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ABG Practice Questions NCLEX for Nurses

Good morning I'm not sure if you can hear me sound check? Evening Hello Okay, so good morning everyone already so I guess I'm live in Facebook like on your page. So, by the way, I guess I would like to introduce myself before starting everything right here and what we're going to discuss today is about blood gases and I will talk about a little bit about, you know the foundation about learning what is really a big, okay by learning some of the anatomy and physiology a little bit of anatomy and physiology concepts about you know, before you understand what really ABGs Okay, so, oh, I postprocessing is also here. Let me shout out a little bit. Okay for at least a moment. Miss Arlene. Good morning. She's from Jamaica. Burger joy. Of course, Ms Melanes and I would like to greet everyone here in Connetics, this my first time here and I'm really happy about it. Yeah, and then of course, we have some Connetics, scholars and our program and I'm really, you know, I really appreciate you guys. Okay. And this is not a shout out only for the Connetics people. This is shout out for everybody who's in this journey towards passing the NCLEX I know you guys you can make it. This my first wisdom, you know, to you guys that I know everyone can make it if others was, you know, were able to make it. I do not believe that you cannot make it definitely you can make it as long as you plan well, as long as you organize your, your task. Well, I know you're working, most of you are working. But at the end of the day, you know, we aim for the best, which is to pass the NCLEX which is to succeed as nurses. And I would like to tell you something, it's not this is just not just about you know, passing the NCLEX This is about you guys being successful in life as a nurse Okay, being a good nurse practicing in the US here in the US in Australia or in Canada. Wherever it's applicable. You know, those are the three countries I guess.

We're in places applicable by the way. Miss Morrison, good morning. Oh, okay. Yeah. You probably from our iPad, iPad or Online Academy student. And of course he miss Monica. He's also there. Okay, so Well, by the way, my name is for those who don't know me. I'm Jay Badung. I've been a nurse for like, probably like 19 years. Yeah. 19 years. I've been in the education and it's like half and half, but I guess mostly like education. So I'm from Davao in my graduate of St. Pembroke College. One of the best schools actually. Well, not only in Mindanao, though, but I was also a clinical instructor there for quite a time like six years and I was a an ICU nurse before and then I went to Saudi for about four years. I was an educator there you know, in the hospital. It's also a joint commission hospital and then you came to the came back to the Philippines and then became a reviewer in IPASS. We started the review program in IPASS. And then we stopped for a little you know, little time I came here in the US and then here I go. So still doing the education, half and half again. You know doing the bedside, I work weekends. for like three days in a week, and I'm working in a medical surgical telemetry floor, and at the same time, on my off days, I do the, you know, the task in IPASS, like, which is to basically teach right? On our program. But anyway, so I've been like doing this for quite a time already.

So but I'm not getting older. Yeah, I'm getting older, technically, but sharing of knowledge doesn't really get old. That's what I'm saying here. Okay, and it needs to be shared, if you have something, you know, if you have something in your, your capability, if you have some potentials in education, then, you know, come join us. Because knowledge is, you know, it's absolute, it's not gonna get old, okay? And we need to help people back in the Philippines or back in the Middle East to come here. And join us in, like I said, this is not limited for just one person. This is for everybody success. You know, what I'm telling my students back, you know, in iPads, I'm always telling them, not only in IPOs, but, you know, people are really like, into learning, right, and you're reaching one to reach their dreams. You know, success is contagious. So it's not only for one person, it's not limited for him or her, it's for everybody. If I was able to make it here, you know, you will be able to make it as well. It's just a matter of time. All right. Do not worry about you know, anything. Instead you pray about everything. That's my another words of wisdom to you guys. It's a very good verse. Okay, let me start with the prayer. I can also see the you know, the comments here, the comment section from the Facebook live so I can see your questions as well. Can I start with a prayer? Is that okay? Is that okay to start into a prayer? I was introducing myself, by the way, but well, so I guess we can start to pray a little prayer.

Okay. So, Lloyd, thank you for everything that they've given us. Always, thank you for thank you for everything. For the opportunities. Thank you for the blessings every day, not only for us, but at the same time to our families and our friends back in the hospital, to our workmates regard, thank you for everything, thank you for the knowledge and the wisdom and we pray that we'll be able to make this journey or Lord, passing the NCLEX. And ultimately, to be able to, to be a good nurse here in the US, Australia or Canada or good, all for your glory or, Lord, what we're doing here is all for your glory, because you're so good to ask God, God, and Please guide us, please guide me on this lecture. At the same time, please guide these people to understand what is being discussed here. And thank you, Lord for everything. In Jesus name we pray, Amen. All right. See, Mr. Mark is also watching. All right, so Connetics nurse. With Pamela. Good morning from Yeah, from Kenya. Good morning was Pamela okay, I guess you can see my screen. Like I said, my discussion today? Am I gonna discuss this for like, an hour? Are you giving me one hour? Melanes? I'm not sure. So I guess an hour we'll do. So this is blood guts. This is common topic in NCLEX. Right, a very common topic in NCLEX in a very common concerns, you know, in the hospital, right, a very common thing in the hospital, there is still some nurses, you know, back in their work, like, I don't know, ABG much.

So they know, some ABG but they will, you know, they're kind of confused. If this is the answer if this is the analysis or the interpretation or not? The it's kind that you know, they're not really sure. So, I would like you to like, you know, I would like you to remember that, you know, reading EB ABGs like, it has to be like simple, right? It has to be like simple, but we still we're still having some problems to it. So, I would like to resolve as much as I can, I would like to resolve those kinds of issues, reconcile this knowledge and be able to practice well, in terms of breathing you know, or interpreting a BDS because at anytime you will encounter a BDS if your patient will have respiratory distress, expectedly The doctor will order you know, APD sometimes it's a nurse driven when I say nurse driven, it's your pre rock, I mean, it's your prerogative to okay or anticipate at least anticipate that the doctor will order a BD. So I can, I can call the, you know, practically speaking, what we do here is that called the RFP and this patient really needs ABG and later on, you know, just call the just call for order because expectedly 100%. The doctor will order an ABG for that particular patient.

So what about if you don't read if you don't know how to read ABG that's going to be a problem. Right. So, practically that's what we're doing. Right. But of course, that gas is drawing blood gases is definitely coming from the physician's order. But anyway, going back to the NCLEX, it's also a common question in NCLEX, talking about ABG, and there's also branches of knowledge related to ABG. Alright, there's also a lot of, you know, this is talking about gas exchange. So it's quite important. Okay, even if you don't encounter specifically asking you about, what is this reading? What is this? What What's the interpretation of this blank gas? Alright, they might also throw your questions related to gas exchange. So I would like you to, I would like to discuss a bit of the foundation about blood gas, this is talking about buffer system in our body. Okay. So hold on, let me just use my cursor to advance it. So like I said, I'm going to talk about a little bit of foundation, right? In order for you to understand what is really blood gas, arterial blood gas, okay, I'm gonna draw something like this on. Oops, it's not writing. Okay? Can you see my screen? Right? These are your words, these are your forgive about my drawing. But you know what I'm trying to draw here. This is your blood vessels, guys. All right, your blood vessels is made up of endothelial cells, the lining of your blood vessels, okay? But what we're up to here are your RBCs. Okay, these are your RBC skies, right? RBC is red blood cells. It looks healthy, though, you know, talking about my drawing, or I mean, normal. Okay, it's not cycling, you know what I mean? Like, yeah, these are your RBCs. What is in your RBCs? By the way? What is in your RBCs? Let me ask a question, guys. It's a very simple question.

