Using an algorithm to interpret arterial blood gases.

The arterial blood gas (ABG) analysis, one of the most common tests ordered, provides clinicians with valuable information on a patient's oxygenation and acid-base balance. Interpreting ABG analysis results can be challenging, even for the most experienced practitioners, because it requires knowledge of the physiology and cause-and-effect relationship of the disturbances. Applying the principles and the ABG algorithm described in this article will provide nurses with a systematic way to interpret uncomplicated arterial blood gas results, including primary, mixed, and compensated acidbase disturbances.

Interpretation of arterial blood gases by nurses.

Many clinical nurses find the concept of acid/base balance confusing. This article presents a step-by-step approach to arterial blood gas (ABG) analysis. In addition, the components of ABGs (pH, PCO2 and HCO3) are presented; metabolic and respiratory abnormalities (acidosis and alkalosis) are discussed in relation to cause and signs and symptoms; the concept of compensation is reviewed; the degrees of compensation are explained; the five steps of ABG analysis are outlined; and practice problems are provided and explained. By using this approach, the nurse can analyze the ABG values confidently and make a wise choice about appropriate nursing actions.

Assessment and nursing diagnosis in fluid and electrolyte disorders.

Disorders of fluid and electrolyte balance are common considerations in adult medical-surgical clients with underlying pathologic conditions. The assessment framework presented in an integrated approach is an attempt to provide the clinician with a nursing model to be used in gaining pertinent clinical information from clients with existing or suspected fluid and electrolyte disorders. The use of health patterns facilitates the collection and organization of information gained by the nurse through assessment. This framework assists the nurse in processing subjective and objective assessment data to obtain an accurate nursing diagnosis. Nursing diagnosis is the keystone of the nursing process--without an organized framework for the collection of assessment data, the nursing diagnosis may not be valid and, therefore, nursing care will not be client-centered.