Step 1: pH – ABG Interpretation (Nursing)

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.

02:47 Please remember that homeostasis is all about balance.

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.