What is this clients disorder?
--> Client with an NG Tube has a pH of 7.50 (Alkalosis), pO2 90 (normal), PCO2 of 42 (normal) and HCO3 25 (normal)
Answer: Metabolic Alkalosis.
... I understand why it is alkalosis, but why is it metabolic if the HCO3 is in the normal range???
So, take a look at the labs. A long look. What do we know about metabolic syndromes -- be it alkalosis or acidosis? Is that it first goes through respiratory alkalosis/acidosis and is then advanced to metabolic syndrome. COMPENSATORY. The renal system is trying to fix the system by doing what it does best.
You have a pH that is 7.50 -- this is high, KIND of near normal. You then have a PaCO2 that is nearing ABOVE normal levels. Then, you have the bicarbonate that is high but seems to be lowering. Your kidneys are excreting bicarbonate and your system is retaining the carbonic acid to try and normalize it.
Look at the PO2...what does this look like? Hypoventilation. This patient is not breathing enough and is retaining CO2 -- ACID! However, hypoventilation is COMPENSATORY and will actually stimulate the action to breathe.
Think to yourself when you look at the labs, "Ok. I know several of these labs are normal; however, many of the labs are nearing the high range or low range." What does this mean? Again! COMPENSATORY. The kidneys are long term compensatory systems.
Last edit by Kuriin on Oct 3, '13
Quote from EP10
My professor told us the range for HCO3 is 24-32. My professor is also the same one that Nursing2102 has. We are confused because according to the ranges we were given, 24-32 bicarb, the example of HCO3 being 25 would be in the lower end..
You just answered the rationale, in your last sentence.
Like StephenAndrews posted, you have to look at the ranges...if they are trending on the lower and higher end, the imbalance will be compensated; you must look at what is affected, as another poster stated, as well as the pH.
Last edit by LadyFree28 on Oct 3, '13