and the pH will be less than 7.35
3. The ABG is more basic, and the pH will be greater than 7.35
4. The ABG is more acidic, and the pH will be less than 7.45

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