ILuvBabies2005

Hi! This helped me understand it a little better... CO2 = acid, makes things acidic HCO3 = base, makes things alkalotic Remember ROME R-Respiratory O-Opposite M-Metabolic E-Equal Ok always look at the pH first... pH pH>7.45 = alkalosis Then, if the CO2 is high or low, then it is respiratory...If the HCO3 is high or low then it is metabolic. How you remember that is that the respiratory system is involved with CO2 (blowing air off or slowing RR), and the kidneys (metabolic) are involved with HCO3 (excreting or not excreting). Example (Here's how you think thru it): pH = 7.25 CO2 = 40 HCO3 = 17 Ok, first, the pH is low so think acidosis. CO2 is WNL. HCO3 is low. Draw arrows if it helps. The abnormal values are both low (think Equal). Metabolic imbalances are equal. So, this must be metabolic acidosis! Now, for compensation... If you have a metabolic imbalance, the respiratory system is going to try to compensate. Respiratory = CO2. If the CO2 is normal in the ABG, then there is no compensation going on. Compensation in acidosis will decrease the CO2 because you want to get rid of the acid (CO2). In alkalosis, it will increase because you want to add more acid (CO2) If you have a respiratory imbalance, the kidneys will try to compensate. Kidneys = HCO3. If the HCO3 is normal in the ABG, then there is no compensation going on. Compensation in acidosis will increase HCO3 because you want to hold on to the base to make it more alkalotic. In alkalosis, it will decrease because you want to excrete the base to make it more acidic. I know this can be confusing just reading it but it has always helped me to look at it on paper and draw little up/down arrows and rationalize the changes. Work several ABGs for practice. Hope this helps and good luck! :)

I am a Student Nurse Assistant in an NICU in Mississippi. Several infants are placed in the prone position in order to assist them with breathing. It is easier for infants to breathe in the prone position. Plus with them being hooked up to monitors, if an apnea spell occurs, nurses are readily available to intervene. My hospital does not focus much on developmental care. Nurses just simply place the infant on the belly and turn the head to one side or the other. The head is turned to the opposite side q3-4hrs with the routine care. Sometimes trochanter rolls are used to keep the infant in place, but not always. I wish I could offer more info, but this is all I know. Hope it helps!

I am still a student about to graduate in May and I am going to work in the NICU when I graduate. My advice is to start working in your area of interest as a Student Nurse Assistant or Extern or whatever may be available in your hospitals around you. They are usually very flexible with student hours and you'll get a good feel for how the unit is run, and if you even like working with that particular type of patient. Also, look for great NG orientation programs at hospitals. Many units, especially NICUs need nurses badly, and though experience is beneficial, they are willing to train you well to have you on staff. Having the experience as a tech or assistant looks great and is great experience beforehand. Follow your heart. It will lead you where you're supposed to go. Hope this helps! -Jenn

I was wondering if anyone knew if a misdemeanor charge, such as a DUI, would affect a student nurse from obtaining their RN license in the state of TN. Thanks for any help you may have!

I was wondering if anyone knew if a misdemeanor charge, such as a DUI, would affect a student nurse from obtaining their RN license in the state of TN. Thanks for any help you may have!

This is definitely one of those situations that is truly ethical. From my experience in the NICU, a Grade IV IVH is pretty severe with severe limitations to the infant should she ever survive outside the hospital. Infants with IVH that severe, I have been told, will have massive mental retardation and disability. The bleed in the brain inhibits brain growth in essential areas and can actually cause the brain tissue to deteriorate. I took care of an infant with a Grade IV and after an MRI, the majority of his brain was missing. Its an awful thing. This infant later died due to a gram neg sepsis but this may have been the best thing for him. He (and his parents) would have had a long road of disability and diminished quality of life. I do NOT, however, agree with not telling the family about it. Educating the families on what is going on is one the most important jobs we do, and like you said, I would want to know what was going on. It sounds like the Dr. is avoiding a confrontation or having to tell the family their infant may not live or will have severe disabilities. Anyways, I hope this information has helped some. Situations like this is why I wish to go on to become a NNP so that I can make those decisions to educate families and not be told not to. Good luck with everything!

This is definitely one of those situations that is truly ethical. From my experience in the NICU, a Grade IV IVH is pretty severe with severe limitations to the infant should she ever survive outside the hospital. Infants with IVH that severe, I have been told, will have massive mental retardation and disability. The bleed in the brain inhibits brain growth in essential areas and can actually cause the brain tissue to deteriorate. I took care of an infant with a Grade IV and after an MRI, the majority of his brain was missing. Its an awful thing. This infant later died due to a gram neg sepsis but this may have been the best thing for him. He (and his parents) would have had a long road of disability and diminished quality of life. I do NOT, however, agree with not telling the family about it. Educating the families on what is going on is one the most important jobs we do, and like you said, I would want to know what was going on. It sounds like the Dr. is avoiding a confrontation or having to tell the family their infant may not live or will have severe disabilities. Anyways, I hope this information has helped some. Situations like this is why I wish to go on to become a NNP so that I can make those decisions to educate families and not be told not to. Good luck with everything!