And, please, mind also your anatomy and physiology, because that will also serve as your foundation in understanding business conditions, right? In every business conditions, you have to understand, at least, you know, not at least But primarily, you're here your anatomy and physiology. Guys, come on, I would like you to participate, because later on, I'm gonna give example to your blood gases. And then you'll be the one to answer it. Okay, live, or you can actually type it in. Is it possible man to, you know, to call someone and then, you know, recite, to unmute themselves, and then be able to answer what's my, you know, what's my question for them to participate? At least? Is it possible? I'm not sure. But well, what's in your RBCs? By the way, let me know, let me get your answers, guys. Well, what's in your RBCs? Come on? This is talking about gas exchange, by the way. I cannot see your answers here. Come on, come on, let's have a look at least interactive red blood cells. What's in your red blood cells? What can you see in your red blood cells? Come on? Let's dig in a little bit. You know, cellularly, oxygen, very good. We have your oxygen here, where your oxygen is writing to your hemoglobin, right? Your hemoglobin is found in your RBCs. In your hemoglobin, there you go.

There are absolutely four. But in every molecule of your hemoglobin, there are four pockets of your of your oxygen. When you say like pockets, they can insert, you know they can go in there, right? They can get in, you know, to the pockets of oxygen. So basically it contains oxygen. Right? It contains oxygen. Now I'm going to ask you something, what's the byproduct of your oxygen? What's the byproduct of your oxygen, oxygen and hemoglobin? So oxygen is found in the pockets of your hemoglobin by the way, hemoglobin is him and your globin. These are globin chains right there in your hemoglobin. You can also find your iron there, but I'm not going to dig in, you know, some more. But again, like I said, it contains oxygen, what's the byproduct of your oxygen in the context of this lecture? My question is, what's the byproduct of your oxygen? Come on, guys? Come on guy. So what's your Bible? What's the byproduct of oxygen command? What's the answer? They're not the might not going to ask you about, you know, what's the byproduct of oxygen in NCLEX. But you have to know this very good. Mr. Eiland said it's carbon dioxide. So let's begin it with your carbon dioxide. Your carbon dioxide is a byproduct of your oxygen metabolism.

All right. Again, your carbon dioxide is a byproduct of your oxygen metabolism. So your carbon dioxide can also be located in your RBCs. Okay? It can also be located in your RBCs. Alright, so as a byproduct of your oxygen metabolism, we only inhale about less than 1% of your carbon dioxide. So there is no way it's not coming from the environment, a little bit of carbon dioxide from the environment. You know, a partial pressure point three to be exact. But anyway, so it's more produced in your body. Right? It's more produced in your body. Alright, so carbon dioxide. I'll have a question. What is more compatible with water? Is it your carbon dioxide or your oxygen? Come on guys? What is more compatible with water? Is it your carbon dioxide or your oxygen? Okay, come on. Come on, come on. What's more compatible to your car or to your water? Is it carbon dioxide or your oxygen? What goes with your water? Well, either carbon dioxide or your oxygen. Carbon dioxide is more compatible with your water. Okay, it's more compatible with your water. Alright, so carbon dioxide plus water. Well guys by virtue of neutrality as well, what goes with the positive and negative ions? So virtue of neutrality, positive and negative? Absolutely, your carbon dioxide is positive and your water is negative. Okay, so they can actually go together based on this principle. So carbon dioxide and water if you mix them together, what's the result?

Okay. You know, and plus, it's not going to ask you what's the formula or what's the chemical equation alright, but like I said, this is a very good foundation in terms of gas exchange in terms of like, you know, blood gases, okay, I'm gonna write an arrow like this towards that equation. If you're going to make sure carbon dioxide and your water it's what we call as your h2 co three look at this, your h2 co three h2, and then how many C one C and then how many O's, three O's, there are two O's here and one over here. It's what we call as your h two C O three and we call them a short carbonic acid. In other words, if you mix your carbon dioxide to water, which is very abundant in your body, it will mix up with your again with your water it will become like you know carbonic acid, okay, carbonic acid, when you dissociate carbonic acid as well towards this equation, okay, look at the arrow, the arrow towards that equation is kind of half of an arrow right? If you look at the drawing, because the equation goes towards the right, right on my right sorry, okay, your HDL C oh three when you also dissociated when you also split it out, it will form hydrogen ion which is a positive ion and your bicarbonate as well. HC o three, look up the equation. One H How many h two h sorry, there's one here there's also one here, community's only one Z, how many O's three O's, so hydrogen ions and bicarbonate.

Bicarbonate is also a negative one, like I told you virtue of neutrality, they can go together positive and negative hydrogen ions and bicarbonate when you dissociate or carbonic acid. Carbonic acid by the way, is a weak kind of acid. Okay, it's a weak kind of acid alright. So hydrogen ions and bicarbonate when you dissociate your bicara your carbonic acid, alright, look at this equation here. co2 plus water is carbonic acid, when you split it out, it will form hydrogen ions and bicarbonate. This is a basic equation in your buffer system, okay. Now when you mix your bicarbonate and your hydrogen ion as well towards this arrow, what will it yield it will yield or it will form carbonic acid as well, the same way right? And this one, your bicarbonate is one when you dissociate it towards this equation towards the left towards my left. Okay? It will also yield your carbon dioxide and your water. So it's like vice versa, right? It's like vice versa. Remember this hydrogen ions. Hydrogen ion is a very powerful acidifying agent is a very powerful acidifying chemical. That's why it's called like PH. letter P stands for what? Power? Power of hydrogen? That's why it's called PH. What did I say? It's a powerful acidifying agent or is a simplifying chemical that hydrogen ions, all right. Say for example, your carbonic acid can contribute as long as the formula as long as the chemical contains letter H on it, it will contribute. It will donate its hydrogen ions to form to, you know, to cause acidity in your blood, right it will donate, you know hydrogen ions. So it's a very powerful acidifying again acidifying.

