Metabolic or Respiratory

[karenwjk]

It's very simple to tell if it's acidic or alkaline.. but can anyone describe to me in a simple way to tell if it's metabolic or repiratory

[caliotter3]

I found this mnemonic mentioned on this site: ROME Resp opposite, Metabolic equal. Do a search for ROME and you will find it explained better than I can do.

[Daytonite, BSN, RN]

if the co2 is out of whack its respiratory; if the hco3 has gone out of whack its metabolic.

the rome mnemonic is on post #24 of this sticky thread: https://allnurses.com/nursing-student-assistance/pathophysiology-p-microbiology-145201.html - pathophysiology/ a & p/ microbiology/ fluid & electrolyte resources

[SolaireSolstice, BSN, RN]

Sometimes, if the metabolic or respiratory pathways are attempting to compensate, they can both go out of whack. The way I learned it was... (and forgive me multiple edittings because I'm sure I'll have an issue with formatting here) draw a table like this: (remember to "flip" the pCO2 to 45 on the acidic side and 35 on alkaline side).

acidic alkaline

pH |7.35 | 7.45|

pCO2 |45 | 35|

HCO3 |22 | 26|

Then you just put a dot (*) where each level lands ie: pH of 7.24, pCO2 38, HCO3 21

acidic alkaline

pH * |7.35 | 7.45|

pCO2 |45 | 35| *

HCO3 * |22 | 26|

since pH and HCO3 land on the same "side", it is metabolic acidosis, and it is partially compensated because the pCO2 has moved out of whack to try and compensate for the metabolic being out of whack.

Another example: pH 7.36, pCO2 44, HCO3 27

acidic alkaline

pH |7.35 * | 7.45|

pCO2 *|45 | 35|

HCO3 |22 | 26| *

This one is respiratory acidosis (because it lands on the acidic side of pH), and it is fully compensated because the pH is within the normal range.

One more example: pH 7.48, pCO2 40, HCO3 27

acidic alkaline

pH |7.35 | 7.45| *

pCO2 |45 *| 35|

HCO3 |22 | 26| *

Metabolic alkalosis and not compensated, because pCO2 has remained within normal range and hasn't yet moved to compensate.