Am i on the right track with this case study

[tookewlandy]

"Patient with acute renal failure has a pH of 7.36,PaCo2 30, and Hco3 16. describe the patients acid-base status"

I figured that the patients Bicarb was abnormal(low) and the Paco2 was low as compensation(blowing off co2), now the pH is just normal due to the compensation. Metabolic acidosis with respiratory compensation

Anyone gimmie some feedback!!!!!

[cn2007rn]

Yeah I would say the same thing....

[Daytonite, BSN, RN]

the acid-base mnemonic most popularly used is rome for respiratory opposite metabolic equal. what this means is that in respiratory alkalosis ph goes up and pco2 goes down; in respiratory acidosis ph goes down and pco2 goes up (they change in opposition to each other). in metabolic alkalosis ph and hco3 both go up; in metabolic acidosis ph and hco3 both go down (they change equally in relation to each other).

you have a patient here who has:

• a ph of 7.36 (normal is 7.45), so the ph is down, or acidic
  
• a pco2 of 30 (normal is 35mm hg), so the pco2 is elevated
  
• an hco3 of 16 (normal is 26meq/l), so the hco3 is down

if you fit this into the mnemonic, rome, you have:

• ph down and pco2 up = respiratory acidosis (respiratory opposite-down/up)
  
• ph down and hco3 down = metabolic acidosis (metabolic equal-down/down)

based on what you've posted, i think you are on the right track. the patient is in metabolic acidosis and attempting to compensate through the respiratory track, but losing the fight. he is in both metabolic and respiratory acidosis. did you check out the links on the fluid and electrolyte sticky on this forum?

https://allnurses.com/forums/f205/pathophysiology-p-fluid-electrolyte-resources-145201.html

[tookewlandy]

WOW ROME is an awesome way to remember thanks DAY!!! thanks for the link as well

I figured i was on the right track i just wanted some feedback before i discuss this in front of the class