Agent or chemical. Alright, that's your hydrogen ions. You have to have a good kidney, sir. You have to have a good kidneys in order for you to buffer. In order for you to buffer hydrogen ions. It takes a lot of chemicals of your bicarbonate to neutralize your hydrogen ions. Like I said, it's a very powerful acidifying chemical. Right? You have to have a good kidneys. What did they tell you? Keep Nice. Alright, kidneys. So I'm going to emphasize on this one. So this equation is talking about towards the right is talking about your kidneys. And there you go. is talking about kidneys. On the other equation towards my left your carbon dioxide, carbon dioxide, when again when it's mixed up with water, it will become carbonic acid. Okay. So it's a very, it's a it's a weak acid though. But once it's mixed with water, you know, it becomes carbonic acid and will contribute to, you know, to the acidity. Where can you find this carbon dioxide? Where do you eliminate this, which particular system in your body we're in you can eliminate your carbon dioxide. Alright, where do you eliminate this in your respiratory system right in your respiratory system. So we have the kidneys and we also have the respiratory system. All right. These are the buffering systems that we have in your body. Let's just say your kidneys, what's the work of your kidneys excreting primarily excreting the metabolic waste products. So let's just say here metabolic. Alright. So any problems to your either metabolic acidosis or alkalosis? That's related to your kidneys that's related to your bicarbonate? Did you understand are you understanding so far?

Okay, any problems to your bicarbonate levels, is talking about your kidneys, okay, primarily your kidneys. That's metabolic that's the metabolic part there because again, like I said, your kidneys are responsible for excreting the metabolic products in your body. All right. And by the way, for your information as well all metabolic products, like I said earlier, are forms of acids, they can form acids, they can contribute to the acidity, they can contribute hydrogen ions to make your blood acidic. Alright, so on the on the other side, the respiratory system, talking about your co2 levels, it's just simply talking about your respiratory system. It's simply talking about you know, your ability to eliminate your carbon dioxide. You want it to eliminate your carbon dioxide because once it's accumulated in your system, it will mix up with your water which is very abundant in your body. Again, it will form carbonic acid, it will also form hydrogen ions, you know what I mean? So there is no way that our body will become acidic. Our body is not designed to be acidic. Okay, what I'm trying to say is that if you have problems related to acidity of your blood irregardless if it's you know, respiratory and metabolic acidosis it's gonna be a problem. Because like I said, our body is designed to you know, not to our body is designed not to become acidic. Alright? Are you understanding me here so alkaline is okay, alkaline is really okay.

But there should be a designed you know, PH, alright, so respiratory here and this is kidneys, he's talking about compensation. If your kidneys are not able to conserve bicarbonate, what they expect Okay, your respiratory system will compensate, alright the respiratory system will compensate if your blood is very acidic, okay, your respiratory system will also you know compensate what will happen it will eliminate more of your carbon dioxide, okay, because carbon dioxide again, mixed your water it will become carbonic acid. It's a you know, it's a compensatory mechanism. If you are not able to conserve bicarbonate, so the same thing, alright, the respiratory system again, we'll  be able to eliminate more of your carbon dioxide. Okay. So to neutralize your PH. Now let's, let's draw this and let's draw this form meal again. Okay, so this formula again. So again, we started from your oxygen, we ended up not ended up but we discussed about carbon dioxide, respiratory system. And we also discuss about bicarbonate talking about your kidneys that your metabolic part in your ABG.

Okay, this equation is absolutely enhance or capitalized through an enzyme, which is your carbonic anhydrase. But I'm not going to discuss about that anymore. You know, how is it done? Right? So let me draw it again. And then so I can discuss to you the normal values, it's very important for you to memorize the normal values, if you don't memorize normal values and then your gun. Okay? co2, this is what respiratory, alright, plus water, okay? yields the word towards the arrow, H two, C O three. Okay, that's basically your carbonic acid. Right? And towards this arrow again, when you split it out, it will form hydrogen ions plus your bicarbonate. h2 co three. Alright, your HTC oh three is basically metabolic, right? You're talking about metabolic or kidneys. So respiratory. Let's start it off with your PH. Okay, this is your hydrogen. I'm gonna make it white. I guess I'm going to make it up. Sorry. Is the white one here? Just yellow, I guess. Okay, yellow. Sorry. So this is metabolic. All right. So I'm gonna write the values now. Hmm, normal values. Sorry. Okay, so HH talking about PH? What's the normal PH? What's the normal PH? What's the normal pH? Come on? Come on, guys. You can answer at any time you can answer or you can ask questions. And then so I can read it from your comment section. So pH, what's the normal pH nearby? Whatever they told you earlier? There should be a design there should be a normal PH. Right? So what's the normal pH? By the way? Come on, it cannot move on without you answering. Come on. 7.3 to five to seven point 45. Good answer. Good answer. Guys. For me, that's wrong. Okay. Trust me. Some of you guys here that are my students. They know that it's not the correct answer on the context of this lecture. I would like to say the mean.

Okay, you're gonna trust me? Why am I telling only 7.4 P? All right. Okay. So the very first step, absolutely. The debtor mean, I mean, to do to interpret your ABD is to know, the pH better mean, the pH? Please tell me the mean. Okay. When you say mean? The mean is 7.4? The, the range is seven point, you're correct. You're technically correct. But like I said, in your approach in understanding ABG, the very first step is to determine the pH, which is I'm talking about the mean, I'm not talking about the range, you will only talk about the range later on, you know, when you when you're looking for compensation. That's the next steps. Right? The very first step is to determine the PH. And what I'm telling you is that, please tell me the mean. Okay, which is 7.4. All right, 7.4. I'm just gonna write here, the range is seven point 35 to 7.4. Define. The very first step is to determine the pH, which is 7.4. That's the mean. All right, you will only refer to the range if you're looking for compensation. Okay, so that's the normal, we're talking about the normal values here. So pH is 7.4, D, and the range is 7.4 35. To seven point 45. What about your respiratory, the normal rest? You're in the normal co2 level? Or PCO? Do the normal PC oh two s? Seven. I mean, 35 to 45.

Okay, 35 to 45 Forget about the unit. It's not that important. Okay. 35 To 45 Okay, so if it's less than 35, that means alkalosis. Right? That means alkalosis. If it's more than 45, that means acidosis. Remember, if you have more co2 level, it will mix to your water to become carbonic acid. Okay? Carbonic acid can become hydrogen ion as well. So which means if it's more than 45, it can cause acidosis. If you have less than 35 of your co2 up co2, specifically because you're talking about pressure, partial pressure, where that's alkalosis. Alright, that's respiratory alkalosis. If it's more than 45, again, that's respiratory acidosis. Okay, let's look at the other value. The normal bicarbonate, this is traditional marathon bet, bicarbonate, the kidney side, the metabolic side. All right. The normal bicarbonate is h2. I mean, HC o three, the normal bicarbonate is 22 to 26. Okay. 20 to 26. Very good Miss Marissa, like 22 to 26. All right, that's the normal. If you have less than 22 that is your acidosis There you go. That's your acidosis Can you can you see my screen up? Sorry.

