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Why ABG interpretation feels like decoding secret language — and how to simplify it.
02:30 – Foundations of Acid-Base Balance
CO₂ = acid (lungs control it)
Bicarb = base (kidneys control it)
The body maintains balance (homeostasis) through both systems.
06:00 – Respiratory Acidosis
Cause: CO₂ retention (slow, shallow breathing)
Examples: Opioid overdose, pneumonia
ABG Pattern: ↓ pH, ↑ CO₂, normal bicarb (acute)
Symptoms: Confusion, hypoventilation, drowsiness
Chronic case: COPD → compensated by high bicarb
11:30 – Respiratory Alkalosis
Cause: Blowing off too much CO₂ (hyperventilation)
Examples: Panic attack, pulmonary embolism, pregnancy
ABG Pattern: ↑ pH, ↓ CO₂, normal bicarb
Symptoms: Dizziness, tingling fingers/lips, lightheadedness
16:45 – Metabolic Acidosis
Cause: Too much acid or loss of base
Examples: DKA, renal failure
ABG Pattern: ↓ pH, ↓ bicarb, ↓ CO₂ (compensation)
Signs: Deep, rapid (Kussmaul) respirations, fruity breath, fatigue
22:15 – Metabolic Alkalosis
Cause: Loss of acid or gain of base
Examples: Prolonged vomiting, NG suctioning
ABG Pattern: ↑ pH, ↑ bicarb, ↑ CO₂ (compensation)
Symptoms: Shallow breathing, muscle cramps, EKG changes
27:00 – The Big Nursing Pearl
“You treat the patient, not the paper.”
ABG numbers mean nothing in isolation — always match them to your patient’s story and symptoms.
29:00 – Critical Thinking Challenge
How do shifts in pH affect electrolytes like potassium and calcium?
Recognize how alkalosis causes low potassium and low calcium, showing up as cramps or EKG changes.
30:00 – Wrap-Up & CTA
Visit ThinkLikeANurse.org for more NCLEX practice and weekly episodes that help you think like a nurse — not just study like one.
Need to reach out? Send an email to Brooke at [email protected]
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