ON
“Arterial Blood Gas analysis”
SUBMITTED TO :- SUBMITTED BY :-
Prof. Mrs. Sasmita Das Itismita Biswal
Associate Dean M.SC(Nsg) 1ST YEAR STUDENT
HOD, Medical-Surgical Nursing Obstetrics & Gynaecological Nursing
SUM NURSING COLLEGE,BBSR SUM NURSING COLLEGE,BBSR
SUBMITTED ON:-
Subject – Advance Nursing Practice
Topic – Arterial Blood Gas Analysis
Venue – Nursing Foundation Lab
Group – M Sc. nursing 1st year students
Date –
Time –
Size of the group – 24
Method of teaching – Demonstration & Lecture cum Discussion
Language – English
A.V aids used – Power Point presentation, Chart , Video demonstration, Hand Out
Name of the student teacher – Itismita Biswal
Name of the evaluator – Prof. Mrs. Sasmita Das
General objectives – After the completion of the class, the student will gain knowledge
regarding ABG analysis & it’s interpretation.
DURA SPECIFIC CONTENT TEACHERS LEARNERS A.V AIDS EVALUATIO
TION OBJECTIVES ACTIVITY ACTIVITY N
2 min. i) Introduction to the topic- Explaining Active
Introduction- The test measures the amount of Listening
oxygen and carbon dioxide in the blood is known
as blood gas analysis (ABG) test . It is used to
determine the PH of the blood and used to
determine how acidic or basic it is .
3 min. 4) List down the Contraindications- Explaining Observing Hand Out What are the
contraindication with giving Hand out & showing contraindicatio
of ABG analysis Hand Out understanding Contraindicati n for ABG
Absolute contraindication-
on of arterial analysis?
blood gas
1. Infection/lesion at the site analysis
2. An abnormal modified Allen test
3. Presence of Arteriovenous fistulas
4. Known or suspected severe peripheral
vascular disease of the limb involved.
Relative Contraindication-
1. Severe Coagulopathy
2.Anticoagulant therapy with warfarin, heparin.
3. Use of thrombolytic agents, such as
streptokinase or tissue plasminogen activator.
3 min. 5) List down the Articles- Explaining Observing Powerpoint What are the
articles required 1 ml or 2 ml disposable syringe. with Powerpoint presentation articles
for ABG analysis Disposable needle size 20guage Powerpoint presentation & showing required for
Luer-lock for syringe presentation understanding articles ABG analysis?
Heparin 1:1000 required for
Alcohol swab ABG analysis
Crushed ice in specimen bag
Disposable gloves
Arterial catheter for continuous pressure
monitoring
Water proof pad
3 min. 6) Enemurate Site of arterial puncture- Explaining Observing Power Point What are the
the sites of Brachial artery with Powerpoint presentation sites used for
arterial puncture Femoral artery Powerpoint presentation & showing sites arterial
Radial artery presentation understanding of arterial puncture?
Ulnar nerve puncture
Median nerve
3 min. 7) Explain the Client and Environment Preparation: Explaining Observing Power Point How to
Preparation of 1. Explain the procedure to the client thoroughly. with Powerpoint presentation Prepare Client
Client and 2. Place the Client in comfortable position. Powerpoint presentation & showing and
Environment for 3. Before a radial artery puncture is executed or presentation understanding Preparation environment
Procedure a arterial line is inserted, allen test is performed of client and before
to ensure adequate circulation of blood to the environment Procedure?
hand. for Procedure
4. Prepare ice and heparinized syringe.
5. Instruct the client about the arterial puncture,
it is painful.
6. If the client is anxious, hyperventilation may
occur, giving false reading because CO2 is blown
off.
7 min. 8) Describe the Procedure- Explaining Observation Video How you can
procedure NURSING ACTIONS RATIONALE with doing & Active demonstratio draw the
1. Identify the It helps in obtaining demonstarti participation in n showing arterial blood?
patient by asking co – operation of on and discussion Procedure of
name and explain patient. Showing a Arterial Blood
the procedure. Video draw
2. Check the body Demonstrati
temperature. Hypo/hyperthermia on
influences o2 release
in hemoglobin.
3. Heparinize the
2ml syringe and It helps in preventing
then hold it in the clotting of blood
upright position in the syringe.
and expel excess
heparin and air
bubbles.
4. Hand washing and It helps to prevent
then wear the infections.
gloves.
5. radial, brachial, The arterial puncture
femoral artery is is to be performed in
to be palpated . the areas where
pulsation is good .
7. For radial
puncture a small To prevent soiling of
towel is put under linen and allow the
the hand along better control over
with water proof the needle .
pad.
