All three values are ABNORMAL, therefore solving for goal #3, we have a PARTIALLY COMPENSATED ABG. Neave Interactive. your own Pins on Pinterest Hopefully the tic-tac-toe method gave you an easy way to interpret blood gases and acid base status! If we have more base than normal, then excess base is present. The first step is you need to familiarize yourself with the normal and abnormal ABG values when you review the lab results. 0 Full PDFs related to this paper. For med-surg, our instructor again taught us the ROME but I came on here and found the tic-tac-toe (from VickyRN) and I had it figured out within two practice problems. If the blood pH is between 7.41 to 7.45, interpretation is NORMAL but SLIGHTLY ALKALOSIS, place it under the NORMAL column. https://nursing.com/lesson/abg-01-04-abg-interpretation-tic-tac-toe Deliver the blood sample immediately to the laboratory. ABGs Tic Tac Toe game. Write. First, we need to know the normal values of a blood gas before we can start to interpret it. Tic-Tac-Toe-Attachment.docx Tic-Tac-Toe-Part-2.docx Tic-Tac-Toe-References.docx. Respiratory acidosis is typically caused by an underlying disease or condition. “Acid, pH, and PaCO2” are all circled in this example. My goal is to show you how to use the Tic Tac Toe method for partially and fully compensated interpretation. A pH greater than 7.45 is consistent with alkalosis (base). Computer Player 2 0. An Arterial Blood Gas (ABG) is a blood test that is used to measure a few vital things is the body, such as the levels of oxygen (O2), carbon dioxide (CO2), acid, or pH from an artery. Treating the condition is a matter of rising carbon dioxide levels in the blood. pH is NORMAL but is leaning towards ALKALOSIS, therefore under the same column as PaCO. Inform that client about the procedure and that there is no food or fluid restriction imposed. His situation drove his passion for helping student nurses by creating content and lectures that are easy to digest. Visual Studio Winform Tic Tac Toe Tutorial Example (C#) Codahejaj Amir Bazid. Determine if HCO3 is under NORMAL, ACIDOSIS, or ALKALOSIS. Interpret the results as follows: Let’s solve for the ABG interpretation with the examples below: Practice Problem #1:pH=7.26 | PaCO2=32 | HCO3=18, The answer to Practice Problem #1:Metabolic Acidosis, Partially Compensated, Practice Problem #2:pH=7.44 | PaCO2=30 | HCO3=21, The answer to Practice Problem #2:Respiratory Alkalosis, Fully Compensated, Practice Problem #3:pH=7.1 | PaCO2=40 | HCO3=18, The answer to Practice Problem #3:Metabolic Acidosis, Uncompensated. Tie 0. Patients with arterial blood gas indicating metabolic acidosis are managed and treated by: Metabolic alkalosis occurs when bicarbonate ion concentration increases, causing an elevation in blood pH. Then we take a look at HCO3. PaO2 or partial pressure of oxygen or PAO2 indicates the amount of oxygen available to bind with hemoglobin. They are easy to remember: The recommended way of memorizing it is by drawing the diagram of normal values above. We were taught the ROME method in patho and I couldn't understand it for the life of me. Therefore, HCO3 will go under the base column. Recommended Links. Note if the client is receiving oxygen therapy (flow rate, type of administration device), and the client’s current temperature. Remember that a pH < 7.35 is acidosis and a pH > 7.45 is alkalosis. If you need more information or practice quizzes, please do visit the following links: Nursing Test Bank: Free Practice Questions UPDATED! Neave Interactive. Therefore, it is not doing anything to compensate for the metabolic disorder (otherwise CO2 would have been under the acid column). 5. Partially compensated respiratory acidosisD. This happens in diarrhea, ketosis, and kidney disorders. © 2021 Nurseslabs | Ut in Omnibus Glorificetur Deus! Before You Go, Make Your Medical Experience Easier! If you want more information on this, be sure to check out the EZmed anion gap post for simple mnemonics and explanations! Depending if HCO3 or CO2 is circled, it will either be a metabolic, a respiratory, or a mixed disorder. Let’s play tic-tac-toe • Daniel is a 50-year-old executive who complains of indigestion and heartburn that has increased over the last six months. We do this by looking at the remaining unused value, and in this case it is CO2. If the blood is acidic, the PaCO2 or partial pressure of carbon dioxide in arterial blood is assessed because the lungs regulate the majority of acid. For Hire . Jan 17, 2019 - This Pin was discovered by Michele Rudolph. Now that the tic-tac-toe board has been drawn, we simply plug in the blood gas numbers. ABG Tic-Tac-Toe. Search. The content is not guaranteed to be error free. A normal PaCO2 range is 35-45. Arterial blood is usually drawn via the brachial or radial artery. Click below to check them out, and join to save time and help you study! A pH less than 7.35 is consistent with acidosis (acid). This platform and its contributors are not responsible from damages arising from its use. Don’t miss out on the other EZmed videos people are using to make medicine easy! Unfortunately, analyzing blood gases can be confusing to learn at first. READ PAPER. ABGs Tic Tac Toe game Learn with flashcards, games, and more — for free. See Terms of Service and Privacy Policy above for more detail. People with this type of alkalosis more often complain of the underlying conditions that are causing