My screen is kind of excited. It's, it's in a hurry. But anyway, so normal bicarbonate level, or HC o through is? Three years 22 to 26? If it's less than 22, which means what did they tell you? Bicarbonate is a buffering, kind of chemical buffering your hydrogen ion, it will actually serve as like a sponge. If you have some dirt in your plate, you know, the action of you're here bicarbonate is to buff it out. You know is to you know, a sponge, you know, a sponge, and detergents. Am I telling the right word. So as far as you know what a sponge is, if you have some dirt there, and then you put it there, you put the sponge there, and it's gonna absorb the dirt. Alright, anyway, so that's your, that's your bicarbonate. That's the word that's the function of your bicarbonate to buffer out your excessive amounts of your hydrogen ions. So which means if you have less of your bicarbonate ions, bicarbonate substance, what's going to happen, you will have acidosis in your blood, because you cannot you're not able to buff out you know, your hydrogen ions, okay? And which also means if it's more than 26 It's alkalosis. Too much conservation of your bicarbonate. That's where it's not also good. You know, life is all about balance. It's all about Tommy stasis. That's the very first thing that you learn in your anatomy and physiology. If you if you're serious about it, if you're serious about it, and I guess, you know, what's really, you know, what's the first thing that we learned in back in anatomy and physiology? Right? So if it's more than 26 homeostasis, it has to be balanced, right? It has to be balanced. If it's more than 26. It's not good also to conserve more by carbon because again, it will cause alkalosis more than 26 is alkalosis. Okay, more than 26 is alkalosis. Going back here, normal PC oh two is 35 to 45. Less than 35 is alkalosis.

More than 45 is acidosis. What did they tell you? Because it will mix up to your abundant water in your body. Of course it's present in your plasma to become carbonic acid. We don't want it again more than 45 is acidosis. Okay, on your metabolic side, what's the normal bicarbonate 22 to 26. If you don't have if you don't conserve bicarbonate, it will cause acidosis hydrogen is just way too powerful than your bicarbonate. Now if you produce more concerned more of your bicarbonate, I'm talking about your kidneys guys. That's one of the functions of your kidneys is going to be absorbed back your you know, your bicarbonate, conserving bicarbonate causes you to have alkalosis Are you understanding so far? Are you understanding so far? Are we good? So these are the normal values that we're talking about here? Forget about oxygen first. It's very easy. 80 to 100. All right. If you have 70 to 80, that's my hypoxemia. If you have like less than 60, that's severe hypoxemia. It's very understandable. But what about this new parameters in order for you to interpret your ABG? The normal pH is what the normal pH is 7.4 the right 7.40 normal PCO two is 35. The four define the normal bicarbonate is 22 to 26. Now, let's do the math. Let's do the interpretation guys. Again, these are the normal ones. Use if you don't understand. I mean, yeah, if you don't memorize these values and you're gonna have a problem, there is no solution always to the problem if you don't have the if you don't know the concepts if you don't know the foundation if you don't know the normal, you know, thing happening. Okay, let me move on. All right. So are we good? Can we move on? Let's go to the steps on the data you hold on. Let me just charge my laptop. I guess it's kind of loose.

Just an intermission. So shout out for those people are listening here. Right now. Good evening in the Philippines. I know it's what time is in the Philippines? 736 736. Here, Nana, it's 836. Sorry. Here in Texas. By the way, I'm here in Texas. Did I mention it earlier, I'm here in Texas, I'm working as a medical surgical, those who just came late May in this game. I'm working in a medical surgical telemetry. So it's a very active floor, or a and you can see all the types of patients. Okay, all the types of patient, I'm telling you guys in your NCLEX you always encounter like medical surgical, I would say, like 80% of your NCLEX questions are medical surgical. So you really have to dig in as much as you can. It's not just okay, I'm just gonna review because I had it in your NCLEX like in your national licensure examination, it's quite different when you talk about NCLEX. Okay, we cannot just simply say like, okay, to your patient. In practice, you cannot just simply say that, okay, I can I'll give you the medication and that this is for your own good. This is for, you know, this is for your betterment. You know what I mean? It's not that you will have to at least explain to them, what's the classification? What, how does it work, I'm giving you a blood thinner. The name of the drug is War frame, for example, you don't need to explain the you know, the details.

What I'm trying to say here is that you have to be you have to be a good nurse in terms of education to your patient, because they know, they know what's going on, they're really going to ask you guys, so if you don't dig a little bit to your, you know, to your concepts, for example, you will not, you know, you cannot answer well to your patients, in which if I'm the patient, that's what I'm going to ask you as well, I'm going to ask you as a nurse, so passing NCLEX is if you think about it, passing NCLEX is just passing NCLEX. But it doesn't mean that you can become a good nurse in the US. If you know, you know what I'm saying? Like you have to dig in at least knowledge. That's your you know, that's your, that's your weapon when you come here, because as I would tell you, it's, we really have to aim to become a good nurse here in the US, not only in the US. Okay, wherever you are even in the Philippines, and I'm serious about it. I'm always telling my students about being you know, being a good nurse. Okay. It's not just about passing the NCLEX it's not just about passing your exams. No, there's no way you're doing this because you wanted to become at least a good nurse. You know, following the standards, okay. There is no ninja moves here. You know what I'm talking about? There's no need, there is no shortcut methods. There is no shortcut moves. Right.

Okay, let's go back to our lecture. Let's go back to our lecture. Anything. Any questions, guys? All right. So yeah, this is amazing. Yeah, Connetics is a Connetics is really amazing. I know you guys are, if not the best, you're one of the best. Direct hires. As far as I know. Like I said, it's my first time here, but I heard about you. In fact, I can, probably next month, I may join some of the conventions that were the Connetics is also present. If I'm not mistaken. It's like a nurse, a big nurse convention in Galveston. I hope I can be there. Anyway, so let's go back to our lecture have so many like, you know, extra talks. First things first is determine the PH. Okay, let me go back to my read, Ben. Sorry. Okay, that's the first thing. Determine the PH. What did they tell you? 7.4, D, seven point 40. And the second thing is to look at the source of the problem, if I'm talking about problem, the word problem, it's either acidosis or alkalosis. Right? So seven point 40. If it's less than, by the way, if it's less than seven point 40. All right, that's acidosis. All right, that is acidosis. Again, I did not tell you about seven point or divide seven point 45. Right.

