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Quick Reference

    Metabolic Acidosis
    Clinical Manifestations
    • hyperkalemia: shift of acid to ICF and K+ to the ECF
    • anorexia, nausea, and vomiting
    • warm, flushed skin
    • cardiac dysrhythmias & CNS dysfunction
    • headache, diarrhea, tremors


    Metabolic Alkalosis
    Clinical Manifestations
    • cardia dysrhythmias; seizures; confusion; muscle twitching, agitation
    • >pH;>HC03; normal PaCo2 or elevated if compensation occurs


    Respiratory Acidosis
    Clinical Manifestations
    • > PaCo2; HCO3 is normal or > with renal compensation
    • vasodilatation; cardiac dysrhythmias, tachycardia, somnolence, decreased ventilation


    Respiratory Alkalosis
    Clinical Manifestations
    • > pH; < PaC02; HCO3 normal or low due to compensation
    • nausea, vomiting, tingling of fingers
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Welcome to the ABG Tutorial

A note about pre-requisite learning: A clear understanding of human acid-base physiology is necessary before you begin this learning activity

An introduction to acid-base imbalances will facilitate your understanding of the contents within this tutorial.


    Upon completion of this learning activity, you will be able to


    o recognize clinical manifestations associated with acid-base imbalances.

    o match pH values with acid-base imbalances.

    o select the correct answer following the review of each case study.

    o compare and contrast the step-wise assessment of determining the acid-base balance of the blood.

    o identify the appropriate etiology of metabolic acidosis/alkalosis and respiratory acidosis/alkalosis.

    o differentiate between compensatory and non-compensatory ABG changes.


    Sometimes reading and deciphering Arterial Blood Gases (ABGs) can be a challenge! I have provided an interactive online tutorial for your review.

    Arterial blood gas values reflect ventilation and acid-base balance. The results include the arterial blood pH (concentration of hydrogen ions in the blood) , partial pressure of carbon dioxide (PaCO2) dissolved in the arterial plasma, and the concentration of sodium bicarbonate (HCO3-) in the blood. Our bodies regulate an acid-base balance through a "buffer system." This buffer system neutralizes acids. There are three buffer systems that exist for the maintenance of our acid-base equilibrium: a buffer system in our blood, respiratory system, and renal system.

    Some of the common causes of the retention of carbon dioxide (respiratory acidosis) are:
    pneumonia, drug overdose, pulmonary edema, pneumothorax

    Some of the common causes of the respiratory alkalosis are:
    pain, fever, asthma, congestive heart failure (CHF), anxiety, fear, pulmonary embolus

    Some of the common causes of a gain of metabolic acids or a loss of base (metabolic acidosis) are:
    Increased acids: renal failure, diabetic ketoacidosis, aspirin overdose, anaerobic metabolism
    Loss of base: diarrhea

    Some of the common causes of gain of base or loss of metabolic acids (metabolic alkalosis) are:
    Gain of base: Increased ingestion of antacids or an excessive administration of sodium bicarbonate
    Loss of metabolic acids: vomiting, nasogastric suctioning, low potassium and/or chloride levels, diuretics, steroids, increase in aldosterone

    Are you currently enrolled in a class at USF that requires you to complete this tutorial for credit? If so, you will need to login on the left side of this page before continuing.

    If you are not completing this tutorial for credit, start here!

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