compensating balances This is a topic that many people are looking for. daweaselonline.com is a channel providing useful information about learning, life, digital marketing and online courses …. it will help you have an overview and solid multi-faceted knowledge . Today, daweaselonline.com would like to introduce to you Partially Compensated vs Fully Compensated Uncompensated ABGs Interpretation Tic Tac Toe Method. Following along are instructions in the video below:
“Everyone it s sarah threads to nurse orion dock home and in this video. We we re gonna be going over partially versus fully compensated arterial blood gas practice problems after you watch this youtube video. Don t forget to access the free quiz. That will give you more abg practice problems so let s get started now in our previous video on how to solve abg practice problems we use the tic tac toe method.
But sometimes whenever you use the tic tac toe method you may notice that you don t get a tic tac toe. Where you get those three in a row. And when that happens you have to further analyze these values that you are given. And you have to ask yourself am.
I dealing with partial or full compensation and is this a respiratory or metabolic problem so in this video. We re going to tackle those issues now before you even attempt to answer abd problems you have to commit some normal lab values to your memory. So let s go over those first is blood. Ph a normal blood ph is.
735 to 745. Anything less than seven point. Three five is considered acidotic anything greater than seven point four or five. Is considered alcoholic so basic next is paco2 this is the partial pressure of carbon dioxide.
So it represents our respiratory system and remember that a normal pa co2 is anywhere between 35 to 45. Now these numbers are flipped whenever. If you set up a table like this anything greater than 45. Is considered an acid anything less than 35.
Is considered alkalotic. So remember that as well the last thing. I want you to remember is the by card. The hco3 this represents metabolic cancer renal system in normal values for bicarb is 22 to 26.
Anything less than 22 is considered an acid and anything greater than 26 is considered alkalotic now whenever we re dealing with abg problems and we have compensation going on especially full compensation. We have to look at that blood ph to help us determine if we have a respiratory or. Metabolic. Problem now i said that a normal blood ph is.
735 to 745. Now let s further analyze it the absolute normal for a blood ph is. 7 point. Four zero so that s like right in the middle of.
735 to 745. And if we had some full compensation. Going on meaning our ph is back to normal. So some system either the respiratory system.
Or the metabolic system has helped put us back to normal and you re gonna see with these abg s is that the respiratory and the renal system metabolic system is always trying to balance that blood ph out it will either increase the bicarb lower the bicarb increase the carbon dioxide or learned about the carbon dioxide to help get that blood ph back to normal and depending on what side of the spectrum innocence that this value of blood ph is falling from that absolute normal can tell us is it a little bit more on the acidotic side or is that blood ph a little bit more on the alcoholic side so let s..
Go over this the absolute normal. With 740 and. 735 to 745. Is our normal.
So any value of a. Blood ph that s normal that get falls. Between 735 to. 745 and any blood ph that falls between 74.
Zero. To seven point four or five is on alkalotic side now it s still normal. But it s falling either more on the acidotic or alcoholic side. So let s go reverse.
Few practice problems okay. The first problem i want to go over is something where we don t have any compensation going on and then we re going to add on partial compensation. Full compensation and you can see how these values are changing. And how we re getting our answers using the tic tac toe method and looking at those normal values that we ve commit to memory.
So. Our problem is our ph is seven point two to our paco2 is 49. And our bicarb is 24. So have our tic tac toe set up and we have acid over here normal over here alcoholic here.
If you re not familiar with that how to do the tic tac toe method i m going to show you okay so we re gonna look at each of these values and we re gonna put them in the column that they go and we re looking for a tic tac toe and again as i said the being in the lecture. If we have some type of especially full compensation going on we re not going to get a tic tac. Toe because our ph will be normal okay so. Ph.
Is 72 what s the. Normal. Value 735 to. 745 so it s less than 73.
Bucks. So we know it s acid on it so we re gonna put our ph. Here. Our paco2.
Which represents the respiratory system is 49 normal. Pa. Co2 is 35 to 45 since it s 49. It s greater than 45.
It s on the acidotic side..
So we re gonna put it over here. Oh we have a tic tac toe right here. But we re not done yet. Let s mess with our bicarb.
Our bicarb is 24. What s a normal bicarb. 22 to 26. This is normal it s falling with a normal range.
So we ll put that here well looking at this we know that we have acidosis going on and we have respiratory acidosis because paco2 represents respiratory. So we have respiratory acidosis. Now do we have compensation going on that s the next thing you ask yourself and the answer is no and how do i know that we don t have compensation going on well our blood ph is abnormal. Still it hasn t been corrected.