My reference is seven point 40. If it's less than 7.4 T, that's acidosis. Forgot to write this one on my previous slide. If it's more than point 40. Again, there is no range here. That's alkalosis All right, so the problem that I'm talking about here, it's either acidosis or alkalosis. Okay. acidosis if it's less than seven point 40 I'm gonna repeat it every now and then, because repetition is also a key. All right? Remember that? If it's more than seven point 40, that's alkalosis. Again, I'm not referring to the rage. Okay. So the next thing is the source of the problem determine the source of the problem. So where is the acidosis? Coming from? Or where is the alkalosis? Coming from? Is it the respiratory? Right? Is it respiratory? Or metabolic? Alright. So if you if you're, if your value is like acidosis, from your pH, that's the first step, right? If your value is acidosis, because it's less than 7.4, D, for example, it's seven point 39. Okay, the permanent source of the problem? Is it respiratory or metabolic? Is it is it the co2, which is acidotic? Or is it the bicarbonate? Which is acid? Sidoti? All right? That's what I'm trying to say here. Determine the source of the problem. Where is the acidosis coming from? Is it from the co2, which is representing your respiratory system? Or is it your bicarbonate, which is representing your metabolic which is representing your kidneys? Or representing your metabolic you know, function? Okay. So it's either a respiratory or metabolic. Okay. And compensation? Well, guys, ABG is all about buffer system. If there is compensation question mark, if there is compensation, or no compensation at all? Is it if there is compensation? Sorry, if there is compensation, it's either full or partial.

Okay, full or partial? What did they tell you earlier? This time? You think about the range, the pH range? If you're, if you're questioning, oh, there's a compensation. There's a compensation if you're questioning, oh, there is a compensation. Is it fully or partially? Now you think about the range, you will figure out once I do my example, while compensation means buffer. All right, if your problem in the first place is acidosis. And the origin of the problems of source of the problem is the respiratory or the co2. So you're expecting that your kidneys are conserving more bicarbonate, This buffer system in order to neutralize, in order to neutralize, neutralize the acidity, you're expecting that your pH Oh, okay, you will refer it to your pH as well. Because you're trying to think of the Okay, this is compensating This is buffering the acidity of my blood, it means to say it's working, you know, it's, it's neutralizing, if you have an acidic kind of substance, you have to have an alkaline substance to neutralize the acidity. All right, so you still have to refer to your, you know, to your, the your pH, you still go back to your pH, I'm talking about the range. When you say like no compensation, when you say like no compensation and compensated if your source of the problem. I mean, if you're if your pH is acidic, let's say for example, respiratory acidosis. And then you're expecting that your kidneys are going to conserve bicarbonate. But when you look at the bicarbonate, it's not doing anything. It's just normal, you know, it has to compensate, which means it has to neutralize, it has to become alkaline, alkaline in order for it to neutralize the acidity of your blood, but it's not doing anything. Your pH is just No, I mean, your bicarbonate is just normal, right in the presence of your acidosis. Okay, let's take a look at your problem. Let's take a look at your problem here. Example. Okay, so you can figure out what's the normal pH? Let's interpret this. I know you guys heard this already back in the college days, or if you're in currently on the review program. You know this very well. Okay, but if you're from IPASS, you know my drill, if you heard my lecture, right, you know, the drill already, right?

So sub one point 32. What did I say? Let's review you know, let's review the steps, determine the pH determine the source of the problem and look for compensation. If there's compensation, it's  either partially or fully compensated. Alright, so those are the three steps three steps in interpreting your ABD Let's go directly to the example and later on once I go along, I may call you at any time. Is it possible? Is it possible to call anyone and speak? I hope it's possible when let's move on to my example. Determine the PH. This is your values here. pH, P, co2 and bicarbonate. All right? What's your pH here? Seven point 32. What do they say? Determine the PH. That's the very first step. You always look at the PH. The pH value is seven point 32. What do I say if it's less than 7.3? I mean, 40. Sorry. All right. So this is acidosis. Right? If it's more than seven point 40. That's alkalosis. Again, please forget about the range first. That's absolutely the secret here. Okay. Less than seven point 40 Which is what? What is the seven point 32? Is? Seven point 32? Is what? Come on answer. Your computer, my or your cell phone might be lagging because I cannot you know, or my cell phone is lagging. I cannot see the comments. I see the comments. But sometimes it's late. It's probably because I'm using different devices. I don't know, for some reason. Okay, very good. acidosis. What's the normal pH again? Seven point 40. Alright, so this is basically acidosis. Right? So that's acidosis. You have a problem already. We just have to determine where is the acidosis coming from? Is it respiratory? Or is it metabolic? Where is the acidosis? part here? 49 is what PC Oh, two laps later on later, you know, just think about acidosis first, determine the source of the problem. That's the second.

That's the second step. 49 is what 49 is lots of co2. Again, the normal is 35 to 45. If it's more than 45, which is 49. This is acidosis. Right? That's acidosis. Because morpc oh two again, but our principle earlier, don't mix your water, it will form carbonic acid, it will again produce more hydrogen ions which will contribute to your acidity of your blood. See, if you just know that equation, then you'll  be okay. Everything will follow. 49 is more than 45 which is acidosis. Again, it's acidosis. Bicarbonate is 24. What's the normal bicarbonate 22 to 26. So 24 is within normal range. When you say within normal range, the problem here talking about buffer system and the problem is acidosis. The kidneys must compensate, right, the kidneys must conserve more bicarbonate, because the problem is acidosis it needs to buffer it needs to neutralize the acidity of the blood. But the thing is, it's not doing anything. letter N stands for not doing anything. If you're a Filipino here, you will say that this is not to do low, it's not doing it's the In other words, it's sleeping. The word not to look in Filipino or English is not to duel. It's not doing anything rather and stands for what not doing anything. The problem is acidosis. Again, like I said it this is buffering system. It has to neutralize it has to cause it has to conserve more bicarbonate, you know, to buffer the acidosis to neutralize the acidosis. It's not doing anything. So what's the problem here? What's BCL two? This is respiratory. Alright, so acidosis, respiratory acidosis. Right. Third step, we're not done yet. We're not done yet. The third step is compensation, right? compensation. So is this compensated or without compensation? Definitely, like I said, it's not doing anything and either n stands for normal or not doing anything letter N not doing anything it means to say and compensated by virtue of your compensatory mechanism buffer system. It's not doing anything. Alright, so it's uncompensated respiratory acidosis to get that, okay, let's move on.

Let's give you another example. Or seven point 32 is what's this is acidosis what's the normal pH again? 7.4. The you go if it's less than seven point 40. That's our see though, says okay, that's acidosis. So where's the Osteoporosis coming from? Is this respiratory or metabolic? Where is that To go thick part 45 is normal. Okay. And 19 is words, look for the source of the problem. All right. 19 is acidosis. And the urine bicarbonate is represented, I mean, it's representing your kidneys or metabolic part. So this is a case of what? Metabolic acidosis. Next question. Is there a compensation? Or is there a compensation or no? How do you know if it's compensated or not? Again? If the other value is compensating or not, if the other value is neutralizing, which means if you're acidic? Is it alkaline topic? No, it's an alkyl. letter N means what? Not doing anything? Normal. Alright, so this is a case again, of your uncompensated and compensated metabolic acidosis. That's your problem here. We're not done yet. We still have a laugh here. Okay, this is a metabolic acidosis uncompensated? All right, metabolic because the problem the acidic part is your bicarbonate. And of course, the pH is acidic. All right. And there is no compensation here. Because again, your respiratory system, your co2 is not doing anything. It's just normal. Forget about your own method. Forget about your what else your as our method, respiratory opposite metabolic equal, forget about it. Alright. So for me, I don't really you know, I don't really defer to those, you know, to those strategies, but if you're comfortable with it, that's fine.

