ACID & BASE HELP & ABGs

Beary-nice · May 21, 2008

Metabolic acidosis can occur from diarrhea, I think of upper GI tract as acidic and lower GI alkaline if that makes sense. Loss of bicarb results in acidosis.

Beary-nice · May 21, 2008

I forgot there are 2 parts to your question, sorry, please forgive Beary.

I look at what is abnormal, if the PaCO2 is out of whack, it is respiratory related, if the bicarb is out of whack, it is metabolic related. If PaCO2 is high, I am thinking resp acidosis especially if the pH is low too. If the PaCO2 is low I am thinking respiratory alkalosis especially if the pH is high. I s that making any sense.

Daytonite, BSN, RN · May 21, 2008

is diarrhea considered metabolic acidosis because it is over elimination of bicarb or is it alkalosis?

diarrhea is the loss of fluid through the lower gi tract. in general, bicarbonate is largely lost in diarrhea fluid, extracellular fluid is depleted because it is being pulled into the intestinal tract and chloride becomes concentrated in the blood. the result is metabolic acidosis.

-in abgs

to determine if it is resp or metab, you first look which is abnorm right?

to determine alkal vs acid, you look at the ph or the pco2 less than 35 acid and hco3 more than 26 alka\

just slightly confused on which we look at to determine the acid or base part?

very simply, the ph tells you whether you have acidosis or alkalosis. you look at the ph first. then. . .the co2 is the respiratory component; and, hco3 is the metabolic component. depending which is most out of whack with the ph tells you if you've got a metabolic or respiratory situation.

the easy way to remember this is the rome mnemonic:

r

espiratory

o

pposite

ph
elevated
pco2
diminished
=
respiratory alkalosis
ph
diminished
pco2
elevated
=
respiratory acidosis

m

etabolic

e

qual

ph
elevated
hco3
elevated
=
metabolic alkalosis
ph
diminished
hco3
diminished
=
metabolic acidosis