It s not falling within its normal range and the system that helps balance everything out either the rest or e or the metabolic system. It s still normal our bicarb isn t trying to throw itself. In an abnormal range to help combat this acidotic. So it could if it was going to come.
And say it would start increasing itself to make things a little bit more alkalotic. But it s not doing that so this is uncompensated. So we have respiratory acidosis uncompensated. Now look at that same problem again.
But let s change about you let s change our bicarb instead of being 24 let s make it 28. So we know that we still have respiratory acidosis going on because our blood ph is low and our pa co2 is high putting it on acidotic side. However our bicarb now is not normal. It s 28.
So it is greater than 26. So it s on the alcoholic side so we ll put it over here now next thing we want to ask ourselves do we have compensation going on yes. We do now is it full compensation or partial compensation. It is partial compensation.
How do i know that well it would be only full compensation. If our blood ph was normal. Once a blood ph is normal. Either the respiratory or the metabolic system has helped balance that blood ph out and got it normal.
However. It s not normal here. It s still abnormal so it s partially compensated. We have the metabolic system trying to increase our bicarb to help balance out these acidotic conditions because by trying to make it more basic the blood will hopefully push that blood ph a little bit higher to make it normal.
So we have respiratory acidosis..
That is partially compensated now let s look at our next. Problem. Okay our blood ph is 74. To our paco2 is 32.
And our bicarb is 18. So what we re going to do is we re going to plug it into our tic tac toe so our. Blood ph what s a normal blood. Ph.
735 to 745. And this falls. Within normal range. So our ph is normal.
Now right now you should be thinking compensation. Full compensation because we have got our blood ph back to normal. But let s look at those other values ok pco2. Which represents the respiratory system is 32 normal range is 35 to 45.
It s on that low side so it s alkalotic. So we ll pin it under here and our bicarb is 18 normal bicarb is 22 to 26. It s less than 22. So it s on the acidotic side.
Now this is when you ve set up your tic tac toe and you look and you re like i don t have a tic tac toe. But we know that we have full compensation going on because our blood ph is back to normal. However we have to determine is this wrestle tory or metabolic problem and to help us do that we have to further look at this blood ph. So even though our blood ph is within range at 74.
What side of the spectrum is it falling on that on that acidotic side or is it on the alcoholic side and it falls on the alcoholic side so what s happened is that our bicarb has decreased and it s trying to make things a little bit more acidic in that blood to bring the high alcoholic blood back down. So. Our bicarb is out of whack. Because it s been trying to do that and it s achieved it because we have full compensation.
But it s still a little bit that blood ph on the alcoholic side. And it s originated from a respiratory issue. So it s respiratory alkalosis with full. Compensation.
Now let s look at our next. Problem our blood ph is 737. Our paco2 is 33 and our bicarb is 17. So let s plug it in our.
Ph falls within..
Normal range it falls within. 735 to 745. So we ll be put it here and you should already be thinking ooh compensation our ph is normal. We probably have full compensation.
But let s look at our other values our paco2 is 33 normal is 35 to 45. It falls less than 35. So it s on the alcoholic side. So we put it here and again that represents the vittori system and their bicarb is 17.
So it s less than 22. So it s on the acidotic side and bicarb again represented the metabolic part so we see that we have full compensation going on we don t have a tic tac toe. So we had to look further at our blood ph and it s normal so we have full compensation. But is this respiratory or metabolic.
So we have to look at blood ph closely a normal blood ph the absolute normal is seven point four zero ours is seven point three seven. So it s on the acidotic side. So we have metabolic acidosis going on that is fully compensated and how i got slowly compensated is because that respiratory system tried to decrease the carbon dioxide and whenever it does that it s making things more alkalotic to help push that blood ph higher into that normal range and it did. But it s still on acidotic side.
But it finally got it to normal and achieve what it was supposed to do now. Let s say that this was seven point two seven instead. So that changes things a little bit here. Our blood ph is now seven point two seven.
So it s not normal anymore it fell less than seven point three five. So it s on the acidotic side. So let s move it over here. Now this has changed things a little bit.
Do we have full compensation going on anymore nope. We have partial compensation and i want you to see that because we have our tic tac toe. So we have metabolic acidosis and we have partial compensation. The paco2 has taken itself out of normal range to make things more alkalotic.
But it hasn t corrected it yet by making that blood ph become normal. So this would be metabolic acidosis partially compensated okay. So that wraps this video over partially versus fully compensated abg s thank you so. Much for watching don t forget to take the free quiz and to subscribe to our channel for more ” .
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