All right. But anyway, so this is metabolic acidosis uncompensated? This is my way of interpreting ABG. Guys, I'm just sharing it to you. What's the normal pH again? 7.4. D, this is actually the secret. Okay? Even if you trace the problem, you're going to be okay. 7.4 to eight is one. Don't think about the range. This is what Al Al alkalosis remember, if it's more than 7.4 It's alkalosis. Again, where is the source of the problem? Is this respiratory or metabolic? Look at the co2 43 This is what normal 29 is what this is alkalosis right? This is alkalosis so this is a case of your words. This is a case of your metabolic Alka lo says that instead, is it compensated or not? I'm just gonna write abbreviation and compensated because your co2 is not doing anything. It has to acidify. It has to acidify for it to neutralize your alkalinity right. That's basically your buffer system. So metabolic alkalosis, and compensated. Now I'm gonna ask you something. Are you understanding? Are we good? Are we good so far? Are we good so far? Are we okay? Hi, Miss Erin. I miss Mona Miss Lai, just a shout out little bit Miss Arlene. meats or lean? Who else meet at sell? Oh, we got to look good. I know how we got a good audience here. Thank you for coming. And I appreciate it. That you're here today listening to my lecture. But let's move on. Okay, let's move on. So 7.50 Let's move on. Let's Yeah, there you go. I'm putting in you know, always there 7.4 the value that's the mean? Seven point 50 as alkalosis because it's more than 7.4. That's alkalosis. Second step is determine the source of the problem. Where is the alcoholic part? Is it respiratory? Or your metabolic? For bicarbonate? Okay, 32 is watts 32 is less than 35, which is alkalosis.

Again, what did they tell you? The secret also is to memorize Sir, sir, there's a lot of secrets here. Alright, anyway, so you know, that's just easy to memorize the normal values if it's less than 35. Talking about your co2 that's alkalosis. Okay. 23 is normal. The normal range is 22 to 26. So this is a case of your word, respiratory alkalosis. Right. without compensation, right without compensation. Alright, let's move on. Let's move on to the next slide. Our goal is at the end of my you know, my presentation, you'll be able to understand, you know, what's really, how to interpret your ABG Okay, so seven point Parasuraman right here seven point 40. That's her mean seven point 37 Is what? acidic or alkaline? Acidic acidosis or alkalosis? Come on, come on. Answer this first, let's follow the steps. Okay, there is no way you have to follow the steps you always have to start in the beginning. All right? The very first step is to determine the pH seven point 37. Is one. Come on seven point 37 Is what? Very good. Ms. guymer? Is it Ms. guymer or Guimar? demore? Said acidosis. All right, some of you will tell me normal. No, don't tell me it's normal because the very first step is again, to refer 7.4 D. If it's less than 7.4 D, definitely it's acidosis low is acidosis. Seven point 40 less than 7.4 is acidosis. Okay, so 52 is so determine the source of the problem is it respiratory or metabolic? 52 is acidosis right? So it's acidosis you understand what I mean? Here Okay. acidosis more co2, which normally said 35 to 45 again will yield to I mean, we will combine to your water to form carbonic acid. Again, it will contribute to hydrogen ions, you know, production, okay. 32 is what 32 is? What is this? 32 is acidosis alkalosis? This is alkalosis. Alright, so there is some some twist here, a little challenge.

So acidosis. The problem is acidosis just look for where is the acidosis? part, which is respiratory, respiratory acidosis. What did they tell you? The next step is to look for compensation. Now, how do you know if it's compensated or not? The other value is trying to buffer is compensating the problem is acidosis. Its neutralizing, which means it's trying to neutralize by becoming one alkalosis. It's all about balance. Life is all about balance. It's homeostasis. Right? So the problem is acidosis it's attempting to neutralize look at the value of your bicarbonate. It's alkalosis. So a question is compensated or not? Yes. With compensation. Alright, with compensation. The next question is if it's compensated? How do you know if it's fully or partially? That's the next question, guys. How do you know if it's fully or partially? This time? Go back to the range? Seven point 35 to seven point 45. Is it within the normal range? Yes. Yes, sir. within normal range, okay. If it's within the normal range, again, if it's within the normal range, that's full compensation. Okay, that is full compensation. Now, if I'm going to change this one a little bit, for example, like 31.

That's still acidosis, then look for the, you know, determine the source of the problem. Which is the same thing, which is respiratory the same problem, respiratory acidosis. Is their compensation. Yes, I've been changed the problem except for the PH. It's compensating because it became alkaline. Alright, the other value your bicarbonate. So with compensation mean respiratory acidosis. With compensation. The question is, is it fully or partially remember a change this. If it's not within the normal range, again, this time you defer to your reference to your range? If it's not within the normal range, it's partially compensated. Now, if it's within the normal range again. Okay, that's respiratory acidosis with full compensation. Now you're understanding what I mean here. All right, so let's move on to the next problem. So can I call somebody can I call someone? I guess you're getting the problem here. Seven point helped me out. Help me out in detail. You know, you're answering the problem. Okay, seven point predatory swab. What's the normal pH 7.4. D, this is what? This is acidosis right. So where is the acidosis part here? 52 is also acidosis. Right? 32 as alkalosis All right, acidosis alkalosis. We add them together. That's also one you know, easy strategy. Look for the acidosis This is what co2 is represented bursts mean representing respiratory and this is metabolic. So this is respiratory acid. doses All right.

Third thing is that you look for compensation, you look for compensation. All right, look for compensation. So is it compensated or not? Yes. Because the other value is trying to colonize. Right? So because the problem is acidosis or with compensation, alright, compensation. Question, is it fully or partially fully or partially? Okay, fully or partially? This time you go back to the range? Is it within the normal range? No, it's not within the normal range. So this is just a case of you're partially compensated. Okay. The bicarbonate, the bicarbonate was able to compensate however, it's not enough to normalize your pH within normal range. It's not enough. All right, I was trying to like compensate. I was trying to buffer a relationship. But what happened? It's not enough. All right. So that's a case of your partially compensated respiratory acidosis. Though it's compensated though, give a credit because it's compensated however, it did not became to the point that you were together, that's something else. Anyway. So it's not enough to normalize your PH. Okay. It's not within the normal range. So it's a case of you're partially compensated respiratory acidosis. Now you're understanding what I am discussing here. Are we good? Okay, let's move on to the other question. Let me ask someone Okay, let me ask I cannot really see the you know, every one I can only see the one that are active here that are commenting to the comment section. So I would ask Miss Lie. Is it okay to ask you? So I'm gonna ask you first what is the pH here? Is it okay? Yes, sir. Is Miss Jade? Is it okay for you to answer this? Miss Jade, is it okay. Can I ask you to do to answer this next problem? All right. Yes, sir.

