HELP: SO CONFUSED: Alkalosis VS Acidosis (Met & Resp)

[Jen.Arceneaux]

HELP: Alkalosis VS Acidosis (Met & Resp)

In my final semester of RN school and still totally confused with this topic!!!!

Every time I think I finally understand, someone will say something that totally throws me off and leaves me confused!

I'm the type of learner that if you explain why with real life examples, then it clicks! BUT, I have yet to find any of my teachers who can break it down to the " A+B=C" and the "do this to get D"...

Any help is welcome and appreciated because its like telling me to read German right now!

[Esme12, ASN, BSN, RN]

Sounds a lot like a patient my mom cared for. The residents would call up to her floor (pulmonary medicine) about one particular patient whose gases were horrible, and my mom would ask for the patient's name and then just tell them to bring her up. My mom tears up every once in a while talking about her, she was someone the whole floor got to know apparently.

We do grow fond of certain patients....she was a feisty little thing.

She Lived alone in a rough area......and once knocked out a burglar with her O2 tank....neat lady.

[Larry2016]

This is somewhat easier to understand if you know the values.

Body pH = 7.35 - 7.45 at a normal level

Acidosis

Alkalosis >7.45

The first thing you need to do is ALWAYS ALWAYS ALWAYS determine the blood pH. Metabolic OR Respiratory will follow the pH, as long as the body is not going through a compensatory stage.

Metabolic (normal range: 22-26; affected by bicarbonate, kidneys)

Assuming no compensation:

--metabolic acidosis = pH

-- metabolic alkalosis = pH> 7.35 and metabolic >26

Respiratory (normal range: 45-35; affected by CO2, pulmonary)

** now, here is where it may get confusing. Respiratory follows acidity when the value is between 45-60 (that is why I wrote the normal range 45-35). Respiratory follows alkalinic when the values are between 35-20, for example.

Assuming no compensatory gases:

Respiratory acidosis = pH 45

Respiratory alkalosis = pH > 7,35; Respiratory

If there is no compensation involved, the opposing value is normal range.

Example: if a patient is going through Respiratory acidosis, ranges might be pH=7.25, respiratory=57, metabolic = 26

hope that helps

[Jen.Arceneaux]

Thank you all SOOOO MUCH! Every single response was extremely helpful in clarifying for me! I really appreciate it... Working hard to finish these last few weeks and prepare for NCLEX! Yay! (64 days left until our graduation and pinning!)

[lifelearningrn, BSN, RN]

The first thing I do is know my normals

pH- 7.35-7.45 (7.45 ALKALOSIS)

PACO2 -35-45 (RESPIRATORY)

HCO3- 22-26 (METABOLIC)

Alkalosis and Acidosis is depends on the the pH-- we know that the lower the pH is, the more acidic it becomes so if the pH is lower than 7.35 it's automatically going to be acidosis.. if it's above 7.45 it's automatically alkalosis.

pH

pH >7.45 ALKALOSIS

Now look at the PACO2. This of CO2- what system does that bring to mind? Respiratory! So if your CO2 is outside the normal range you're looking at respiratory.

Your HCO3 usually determines if it's metabolic so if the BG is outside of the 22-26 range, chances are you're looking at a metabolic issue.

I use this as BASIC rules-- there is a lot more to it when you get into partial or complete compensation... but my explanation of those will just act to confuse you (because it still confuses me).. but I've always been able to figure out blood gasses based on the above.