acidious vs alkalosis (forgive the spelling)

Nurses General Nursing

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can someone please put this all in basic terminology?? 3 years into the program acidious and alkalosis still confuses me. what is the deal???? instead of a profession definition i would like "dummy verison please" :)

Specializes in cardiac ICU.
:eek: Oh, duh! How was I never able to put that together before so that I could remember it? :imbar Thank you for your help!
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With this, our teacher gave us a tic tac toe board, and had us use it always to determine what kind of problem it was, and then to determine if it is fully, partially, or not compensated.

Let me see if I can get it to work.

Acid Neutral Base

under 7.35 7.45 over 7.45

Plug the rest of the numbers into the format, and then you can decide what kind of problem it is.

To determine what the compensation level is, use 7.41 as the absolute middle of the normals, and put the pH level in the column as acid or base. This shows compensation, where ever the pH is, lined up with the blood gas part that is off.

Normals: pH 7.35-7.45

PO2 80-100

PCO2 35-45 (respiratory component)

HCO3 22--26 (metabolic component)

BE -2 to +2

O2 Sat >95

poo. I can't get the things to stay spaced the way they should. And don't know how to make a table. phooey. Hope this helps anyhow.

0 Votes

With this, our teacher gave us a tic tac toe board, and had us use it always to determine what kind of problem it was, and then to determine if it is fully, partially, or not compensated.

Let me see if I can get it to work.

Acid Neutral Base

under 7.35 7.45 over 7.45

Plug the rest of the numbers into the format, and then you can decide what kind of problem it is.

To determine what the compensation level is, use 7.41 as the absolute middle of the normals, and put the pH level in the column as acid or base. This shows compensation, where ever the pH is, lined up with the blood gas part that is off.

Normals: pH 7.35-7.45

PO2 80-100

PCO2 35-45 (respiratory component)

HCO3 22--26 (metabolic component)

BE -2 to +2

O2 Sat >95

poo. I can't get the things to stay spaced the way they should. And don't know how to make a table. phooey. Hope this helps anyhow.

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I hope I can explain this in a way that is understandable. I will assume you know the normal ranges for PH, CO2, Bicarb, and the O2.

The main thing to look at is the PH:

-If it is less than 7.35 it is called acidosis (metabolic and/or respiratory)

-If it is greater than 7.45 it is called alkalosis (metabolic and/or

respiratory)

-To determine if it is respiratory or metabolic, you have to look

at the CO2 and the Bicarb (HCO3-). If the CO2 follows the

PH, then it is repiratory. And if the bicarb follows the PH, then it is metabolic. For example: If the PH is 7.20 and

the CO2 is 50, then this will be repiratory acidosis, because the PH is in the acidosis range and the CO2 is greater than what it should be which means that the patient is breathing slower and retaining this CO2 and making themselves acidotic.

-Now if the bicarb followed the PH, then it would be labled metabolic acidosis or alkalosis depending on the numbers. For example: if the PH is 7.50 and the bicarb is say 30, this would show that there is metabolic alkalosis going on in the patient. Since the PH is greater than 7.45 this would show alkalosis. And along with the PH being in the alkalotic range, the bicarb is also in the alkalotic range since anything above 26 (depends on what your hospital/school says) is alkalotic.

-What was confusing to me at first was learning that a decreased PH means acidosis and and increased PH means alkalosis. I kept thinking that an increased PH meant that the body was in acidosis; but finally learned that the opposite is true.

PH Acidosis7.45 --------> Alkalosis

CO2 Acidosis 45 - Alkalosis

HCO3 Acidosis 26 --------> Alkalosis

(bicarb)

Anything in between the numbers in each line is in the normal range.

*Decreased PH/Increased CO2 = Respiratory acidosis

*Increased PH/Decreased CO2 = Respiratory alkalosis

*Decreased PH/Decreased Bicarb = Metabolic acidosis

*Incrased PH/Increased Bicarb = Metabolic alkalosis

That's very very basic. This in not even including when the body is compensating.

If you want to see if the body is compensating, then you have to first determine if the body is in respiratory or metabolic acidosis or alkalosis. Once you determine that, then you can look to see if the body is compensating. So for example, if you have Repiratory acidosis with partial compensation, your numbers may look like this:

PH 7.32 (acidic)

CO2 48 (acidic)

Bicarb 28 (alkalotic)

You can see that the CO2 follows the PH. There-

fore, this is labled Resp acidosis. But you can

also see that the bicarb is increased towards the

alkalotic range..and the reason this is occuring is

because its trying to bring the body back to a more

alkalotic range. But because the bicarb doesn't follow

the PH, this would not be considered metabolic anything.

As a matter of fact, it is going in the opposite direction than

the PH. When I say "following" the PH, I mean that if the PH is

acidic, then the thing (CO2 or bicarb) that is "following" the PH has to ALSO be acidic. I hope this makes sense. But in this problem, since the PH hasn't been corrected, this is labled "partial" compensation.