it. By submitting you agree to our Terms of Service and Privacy Policy below. It can be measured indirectly by calculating the PAO2 and pH Or measured directly by co-oximetry. This test is used to check the function of the lungs, and how well they are able to move oxygen into the blood and eliminate carbon dioxide. Normal Blood pH Scale Diagram for the Tic-Tac-Toe Method for ABG Analysis The recommended way of memorizing it is by drawing the diagram of normal values above. Solve for goal #1: ACIDOSIS or ALKALOSIS. Remember in step #1 that the normal pH range is from 7.35 to 7.45. This TIC TAC TOE method is so super easy when solving respiratory alkalosis, acidosis, metabolic alkalosis, or acidosis. Once you’ve memorized the normal values and the diagram, create a blank your tic-tac-toe grid and label the top row as ACIDOSIS, NORMAL, and ALKALOSIS. Now, answer these questions and see how many you can hit right. We know that CO2 is associated with the respiratory component of a blood gas, and HCO3 is associated with the metabolic component. Metabolic alkalosis may not show any symptoms. Let's Play…. Amir Bazid. The circled pH and base tell us this is alkalosis. If the blood pH is between 7.35 to 7.39, the interpretation is NORMAL but SLIGHTLY ACIDOSIS, place it under the NORMAL column. http:/nurseslabs. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire nursing students. Based on their values, we need to determine in which column we’ll place pH, PaCO2, and HCO3 in the grid. Second, we need to determine if values define METABOLIC or RESPIRATORY. Download Full PDF Package. We are going to use the tic-tac-toe method to easily answer all 3 questions. The normal ABG level for pH is 7.35 to 7.45. Once you’ve determined whether the pH is under the ACIDOSIS or ALKALOSIS, plot it on your tic-tac-toe grid under the appropriate column. However, if the ABG values are partially or fully compensated you must take it a step further by analyzing the blood pH level and which system is trying to compensate. A male patient with a history of COPD presents in respiratory distress. The content and information contained in this website or communicated by its author is for educational purposes only. The kidneys activate its compensatory process (albeit slow, often 24 hours or more) by increasing the excretion of metabolic acids through urination, which increases blood bicarbonate. your own Pins on Pinterest Is it an acid (acidosis) or base (alkalosis)? Rather than the HCO3 being under the normal column (which would have meant no metabolic compensation present), it is under the base column. All you have to do is make a blank chart a bit like a tic-tac-toe chart. Knowing how to interpret blood gases is a crucial skill to have, as it can help you determine the patient’s acid base status, severity of their condition, and potential underlying pathophysiology of their presentation. If compensation is present, then you can calculate if it is partially or fully compensated. Base excess or BE value is routinely checked with HCO3 value. Had HCO3 been normal, then it would have gone under the normal column. Now begin with this given example. Spell. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics. Now we have to determine if there is compensation present. Nous voudrions effectuer une description ici mais le site que vous consultez ne nous en laisse pas la possibilité. Write it down together with the arrows indicating ACIDOSIS or ALKALOSIS. Signs and symptoms of respiratory acidosis are as follows: Medical and nursing management of an arterial blood gas of respiratory acidosis includes the following: Respiratory alkalosis can result from hyperventilation since the lungs excrete too much carbonic acid which increases pH. Any blood pH above 7.45 (7.46, 7.47, 7.48, and so on…) is ALKALOSIS, place it under the ALKALOSIS column. Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. There are 3 main questions to ask yourself when determining a patient’s acid base status. 26953 http:/nurseslabs. Common sites for drawing arterial blood are the radial and brachial artery. Apply pressure to the puncture site for 5 minutes or longer. Hydration for diabetic ketoacidosis. His ABG results are: – pH 7.26 – PaCO2 52 – HCO3- 34 Acid and pH are circled informing us that acidosis is present. The pH plays a role in the combining power of oxygen with hemoglobin: a low pH means there is less oxygen in the hemoglobin. Let’s use an example blood gas to demonstrate how this works. Join the EZmed community for FREE and receive weekly EZmed content right to your inbox! 5. Base excess, the normal range is –2 to +2 mmol/L. If pH is under the NORMAL column, determine whether the value is leaning towards ACIDOSIS or ALKALOSIS and interpret accordingly. Well, I didn’t until my professor taught us the TIC TAC TOE Method for ABGs and then solving ABG problems actually started to be somewhat fun. The tic-tac-toe was the only way that I could figure out ABGs. See Terms of Service and Privacy Policy. ABGs: TIC-TAC-TOE METHOD First, MEMORIZE the normal values: pH 7.35 – 7.45 7.4 = baseline < 7.4 = acidic and >7.4 = alkalotic CO 2 35 – 45 > 45 = acidotic; < 35 = alkalotic HCO 3 22 – 26 < 22 = acidotic; > 26 = alkalotic THE METHOD – Read the ABG values and put the determinants in the appropriate column of the table below. pH is NORMAL, therefore solving for goal #3, we have a FULLY COMPENSATED ABG. Tic-Tac-Toe. The