GENDER
Male
AGE
25
SETTING
■ Hospital
ETHNICITY
■ Black American
CULTURAL CONSIDERATIONS
PREEXISTING CONDITION
COEXISTING CONDITION
COMMUNICATION
DISABILITY
SOCIOECONOMIC
SPIRITUAL/RELIGIOUS
PHARMACOLOGIC
■ Heparin; lidocaine (Xylocaine)
LEGAL
ETHICAL
ALTERNATIVE THERAPY
PRIORITIZATION
■ Critical arterial blood gases
DELEGATION
THE RESPIRATORY SYSTEM
Level of difficulty: Easy
Overview: This case provides the nurse with an opportunity to convey an understanding of the
arterial blood gas testing method and practice the skill of acid-base analysis/arterial blood gas results
interpretation.
30 Part 2 ■ THE RESPIRATORY SYSTEM
Client Profile William is a newly graduated registered nurse. He will begin working on a respiratory
nursing unit next week. During orientation to his role, he will learn how to collect
an arterial blood gas (ABG) sample. He is given five sets of ABG results to practice
acid-base analysis/arterial blood gas results interpretation. William must determine
acid-base balance, determine if there is compensation, and decide whether each
client is hypoxic.
Case Study The five sets of arterial blood gas results are:
1. pH 6.95 PaCO2 48 mm Hg HCO3
2 23 mEq/L SaO2 95% PaO2 79 mm Hg
2. pH 7.48 PaCO2 44 mm Hg HCO3
2 30 mEq/L SaO2 88% PaO2 70 mm Hg
3. pH 7.48 PaCO2 31 mm Hg HCO3
2 19 mEq/L SaO2 93% PaO2 82 mm Hg
4. pH 7.35 PaCO2 42 mm Hg HCO3
2 26 mEq/L SaO2 95% PaO2 83 mm Hg
5. pH 7.53 PaCO2 31 mm Hg HCO3
2 35 mEq/L SaO2 90% PaO2 57 mm Hg
Questions
1. Describe the purpose of the arterial blood gas
(ABG) test.
2. Describe the client preparation that is necessary
prior to drawing an ABG sample. Is written client
consent (a consent form) required prior to drawing
the blood sample?
3. List the equipment the nurse must gather prior
to collecting the ABG sample.
4. List the steps for obtaining an ABG sample from
a radial artery.
5. What are the potential complications of the ABG
collection procedure?
6. Discuss the nursing responsibilities after the
ABG sample is obtained.
7. Explain how an ABG sample should be transported to the laboratory for processing.
8. How long does it take to obtain ABG results?
9. Briefly discuss at least five factors that can cause
false ABG results.
10. What are the normal ranges for each of the
ABG components in an adult: pH, partial pressure
of carbon dioxide (PaCO2), bicarbonate (HCO3
2),
oxygen saturation (SaO2), and partial pressure of
oxygen (PaO2)?
11. What are the critical/panic values for each
of the ABG components in an adult: pH, PaCO2,
HCO3
2, SaO2, and PaO2?
12. Help William analyze each set of ABG results. Determine whether each value is high, low, or within
normal limits; interpret the acid-base balance; determine if there is compensation; and indicate whether
the client is hypoxic.
1. pH 6.95 PaCO2 48 mm Hg HCO3
– 23 mEq/L SaO2 95% PaO2 79 mm Hg
2. pH 7.48 PaCO2 44 mm Hg HCO3
– 30 mEq/L SaO2 88% PaO2 70 mm Hg
3. pH 7.48 PaCO2 31 mm Hg HCO3
– 19 mEq/L SaO2 93% PaO2 82 mm Hg
4. pH 7.35 PaCO2 42 mm Hg HCO3
– 26 mEq/L SaO2 96% PaO2 83 mm Hg
5. pH 7.53 PaCO2 31 mm Hg HCO3
– 35 mEq/L SaO2 90% PaO2 57 mm Hg
13. Identify three appropriate nursing diagnoses for a client having an ABG sample obtained.
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