I hope I didn't screw any of this up. If anything, I hoped it helped.

Maria

0 Votes

I hope I can explain this in a way that is understandable. I will assume you know the normal ranges for PH, CO2, Bicarb, and the O2.

The main thing to look at is the PH:

-If it is less than 7.35 it is called acidosis (metabolic and/or respiratory)

-If it is greater than 7.45 it is called alkalosis (metabolic and/or

respiratory)

-To determine if it is respiratory or metabolic, you have to look

at the CO2 and the Bicarb (HCO3-). If the CO2 follows the

PH, then it is repiratory. And if the bicarb follows the PH, then it is metabolic. For example: If the PH is 7.20 and

the CO2 is 50, then this will be repiratory acidosis, because the PH is in the acidosis range and the CO2 is greater than what it should be which means that the patient is breathing slower and retaining this CO2 and making themselves acidotic.

-Now if the bicarb followed the PH, then it would be labled metabolic acidosis or alkalosis depending on the numbers. For example: if the PH is 7.50 and the bicarb is say 30, this would show that there is metabolic alkalosis going on in the patient. Since the PH is greater than 7.45 this would show alkalosis. And along with the PH being in the alkalotic range, the bicarb is also in the alkalotic range since anything above 26 (depends on what your hospital/school says) is alkalotic.

-What was confusing to me at first was learning that a decreased PH means acidosis and and increased PH means alkalosis. I kept thinking that an increased PH meant that the body was in acidosis; but finally learned that the opposite is true.

PH Acidosis7.45 --------> Alkalosis

CO2 Acidosis 45 - Alkalosis

HCO3 Acidosis 26 --------> Alkalosis

(bicarb)

Anything in between the numbers in each line is in the normal range.

*Decreased PH/Increased CO2 = Respiratory acidosis

*Increased PH/Decreased CO2 = Respiratory alkalosis

*Decreased PH/Decreased Bicarb = Metabolic acidosis

*Incrased PH/Increased Bicarb = Metabolic alkalosis

That's very very basic. This in not even including when the body is compensating.

If you want to see if the body is compensating, then you have to first determine if the body is in respiratory or metabolic acidosis or alkalosis. Once you determine that, then you can look to see if the body is compensating. So for example, if you have Repiratory acidosis with partial compensation, your numbers may look like this:

PH 7.32 (acidic)

CO2 48 (acidic)

Bicarb 28 (alkalotic)

You can see that the CO2 follows the PH. There-

fore, this is labled Resp acidosis. But you can

also see that the bicarb is increased towards the

alkalotic range..and the reason this is occuring is

because its trying to bring the body back to a more

alkalotic range. But because the bicarb doesn't follow

the PH, this would not be considered metabolic anything.

As a matter of fact, it is going in the opposite direction than

the PH. When I say "following" the PH, I mean that if the PH is

acidic, then the thing (CO2 or bicarb) that is "following" the PH has to ALSO be acidic. I hope this makes sense. But in this problem, since the PH hasn't been corrected, this is labled "partial" compensation.

I hope I didn't screw any of this up. If anything, I hoped it helped.

Maria

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:)

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:)

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You know, I was looking on Chapters one day and they have Acidosis and Alkalosis for Dummies there! I was tempted to get it as a student myself, because I still don't remember it all...you don't talk about it much on the job...or at least I haven't heard it in the last six months...

Amanda :)

0 Votes

You know, I was looking on Chapters one day and they have Acidosis and Alkalosis for Dummies there! I was tempted to get it as a student myself, because I still don't remember it all...you don't talk about it much on the job...or at least I haven't heard it in the last six months...

Amanda :)

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Think of the acronym ROME.

ROME (RO / ME)

Respiratory Opposite / Metabolic Equal

-------------------------- --------------------

respiratory acidosis (pH down) (PCO2 up) opposite

respiratory alkalosis (pH up) (PCO2 down) opposite

RO = respiratory opposite , directions of pH and gas

*******************************************

metabolic acidosis (pH down) (HCO3 down) equal

metabolic alkalosis (pH up) (HCO3 up) equal

ME = metabolic equal , directions of pH and gas

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Specializes in Emergency Nursing Advanced Practice.
Originally posted by KarafromPhilly

pH describes the hydrogen ion concentration, right? Therefore a lower hydrogen ion concentration equals a lower pH, and the patient is said to be acidotic. .

Nope, wrong. Try again!

ph = -log[H+] (Ph is equal to the negative log of the hydrogen ion concentration). So the more hydrogen ions you have (more acid) the lower the pH(more acidic)

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Easy way to remember the norms:

pH=7.35-7.45

pCO2= 35-45 (same as last 2 numbers of pH)

HCO3= 22-26 (the age you wish you were)

:smokin:

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