third step of this technique is to determine the acidity or alkalinity of the blood with the given value of the pH as our determining factor. If pH is under the NORMAL column, determine whether the value is leaning towards ACIDOSIS or ALKALOSIS and interpret accordingly. If pH is under the ACIDOSIS column, it is ACIDOSIS. Additional Materials. Included here is link to Tic Tac Toe ABG video (video site included due to written permission by originators). This is known as:A. 3. HCO3 is 30 which is greater than the normal value. Flashcards. Start studying ABG (Arterial Blood Gas) Practice Quizzes with Tic Tac Toe Method. Nurseslabs – NCLEX Practice Questions, Nursing Study Guides, and Care Plans, Arterial Blood Gas Analysis Made Easy with Tic-Tac-Toe Method. There are six components of arterial blood gas (ABGs): The pH is the concentration of hydrogen ions and determines the acidity or alkalinity of body fluids. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, break down complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively. Since we started in 2010, Nurseslabs has become one of the most trusted nursing sites helping thousands of aspiring nurses achieve their goals. This does not correct the root cause of the problem, if the underlying condition is not corrected, these systems will fail. Our ultimate goal is to help address the nursing shortage by inspiring aspiring nurses that a career in nursing is an excellent choice, guiding students to become RNs, and for the working nurse – helping them achieve success in their careers! Let's Play…. You begin to interpret the results to determine his acid base status. There is also another method called the ROME method that you can use to solve ABG problems. 6. Neurological symptoms such as confusion, paresthesias, and cell membrane excitability occur when the blood pH, CSF, and ICF increases acutely. For PaCO2, the normal range is 35 to 45 mmHg (respiratory determinant). 1P. Just a reminder that HCO3 is associated with the metabolic component of a blood gas, and CO2 is associated with the respiratory component. View Test Prep - ABG's Tic Tac Toe from NURSING 215 at Pomona College. Let’s Play…. An arterial blood gas is a laboratory test to monitor the patient’s acid-base balance. In addition, you will be tested on if the disorder is partially compensated or … We know that HCO3 is a base, and since we have excess base than normal it will go under the base column. This would have indicated a mixed metabolic and respiratory acidosis. This is simple to remember because bicarbonate and base both start with the letter “B”, and CO2 starts with “C” and there is a “C” in acid. - Free blogs that make medical topics easy, - Free animations and videos that correspond with each blog, - Free mnemonics, tricks, and strategies to learn and remember the content, - Help to improve your exam scores and classroom performance, - Continued medical education for your career. It is PARTIALLY COMPENSATED if all three (3) values are abnormal. Interpret the results as follows: Lastly, we need to determine the compensation to accomplish our goal #3. Next, we will plug in the CO2 and HCO3 values. The pH is 7.53 in our example. Since CO2 is circled, we know we have a respiratory disorder. Fully compensated metabolic acidosisC. Nursing students will be tested on this material in nursing school, and this is one of the easiest ways to solve these … If the blood is basic, the HCO3 level is considered because the kidneys regulate bicarbonate ion levels. Values: pH (acid): < 7.35 pH (normal): 7.35 – 7.45 pH (base): > 7.45 ABG Tic-Tac-Toe … The normal ABG values are the following: Interpreting arterial blood gases is used to detect respiratory acidosis or alkalosis, or metabolic acidosis or alkalosis during an acute illness. This website and its content should not be used in any legal capacity, including but not limited to establishing a legal "standard of care" or as basis for expert witness testimony. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Remember that the normal range for HCO3 is from 22 to 26: Now, we will start solving for our goals. Academia.edu is a platform for academics to share research papers. A pH of 7.35 indicates acidosis and a pH greater than 7.45 indicates alkalosis. The Tic Tac Toe method makes solving ABG problems so EASY. We can see that CO2 is under the normal column. Log in Sign up. For PaO2, the normal range is 75 to 100 mmHg, SO2 or oxygen saturation, measured in percentage, is the amount of oxygen in the blood that combines with hemoglobin. Looking at the tic-tac-toe grid, determine whether in what column the pH is placed and interpret the results: In this step, we can accomplish goal #1 of determining ACIDOSIS or ALKALOSIS. The control of metabolic acidosis in hemodialysis is mainly focused on the supply of bicarbonate during the dialysis sessions. Learn. Put the syringe with arterial blood in an ice-water bag to minimize the metabolic activity of the sample. The next method for ABG interpretation is the Tic Tac Toe method. Thank you for using EZmed! Browse. For example using the blood gas above, if HCO3 had been < 22 then it would have been under the acid column rather than the base. Unlike other blood samples obtained through a vein, a blood sample from an arterial blood gas (ABG) is taken from an artery (commonly on radial or brachial artery).

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