Acidosis and Alkalosis?

caliotter3 · Aug 11, 2010

I decided to draw the line at the compensating part as reaching the limit of my abilities to understand. There are some things that I just set aside and hope I don't see on the test. Don't recommend this approach for a lot of subjects, just those that you don't think you can get under your belt before a reasonable test date. Just how I look at it.

rachelr · Aug 16, 2010

ROME

Respiratory Opposite

Metabolic Equal

This is very hard to explain but I will try

1st analyse the pH

is it high or low?

2nd analyse the CO2

is it high or low?

3rd analyse the HCO3

is it high or low

Where the R.O.M.E come in is:

if the pH is high and the CO2 is low THE CAUSE OF THE DISTURBANCE IS RESPIRATORY BECAUSE THE ABNORMAL READINGS ARE "OPPOSITE"

if the pH is high and the HCO3 is high THE CAUSE OF THE DISTURBANCE IS METABOLIC BECAUSE THE ABNORMAL READINGS ARE BOTH HIGH ("EQUAL")

if the pH is low and the CO2 is high THE CAUSE OF THE DISTURBANCE IS ONCE AGAIN RESPIRATORY BECAUSE THE ABNORMAL READING ARE "OPPOSITE"

if the pH is low and the HCO3 is low THIS WOULD MAKE THE CAUSE METABOLIC AS ONCE AGAIN BOTH THESE ABNORMAL READINGS ARE LOW ("EQUAL")

Acid-base balance is a very complex thing to get your head around and very hard to explain! Its best to find a way that you find easy to remember it and stick to it! It can be very confusing but I hope this helps!

howcanthisb · Aug 17, 2010

Another attempt at describing how "ROME" (Respiratory Opposite, Metabolic Equal) works. All that ROME means is that in Respiratory states your CO2 will be in the opposite state (alk vs acid) than what the pH is. And in Metabolic states your HCO3 will be in the same state (acid or alk) as the pH is.

In a nutshell, if the Ph and the CO2 are in opposite states, then its a Respiratory condition. If the HCO3 and the Ph are in same state, its a Metabolic state. But here's more.....

First: Look at the pH first to determine whether you have an alkalotic or an acidotic condition on your hands. If pH is low, you are dealing with an acidosis. If it's high, then you are dealing with an alkalosis. Easy enough, right? So now you know if your condition is Acid or Alkaline. All you need to know now is whether it's Respiratory or Metabolic. Oh, and remember: even if your pH is w/in normal range (7.35 - 7.45) you still need to make a call. In this case, less than 7.40 is considered acid, and greater than 7.40 is alkaline).

Next: look at the CO2. Determine if it's high or low. If it's high, then you have a Respiratory problem. (Again, "respiratory Opposite". So the CO2 will be in the OPPOSITE direction of the pH. This is the "Respiratory OPPOSITE" part of ROME. CO2 high/pH low). So in this case you'd have Respiratory Acidosis.

Lastly: look at the HCO3 to see if it's high or low. If it's high (meaning alkaline) AND your pH is high (meaning alkaline), then you have a Metabolic condition. This is the "metabolic EQUAL" part of ROME, where the HCO3 is in the SAME/equal state as the Ph. Both the pH and the HCO3 would be alkaline). Your condition in this case (high/high) then is Met Alkalosis.

Other things to remember:

if the pH is NOT normal, then the state is NOT compensated. Not normal, not compensated.
if both the HCO3 and the CO2 are abnormal, then that's an easy way to know that there IS compensation of some kind.

I hope this helps. I understand acid base really well, it's just so darn hard to explain! :uhoh3:

Johnmar · Feb 11, 2011

Has anyone else looked at the site realnurseed.com mentioned in a couple of these comments. I just went to it and understood the explanation and then found some of the answers not to make sense. Does anyone else think there are some errors in the answers? Look at #3 - it shows a pH of 7.55 yet says its acidosis. ???