Okay. Yes, sir. All right. Okay, I asked. Miss lie is Mina is actually answering the question here. So I guess I'll go with Miss lie. So seven point 32 Is what 7.2? Again, I'm gonna write here 7.4 To see your mean, you know, PH. So someone pointed to is what? Whoever, misled or Miss J? Come on. Come on, you guys. So seven pointer to this one? Come on. acidosis. Very good. acidosis. Very good. acidosis. Where is the source of the problem? Where is the source of the problem? Is it respiratory or metabolic? Where is the source of the problem is the respiratory or metabolic 31 is what 31 is? alkalosis. Right. 31 is alkalosis. Because it's less than 35. Again, you have to memorize the normal values, guys. 17 is what 717 is acidosis. So what's the problem? Now, as in, say, you start to pair them together. Bicarbonate is what metabolic? metabolic acidosis. The next step would be what if there is a compensation? What's the problem here? What's the problem is like, what's the problem? So, okay, Miss Eileen said metabolic acidosis. Very good metabolic acidosis. Now, I'm gonna ask you compensated or uncompensated, is this a compliance is a compensated problem or not? Yes or no? compensated or uncompensated, come on, compensated or uncompensated, compensated or on the wire? Everybody's answering uncompensated. What do you mean, when you say like uncompensated? I mean, compensator. And compensated when you say compensated, which means it's trying to neutralize the problem is acidosis. And the respiratory disease, the co2 is trying to neutralize, which means the value is opposite, right? It's compensated very good, it's compensated.

Alright, it is compensated. The question is, is it fully or partially compensated? fully or partially compensated? fully or partially? fully or partially? Okay, Mr. Owen said partially compensated, how do you know if it's partially compensated? Go back to the range seven point 35 to seven point 45. It's not within the normal range. So this is a case of your metabolic acidosis compensated. It's only partially compensated, partially compensated metabolic. However, you know, however you say partially compensated metabolic acidosis. It's only partially compensated because when I look at the range, though it's compensated. It's not within the normal range. Okay. So let's move on let's move on. It's partially compensated metabolic acidosis. Seven point 49 is one, come on. I'll just give you a just get everybody to answer this, this. Just type it in on your comment section and I appreciate it. Okay. So seven point 49 Is what? Seven point 49 Is. Seven point 49 Is, come on. alkalosis. Very good. alkalosis. So determine the source of the problem. Is it respiratory or metabolic? co2 is 23. What's this? 23 is 23 is alkalosis. Right? Is alkalosis. Alright, 17 is acidosis. So where is the occultic? Part? From the start? We determine its alkalosis. Where's the economic part? Is it co2 or your metabolic co2? So this is a case of your respiratory, respiratory alkalosis. Alright, respiratory alkalosis. Next question. Next step. Is it compensated or not? Is it compensated or not? Yes, with compensation, again, your problem is alkalosis. And it's trying to neutralize by acidifying. So it's compensated? All right? The problem is it's is it fully or partially compensated? fully or partially? fully or partially? Again, it's attempting to buffer because it's acidic, you know, trying to buffer your alkalosis.

Okay, compensated. And you're trying to question Is it partially or fully compensated, go back to the range, go back to the range? The range, I mean, the pH S. I mean, go go back to the pH, the pH is not within the normal range. So it's only partial compensation. Alright, it's only partial compensation, respiratory acidosis. mislay said, respiratory alkalosis partially compensated Very good. This is not a case of your fully calm full compensation, because when you go back to the pH, it's not within the normal range. However, it's attempting to you know, it's buffering. Okay. So I wouldn't have I would say that it's an advantage for you to start my, you know, my lecture since I started, you know, an hour ago, I guess, an hour ago, for you to understand it better. If you came in between, I guess you're gonna have a little problem. But as we go along, I guess I still have some, some slides here. Seven point 38. What do I tell you? Seven point 40. Refer to the mean. That's the very first step. This is what alkalosis acidosis alkalosis acidosis All right. So this is what alkalosis acidosis it's less than seven point 40 Right, this is acidosis All right. So determine the source of the problem 49 Is acidosis which is respiratory All right, this is also acidosis 29 is alkalosis 29 is alkalosis. Alright, so this is acidosis. respiratory acidosis. Is it compensated or not? Okay, type in is it compensated or not? compensated or uncompensated? Come on. compensated, alright, compensated. All right, compensated. What do you mean by compensated? What does it mean? You know, how do you know if it's compensated because the other the problem is acidosis. It's, you know, it's neutralizing it's attempting to buffer which means it's trying to colonize, right? So compensation a question is, is it fully or partially? Is it fully or partially? Miss maricon?

Can I ask you something or Yeah, of course Miss Mariko. fully compensated. Miss Christina said it's fully compensated and how did you know if it's fully compensated? Alright? It's trying to buffer. When I look up the range. To me the pH, it's within normal range. It's a case of you're fully compensated, and they are back together, because the guy or the girl is attempting to, you know, to neutralize. And when you look at the pH range, it's within normal range. So it means Okay, we're back together. That's it. Okay, all right. So just to give it a little, you know, spice, respiratory acidosis compensated and it's fully compensated. It's buffering at the same time, the pH is within normal range. Okay? All right. So let's move on. So seven point 18 is definitely it's an acidosis. All right? Recioto is 38, which is what's this? 38 is normal. 16 is acidosis. This is very easy, guys. All right. What's, what's this problem? So this is a case of your metabolic acidosis. All right? Acid, that's metabolic acidosis. Is this a case of compensated or no? Is this compensated or No? Or not? metabolic acidosis. Is it compensated or not? Alright, so this is a case of an compensated, alright, and compensated, look at your look at the other value. It's not doing anything. Like I said, N stands for normal, it means it doesn't mean that you're normal. You're doing you know, you're doing or you're buffering. You're not. Okay, it's not doing anything.

