pH Acid Base question

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I hope that I can make this simple. Here are the numbers. pH = 7.38, HCO3 = 30, PCO2 = 53.

I have a teacher that says that this is Metabolic Acidosis w/ Full compensation, but I have read in books that it is Respiratory Acidosis w/ Full compensation. Both of these have high HCO3 and PCO2 in the books--the only thing different is where the pH lies. They state that it has to be an acid problem because the pH is lying a little on the acidic side. They say that the body will not overcompensate on pH and that this 7.38 shows you which side that the pH started from, an acidic situation. Thank You, Doug

Specializes in Family Practice, ICU.

From my experience in nursing school, a good skill to learn is picking your battles. Sometimes, teachers are wrong, plain and simple. But there are appropriate times and places to talk to them about things like this. There is a girl in my class who, albeit exceptionally bright, gets hung up on tons of intricacies and minute details that the teacher simply doesn't have time to devote to during lecture. It happens with her and all the teachers.

Some teachers are humble enough to know when they're wrong. Fortunately, our instructors know this. They've often said "a good nurse knows when they don't know something and are willing to admit it".

Being a defensive know-it-all is dangerous in health care. All doctors and nurses will make errors in their career. If a person is unwilling to be wrong about something as simple as an in-class blood gas calculation, how likely is this person to lie about a procedural or documentation error to protect themselves?

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Specializes in None.

I understand, and agree. I waited until after class, and then e-mailed her. She blew me off as stupid and told to go study some more. She never would asnwer the simple question of "will the body over compensate on pH, or does where it lies tell the starting condition in full compensation? I know that I need to let it go and I will. I just hope that she doesn't try to make me out to be stupid in class, because then I know that I will not be able to not state what I know to be true.

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Specializes in Family Practice, ICU.

Yeah, that's tough. I believe if your teacher actually cared, she would admit that she doesn't know, and then try to help you find out. Sounds like she doesn't know, doesn't care, and just wants you off of her back. Lame.

The fact that you're wanting to know, though, is a good sign. I'd much have a nurse care for me that wanted to understand and do things right, than someone who merely did the minimum required.

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Respiratory Acidosis with Full Compensation.

Absolutely positive.

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Was there any clinical information given, or just the blood gas numbers? The blood gas numbers make it look like compensated respiratory acidosis, for sure. But if there was also a clinical picture of a patient who had no respiratory issues but had a possible reason for metabolic alkalosis (i.e. losing acid through frequent vomiting), you could make a case for suspecting compensated metabolic alkalosis.

And as others have said above, there are two issues here: the blood gas issue, and the relationship between you and your teacher. It's a dangerous situation for you to know better than your teacher, and it may be in your best interests to swallow your pride and let her think she's won this one. The important thing is to get through nursing school without making enemies of people who have the power to affect your future.

Good luck, Marion

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Specializes in Nurse Scientist-Research.
it may be in your best interests to swallow your pride and let her think she's won this one. The important thing is to get through nursing school without making enemies of people who have the power to affect your future.

Couldn't agree more.

Until you get the results from your NCLEX, then maybe you can send a nice article about blood gases to your nursing instructor. I had an extremely low opinion of my nursing instructors, but I stayed out of their target while I was in school.

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Specializes in jack of all trades.

Agree with previous poster, Pick your battles. I attended a refresher course in 96 and was shocked to find I had more experience (I was a former CCRN) and was surprised how much I hadnt forgotten comparative to my Refresher Instructors. It's best to let it go until after you take your NCLEX as right now is not the time to P off your instructors. Well before I graduated I purchased the Core Cirriculum for Critical Care and it was the best resource in the world for me when it came to issues such as blood gases and other lab results for interpretation. It also helped me in the ability to take not only my CCRN but my NCLEX and do very well on both. Once I hit my experience requirements, I started prepping before I graduated since I externed in a Critical Care Unit starting in my Junior year. I learned very early on sometimes it's best to just let it go. You'll be the one sitting for the exam not the instructor. They make mistakes too.

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