HELP!!! Electrolytes/Fluid Imbalance/Acid Base

mitchsmom · Nov 18, 2005

You could see if there's anything here that would help:

http://health.groups.yahoo.com/group/allnursesstudents/

Or when I'm stuck sometimes I just search google to see if there's something to help me.

There are also books like:

Fluids & Electrolytes Made Incredibly Easy!

Do you have any specific questions for particular parts that are hard for you?

RNin2007 · Nov 18, 2005

Here is an acronym I found helpful

"ROME" (down/up)

Respiratory

Opposite

Metabolic

Equal

Respiratory pH down CO2 up = acidosis (Co2 is respiratory)

Opposite pH up CO2 down = alkalosis

Metabolic pH down HCO3 down = acidosis (HCO3 is metabolic)

Equal pH up HCO3 up = alkalosis

Norms:

O296% - 100%

pH7.35 - 7.45

CO235 - 45

HCO322-26

I have a study guide I made (I have a test on that on my final as well...) but tried to paste here and the formatting wouldn't take...if you would like me to email you a copy, private msg me and I will send it to you as a MS word doc.

~J

stressgal, RN · Nov 19, 2005

One of my super professors taught us this:

pH

7.4 is perfect

>7.4 = B (base)

PCO2

40 is perfect

>40 A

HCO3

27 perfect

>27 B

Makes it real simple, 2 A's = acidosis, 2 B's = alkalosis

Whatever the pH matches with determines respiratory or metabolic.

if it mathces with pCO2 that involves the lungs so it's respiratory

if it matches the HCO3 it's metabolic.

If the pH falls betweem the norm of 7.35 and 7.45 it is compensated

So, if :

pH 7.5 B

pCO2 50 A

HCO3 40 B

You have Metabolic Alkalosis

pH 7.39 A

pCO2 52 A

HCO3 30 B

You have compensated respiratory acidosis.

Hope this helps!

TrickieTam · Nov 19, 2005

Someone posted a website that easily explained the ABG's and made it very easy for me. The website is below:

http://realnurseed.com/abg.htm

*****Scroll down to "The Land of The ABG's". I don't know who the person was that posted it but I thank 'em for the help.

cindyRN 2006 · Nov 19, 2005

First you have to remember that you are dealing with two different systems. You have the respiratory system and then you have the metobolic system(kidneys) these two systems are try to balance each other if one is off you will have the other one trying to compensate. Make it a step by step process.

1. determine the state of the blood if it is less than 7.35 your pt. is acidic and if it is more than 7.45 the pt. is alkaline.

2. Look at the respiratory system if the pcO2 (I remember this is the respiratory from the O2 prompt) is not between the 35-45 normal range than it is the respiratory system where the problem s lie.

3. Next look at the HCO3 if it is not WNL of 22-26 then you know you have a metobolic condition.

Example- pt blood is 7.28

PCO- 49

HCO-25

You know that the blood is acidic then you go to the resp. sys. and find that the patients levels are not within normal limits so now you can stop and know that your patient has respiratory acidosis.

I hope it helps. if I could give you a word of advice it would be to really learn this because you will use it.