Does anyone know of a web site, or a good book that will in detail explain the acid base balance / electrolyte stuff. I'm strugging with it and I have a big test next week.
any and all help would be so great
Nov 28, '07
are you having a proble with figuring out if an actual ABG is metabolic acidosis, respiratory acidosis, etc?
Here's how my instructor explained it....I hope this makes sense when I type it.
EX 1 pH: 7.28 (A)
pCO2: 60 (A)
HCO3: 24 (N)
- ok, first evaluate the pH: in this case it's acidic so put an "A" up by the value
- Next look at the pCO2: 60 means it's acid. again put an "A" by the value
- lastly look at the HCO3: 24 is normal so put an "N"
* now see what you have the most of: in this case it's "A" so acids
* now look where the acid is coming from. Look where the "A" (not the ph "A" but the other one. It's on the CO2. CO2 means it's respiratory and we already determined it was acidic so you have RESPIRATORY ACIDOSIS.
-now to determine compensation look at your other value: in this case it's the bicarb and it's in normal range. Therefore, the kidneys have not kicked in yet to compensate so you have no compensation.
**So in the end you have RESPIRATORY ACIDOSIS WITH NO COMPENSATION
Does that make any sense at all? It's hard to type the way my instructor explained it. Here's another example.
pH: 7.45 (normal but leaning to basic so we'll say "B")
pCO2: 28 (B)
HCO3: 18 (A)
*so, you have more "B"s meaning it's basic. The base is coming from blowing off too much CO2 from the lungs. So it's RESPIRATORY ALKALOSIS.
*For compensation you're looking at the bicarb and you can tell (because the bicarb is low) that the kidneys have kicked in to compensate. The pH is also WNL so that means the kidneys have completely compensated.
*In the end you have RESPIRATORY ALKALOSIS WITH COMPLETE COMPENSATION
I have many more examples if this helps you. Just PM me and I'll gladly send them your way. Best of luck!
Last edit by iHeartNICU on Nov 28, '07