All right. So metabolic acidosis, uncompensated, metabolic acidosis. And compensate that there's no such thing as partial or fully uncompensated. There's no such thing as that. So seven point 35 Is what There you go, which is what this is alkalosis right. The range I mean, the the PHS seven point 4032 Is alkalosis. Alka, Alka, and this is acidosis. Alright, so this is a case of your respiratory rate, respiratory alkalosis. Question is, is it compensated or not? Is it compensated or not? Yes, it's compensated with compensation. Look at the bicarbonate is acidifying is neutralizing, right? By looking at the range? Is it fully or partially? Go back to the pH? Is it within the normal range or not? Yes, it is within the normal range. So that means it's fully compensated, right? Because it's within the pH is within normal range. It's compensating. And when you go back to the pH, considering the range, it's within the normal range, so it's fully compensated respiratory alkalosis. Okay, that's number 11. We're almost done, guys. We're almost done. Okay, fully compensated. Miss Eileen said like, fully, I really appreciate it. Mr. Lin, you're so active here. You're going to be the next US RN. Alright. Guys, think about yourself. You know what, there's always like an intended license number for you guys. Okay, let's claim it. There is a destined, you know, the steamed license number for you. It's just a matter of time. Okay, what did I say? It's just a matter of time, for example, like MS or lean us RN license number 93456. Well, let's claim it. God is so good. He's gonna give it to you. All right. And I can really like you know, testify about it. God is really good, not only to me, but all good to us. I'm telling you, it's just a matter of time. And what did they say earlier? Please don't worry about you know, anything today. Instead, pray about everything. Okay, that's the power of your prayers. That's the power of connecting to God in terms of like, you know, getting through what you're struggling for. Okay. Well, let's move on to number 12. Okay, number 12. Seven point 54 Is alkalosis.

Okay, 23 as watts, this is alkalosis as well. All right, that's alkalosis that's less than 35. Again, like what did they tell you memorize the normal range, I mean, the normal values right 24 is what this is normal, which means you know 20 to 26, which means this is not compensating alright. So, this is a case of your is it respiratory or metabolic? This is a case of your respiratory alkalosis. without compensation, right, without compensation, respiratory alkalosis without compensation. What do you mean by when you say like without compensation, because the bicarb or the other value is not really doing something? letter N. Normal not doing something. All right. And let's move on. I guess you're getting my discussion here. That's our goal. Seven point 39 Is again 7.4. The basic From that point forward, this is a siderosis. 51 is also acidosis. Alright, if I can, like, you know, let you let you recite, and then I that's, that's gonna be a good you know, but I guess it's gonna be a problem because the moderator will unmute you and then you know that you recite is my first time also to use stream yard. This is truth 3,000,029 As soon as this alkalosis alright alkalosis So the problem here is respiratory or metabolic, this is a case of your respiratory acid acidosis with full compensation, Miss Jeanne said or Jenny, Jenny said like respiratory acidosis with full compensation, yes, very good with full compensation, you go it's compensated. And when you go back to the range is compensated because it becomes I mean, the bicarbonate is alkaline and when you go back to the pH, it's within the normal range. So it's respiratory acidosis with full compensation, we're almost done. Seven point 35 Is words acidosis.

Right. 43 is what 43 is 43 S? What is this? Normal 23 Swat, this is normal. Okay, this is a case of your normal ABG. Okay, is a normal ABD it's actually a trick for you guys to answer. But anyway, I'm just you know, I'm just trying to ask you. In the first step, you always have to remember that you refer to 7.4. The mean, instead of the rich, you know what I mean here, so seven point 35 acid, if you're going to refer to my you know, my style 43 is normal. 23 is normal. So well, this is a normal ABG. Again, like I said, What I'm just trying to do to solicit here is for you to remember, the very first step is to refer to the mean, not the range. Okay? Because you can only like rely to your range when you're talking about compensation. Is it fully or partially? Okay. All right. So, oh, let's move on. 7.50. What's this? This is alkalosis. I think this is the last problem. All right, 14 is what? Again, seven point 40? Is the mean 7.5 Definitely is more than that. So it means to say it's alkalosis 49? Is acidosis. All right. Okay. 32 is what? alkalosis? So alkalosis. So just pair it so that I mean the source of the problem, which is metabolic, not the respiratory. So this is a case of your metabolic alkalosis. compensated or not? Is it compensated or not? Yes, it's compensated because it's again, it's buffering, right? It's buffering. All right. With compensation. The question is, is it fully or partially, this is a case of you're partially compensated with partial compensation. You know, it's partial. Because when you go back to the pH, it's not within the normal range. What did they tell you? You can rely on your pH range, only if you are talking about if it's fully or partially, okay, fully if it's within the normal range, martial if it's not within the normal range. Okay. And I guess the secret here is for you to know, the very first step is to determine the pH and please, set when point 40.

Okay, if it's less than 7.4 D, that's acidosis. If it's more than 7.4. That's alkalosis. All right. I guess this is the lecture for today. All right. So let me move on. Commit your actions to the Lord and your plans to succeed. Okay, even if you're a, if you're a couple out there, even if you're like the first honor to your class. If you don't commit yourself to the Lord, your abilities are nothing. Okay? It's all about you know, praying, it's all about connecting to him. Alright, I've seen so many, like people are like really brilliant. But they were they weren't able to make it. Right. I guess there's a problem, you know, probably, you know, there should be a problem to their or let's just say, it's not their time. But what I'm trying to say here is that, you know, in everything that you do, you always have to commit to the Lord and not saying that they're not committing themselves to the door during their mind. be under some reason as well, because, you know, sometimes the Lord will tell you, Okay, I need to break you, for you to become like hole, you know what I mean? So it's just a matter of time as well. Just be patient, and then you will get through it. Okay, so thank you. Thank you guys for listening to me today. And I hope you've learned something. And learning something, at least one thing in NCLEX is very, you know, it's very humongous. It's very big. Alright, so what I'm trying to say is that in every question in your NCLEX, what if it's 1/45? Question? That's the last question. Right. All right, you were you, you, you are into the last question. Last question. 1/45. Question is make or break. What if you're going to be asked what ABG? And then let's just say what if you're asked about myocardial infarction, you know, what the STEMI was not an understanding. And you weren't able to grasp the concept about ischemia.

For example, for instance, you know, it's a micro brake question. There you go, you're not able to make it. So every topics in clicks, what your program is discussing what your program is, you know, giving you guys please, irregardless of what's the program, I'm not you know, I'm not advertising, you know, what my program is, what my iPad is that the iPads or any, you know, any programs available. In fact, I'm, you know, I'm encouraging you guys to enroll to any, you know, any review centers or any review programs. Because my goal is to see you guys come here, in become a US RN. That's my goal. I don't have any bias to anyone. It's just so happened that I mean, I pass you know what I mean? Because my goal again, like I said, is for you to come here and become a US RN. And that is our topic for today. Okay, thank you. Thank you, guys. Thank you, Miss Melanes for getting me in to this to this platform. Thank you Connetics, right. Thank you guys and see you all around. I mean, see around to my, if you're enrolled to I pass, and then I would glad the like, you know, greet you guys there in our platform as well. All right, thank you. Thank you, Miss J, thank you for participating as well, though, it's not as participative as I expected. Not all of you guys are like, you know, typing in or at least like, you know, recite, because we're not able to do it. I usually like unmute my students to ask them what's you know, what's this problem? Something like that. Alright, so yeah. Thank you, Miss Anna. Thank you. Thank you, Miss Cheryl. And I guess that's  all for today, and see you around. All right. Thank you. Thank you. God bless everyone.