4 min. 9) Explain the Special Consideration- Lecture cum Active listening What are the
Special 1. To protect the client from injury during discussion & take part in special
consideration for diagnostic Procedure. discussion consideration
the Procedure 2. Before radial puncture, the Allen test should to be taken for
be performed to ascertain adequate ulnar the
circulation. procedure?
3. If the critically ill clients have femoral or
arterial catheter system, blood specimen should
drawn from there.
4. Excessive amounts of heparin or an air bubble
in the syringe will cause inaccurate results.
3 min. 10) Student will After care- Lecture cum Active listening What are the
able to modify 1. Immediately after the needle is withdraw, discussion & take part in after care of
their behavior exert pressure on the arterial site for a minimum discussion arterial Blood
with knowledge of 5 minutes. draw?
of after care. 2. If the client is taking anticoagulants, Pressure
on the site should be maintained for for atleast
10 minutes.
3. Wash hand
4. Record the procedure.
5. Send the specimen to intensive care
unit/emergency department where ABG
machine is available, with proper labeling.
6. Report all scientific finding
7. All disposable waste disposed into appropriate
bio-medical waste bin
8. Disinfect all non-disposable equipment used
and store appropriately.
3 min. 11) Describe the Complications- Explaining Observing Powerpoint What are the
complications i) Arterial Occlusion from hematoma formation with Powerpoint presentation complication
or thrombosis. Powerpoint presentation & showing may develop
ii) Bleeding. understanding complication during arterial
iii) Infection. of arterial blood draw?
blood draw
4 min. 12) List down Normal value and abnormal values- Explaining Observing Powerpoint What are the
the normal & (PH)- Normal:7.35 – 7.45 , Acidemia : <7.35, with Powerpoint presentation normal and
abnormal values Alkaemia:>7.45. Powerpoint presentation & showing abnormal
(PaCO2)- Normal:35-45mmHg, Respiratory understanding normal & values of
acidosis:> 45mmHg, Respiratory abnormal blood?
alkalosis:<35mmHg. values of
(HCO3)- Normal:22-26meq/l, Metabolic acidosis: blood
<22meq/l, Metabolic alkalosis:>26meq/l
(PaO2)-Normal:80-100 mm hg , o2 saturation:96-
100%
4 min 13) List down Abnormal sign indicate certain medical Explaining Observing Chart showing
certain medical condition:- with chart Chart & certain
condition Blood PH HCO3 Paco2 condition understanding
Common causesmedical
Less than Low Low Metabolic abnormalities
Kidney failure, shock,
7.4 acidosis diabetic ketoacidosis
High High Chronic vomiting ,
Greater Metabolic hypokalemia
than 7.4 alkalosis
Lung disease , COPD,
High High Respiratory Pneumonia
acidosis
Less than Breathing to fast , pain,
7.4 anxiety
3 min. 15) Enumerate 1. Arterial blood gases are frequently ordered by Explaining Observing Power Point
the recent emergency medicine, intensivist, with Power Powerpoint presentation
changes in ABG anesthesiology and pulmonology physicians, but point presentation & showing
analysis may also be needed in other clinical settings. presentation understanding recent
2. Alcohol swab is recommended before skin changes in
puncture . ABG analysis.
2. The ABL90 Flex is a blood gas analyzer
from Radiometer America Inc, that is designed to
provide laboratory quality blood gas results at
the point-of-care for 17 parameters, including
blood gas, oximetry, and electrolytes.
3. The Stat Profile Prime from Nova Biomedical,
launched globally in 2013, is a blood gas analyzer
designed for critical care testing and is intended
to provide actionable, lab-quality results in 60
seconds.
4. The epoc Blood Analysis System by Alere is a
wireless solution for the testing of electrolytes,
blood gas, and metabolites.
5. The article “Assessing Tissue Oxygenation”
(June 2002:22–40) contains a comprehensive
overview of arterial blood gas analysis, routinely
add an additional step in the analysis of arterial
blood gases to determine if another primary
acid-base process is present.
3 min. 16) Explain the Anatomy – Positioning given according to site of Lecture cum Active listening What are the
scientific arterial Puncture discussion & take part in scientific
principle Physics – The pressure with which blood flows. discussion Principles
involved in this Chemistry – Interpretation of Blood gas values. involved in this
procedure Microbiology – Site cleaning with alcohol swab Procedure?
for maintenance of asepsis.
Psychology- Provide psychological support to
patient.
BIBLIOGRAPHY-
1. Clement I, Basic concepts of Nursing Procedure, 2 nd Edition(2013), Jaypee Brothers Medical Publishers (p) Ltd,, Page nos.(281-
283)
2. Jacob Annamma, R Rekha & Tarachand Jadhav Sonali, Clinical Nursing Procedure: The Art of Nursing Practice, 3rd Edition(2015),
Jaypee Brothers Medical Publishers (p) Ltd, Page nos.(369-371)