Page 281 - Saunders Comprehensive Review For NCLEX-RN

elevated (alkalosis), or the pH will be decreased and
HCO – will be decreased (acidosis).
3
3. Look at the pH and the HCO – to determine whether
3
the condition is a metabolic problem.
4. Metabolic acidosis: The pH is decreased; the HCO – is
3
decreased.
5. Metabolic alkalosis: The pH is elevated; the HCO – is
3
elevated.

In a respiratory imbalance, the ABG result indicates an

opposite relationship between the pH and the Paco . In a metabolic
2
imbalance, the ABG result indicates a corresponding relationship
between the pH and the .
D. Compensation (see Table 9-4)
1. Compensation refers to the body processes that occur
to counterbalance the acid-base disturbance.
2. When full compensation has occurred, the pH is
within normal limits.
E. Steps for analyzing ABG results (Box 9-5)
F. Mixed acid-base disorders
1. Occurs when 2 or more disorders are present at the
same time.
2. The pH will depend on the type and severity of the
disorders involved, including any compensatory
mechanisms at work, e.g., respiratory acidosis
combined with metabolic acidosis will result in a
greater decrease in pH than either imbalance
occurring alone.
3. Example: Mixed alkalosis can occur if a client begins to
hyperventilate due to postoperative pain (respiratory
alkalosis) and is also losing acid due to gastric
suctioning (metabolic alkalosis).

Priority Nursing Actions

Performing the Allen’s Test Before Radial Artery Puncture

1. Explain the procedure to the client.
2. Apply pressure over the ulnar and radial arteries simultaneously.
3. Ask the client to open and close the hand repeatedly.
4. Release pressure from the ulnar artery while compressing the radial artery.
5. Assess the color of the extremity distal to the pressure point.
6. Document the findings.

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