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“Everyone this is sarah with register nurse rn. Comm and today i want to be be talking to you about the tic tac toe method and how to use it solving arterial blood gas problems in nursing school. You ll be required to learn arterial blood gas values and how to interpret that based on those values for instance is a patient having respiratory alkalosis or they have a metabolic alkalosis. And you have to be able to differentiate between those two and also you ll have to know whether the patient s trying to compensate or if they re partially compensated so in nursing school.
I remember having to solve these problems and these problems gave me a lot of difficulty. But then someone showed me how to use the tic tac toe method so in this video. I want to show you what the tic tac toe methods about how they actually set up a problem with it and talk to you a little bit about ph levels h. C3o levels and things like that in the next video video.
We re actually going to work these abg problems so be sure to check out that next video and work. The videos along with me and then after that check out the free quiz. We have on our website register nurse orange comm and test your knowledge on abg s along with other in clicks quizzes. And personality.
Quizzes. That we have so first let s talk about the tic tac toe method and how to use it with abg s first the very first thing you want to learn before you start solving adg problems is you need to learn the normal values because in a problem. You ll be given the ph level. You ll be given the pco2 level.
And you ll be giving given the hco3 level. So you need to know what the normal ranges are for people so here are the normal ranges i would write this down. Ph level the normal is. 735 to 745.
Anything. Over seven point..
Four five is a base. Another word for base is alkalotic. Which is alkalosis anything less than seven point three five is an acid so it d be acidotic. I m going to skip two hco3 because it s the same um.
22 to 26. Is your normal range for that. And that represents metabolic. So anything oh.
26. Would be basic. It would be alkalotic just like with the ph. And anything less than 22 would be an acid.
So be alcoholic. So they would be having a metabolic problem and they would be alcoholic. I mean acidotic okay for the pco2 this represents your respiratory level and it s the opposite for what the ph and the hco3 are this a lot of times throws people off so just remember pco2 is opposite in a represent your respiratory. So for instance anything less than 35 is basic so it s alkalotic anything over 45 is acidotic so it s an acid.
So you ll want to memorize these values. Because this is your baseline for whenever you re comparing your problem. That you re given to how to set up the problem. So i would write that down like i said before you actually start working your problems next.
Let s go over the actual setting up for the tic tac toe method as you see this looks like a basic little tic tac toe. You know whenever you used to play with your friends you would set up the tic tac toe..
Like that and someone would be ohs another person would be exes and you would play like this and oh you got chick tac toe. We re not really using the x s and o s we re going to throw that concept out. But we are keeping the concept of lining something up with threes and in a row of threes so for a grid for the tic tac toe grid. We ve automatically going to put acid normal base and this is easy how it set up anything for the ph or the hco3 and remember anything.
That s less than the normal value is an acid and anything greater than that value is a base except for respiratory. Remember paco2 is the opposite. So let s just work a problem. So you can see exactly what i m talking about okay.
In this problem. The patient s ph is seven point two three there paco2 which represents respiratory is 50 and their hco3 is 30. And remember hco3 represents metabolic okay. After you ve set up your tic tac toe.
You wrote acid normal and base up at the top you re going to look. At your ph it. s 73 so remember normal ph is. 735 to 745.
So it s seven point two three. So that would make it an acid so under acid we re going to write ph okay. Now we re going to look at paco2 and remember that represents respiratory it s fifty and looking at our normal paco2. If normals are thirty five to forty five so since it s fifty remember it s the opposite for a respiratory.
It is an ass. It s going to be an acid not a base it s an acid..
So our paco2 is f. It ik. So under that we re going to put paco2 and always solve your problem before you start doing your crosses. Because we need to know how our metabolic fits into this because this is going to tell us if we re compensating or not so always put all your values in before you cross down in your three letters.
So the hco3 is 30 normal hco3 is 22 to 26. So it s 30 so because it s greater than 26. Its basic so there alkalotic so under base. We re going to write hc 0.
3. Now we already have our tic tac toe and looking at this you know that this patient because we have three in a row. This is where you re going to interpret if it s respiratory or metabolic paco2. What does it represent respiratory.
So we know that we have a respiratory issue now for instance let me just throw this out here. If these two values were switched. Say hco3 was over here and paco2 was under base because we got the cross underneath. Here that would be a metabolic problem instead of a respiratory problem.
So we have respiratory problem. Now we have to decide are we alkalotic or acidotic. Very easy underneath on our grid. We know it s an acid.
We have respiratory acidosis next thing. We have to determine is this patient compensating or are they uncompensated..
They are partially compensated and this is how i know that because the body is trying to compensate the metabolic value is thrown off so it s not normal so they re partially compensating now if her hco3 was normal say. It was 25 because remember 22 to 26 is normal this 25 would be under the normal range. The body s not doing anything to try to help balance it out out because your body s always trying to do homeostasis and do a balancing act because if it was under normal it would be and it would be uncompensated. But because the body s trying to correct itself and throw the metabolic rate off its partially compensated.
So your answer to that question would be respiratory acidosis partially compensated. Now in my next video on how to actually work these problems we get a little bit more in depth. We talk about all the disorders and if they re compensated uncompensated using the tic tac toe method. It s very easy and will help you on nclex help you on how to see your eighty eyes on how to just solve these problems so.
Thank you so much for watching. I hope you liked this video. If you did please give it a thumbs up and be sure to visit registered nurse or en comm. We have a lot of free in clicks and quizzes.
Personality. Quizzes. Abd quizzes. Care plans everything you need to help you in nursing school.
And after nursing school. So thank you so much for watching and ” ..
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