Arterial Blood Gas (ABG) Tic-Tac-Toe Full Compensation Examples

4 fully compensated arterial blood gas problems worked using the tic-tac-toe method.

Category:

Education

Tags:

• arterial blood gas
• abg
• tic tac toe
• fully compensated

[AreWeMuslims]

If and when pH is normal, it means there is a 'Mixed Acid Base Disorder". The pH never becomes normal as a result of compensation.

Please correct me if I am wrong with a reference.

thanks

[survivenursing]

@AreWeMuslims “If compensatory mechanisms are functioning, the pH will return toward 7.40. When the pH is back to normal, the patient has full compensation.”

Lewis, S., Dirksen, S., Heitkemper, M., Bucher, L., & Camera, I. (2011). Medical-surgical nursing: Assessment and management of clinical problems (pp. 324). St. Louis, MO: Elsevier.

[survivenursing]

@AreWeMuslims My library doesn’t have a copy of Vincent’s Textbook of Critical Care or The ICU Book so I am unable to read these for myself to see how it’s worded. As far as I know this is how most nursing programs teach ABGs. I think there may have been a nomenclature shift at some point which is where the term “full compensation” came about.

[survivenursing]

@AreWeMuslims A lot of this is not precise science. Ranges vary slightly depending on which source you follow. For example the Medical-Surgical book cited earlier uses 32-48 for the normal PaCO2 range, but the USMLE (licensing exam for US physicians) uses 33-45. Depending on which reference range you use you may get a completely different interpretation, yet either way the patient is the same.

[survivenursing]

@AreWeMuslims This is why it’s not always that useful to apply these tools without critically thinking about the patient’s condition. The more compensation an ABG revealed the more suspicious I would become that there may be a mixed disorder present.

[praxisforever]

this is good but there are other examples you can have like uncompensated metabolic/respiratory acidosis/alkalosis, or partially compensated one... give also examples by which the pH is not within the normal range and one or two parameter are not normal...okay... thank you

[survivenursing]

@praxisforever There's another video titled "Arterial Blood Gas (ABG) Tic-Tac-Toe Examples" with more general examples. This video was to provide more examples of full compensation since it's a slightly more difficult concept.

/watch?v=_OpvyEIlFj8

[AreWeMuslims]

@survivenursing

>>>I think there may have been a nomenclature shift at some point which is where the term “full compensation” came about.<

I Think that is what has happened it is easier for people to remember it. Infact, Paul Morino's ICU Book (there are two versions a MOTHER book and a 'little' ICU book) has pointed this out.

They however also point out that "full compensation does not mean normalisation of pH" and nor is it synonymous with normalisation of chemistry.

[AreWeMuslims]

"pH returns TOWARDS normal, ALTHOUGH NOT normal".

Vincent's Textbook of Critical Care Chapter 109 Metabolic acidosis.

[AreWeMuslims]

Could you please provide the reference for the terms "fully compensated" conditions that you are mentioning. Critical Care text books are categorical "Compenatory mechainsms are never able to fully normalize the pH" (Paul Morino's ICU Book for instance 2007).

Thanks