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Metabolic Acidosis Correction Formula

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Metabolic acidosis and alkalosis made easy for nurses. This NCLEX review is part of an acid base balance for nurses series. In this video, I discuss metabolic acidosis causes, signs & symptoms, nursing interventions, and "How to Solve ABGs Problems using the TIC TAC TOE method" for patients in metabolic acidosis. Quiz Metabolic Acidosis vs Metabolic Alkalosis: http://www.registerednursern.com/meta... Lecture Notes on Metabolic Acidosis: http://www.registerednursern.com/meta... Metabolic Alkalosis Video: https://youtu.be/hmc0y6pJ1tA Solving ABGs with TIC TAC TOE: https://www.youtube.com/watch?v=URCS4... Subscribe: http://www.youtube.com/subscription_c... Nursing School Supplies: http://www.registerednursern.com/the-... Nursing Job Search: http://www.registerednursern.com/nurs... Visit our website RegisteredNurseRN.com for free quizzes, nursing care plans, salary information, job search, and much more: http://www.registerednursern.com Check out other Videos: https://www.youtube.com/user/Register... Popular Playlists: "NCLEX Study Strategies": https://www.youtube.com/playlist?list... "Fluid & Electrolytes Made So Easy": https://www.youtube.com/playlist?list... "Nursing Skills Videos": https://www.youtube.com/playlist?list... "Nursing School Study Tips": https://www.youtube.com/playlist?list... "Nursing School Tips & Questions": https://www.youtube.com/playlist?list... "Teaching Tutorials": https://www.youtube.com/playlist?list... "Types of Nursing Specialties": https://www.youtube.com/playlist?list... "Healthcare Salary Information": https://www.youtube.com/playlist?list... "New Nurse Tips": https://www.youtube.com/playlist?list... "Nursing Career Help": https://www.youtube.com/playlist?list... "EKG Teaching Tutorials": https://www.youtube.com/playlist?list... "Personality Types": https://www.youtube.com/playlist?list... "Dosage & Calculations for Nurses": https://www.youtube.com/playlist?list... "Diabetes Health Managment": https://www.youtube.com/playlist?list...

Acid Base Calculation Made Easy !

Posted by Ash from IP 74.138.144.66 on October 12, 2006 at 17:50:13: 6 steps to ABG analysis, go step by step in the very same order:- 1.Chk whether the pt is academic or alkalemic,by looking at the arterial pH (NL = 7.38 7.42) 2. Chk whether the ABG abnormality is due to a primary repiratory or metabolic disorder by chking the PCo2 levels( NL 38-42) and HCO3 levels (NL 22-26) 3. Now if there is respiratory component identified,chk whether this is acute or chronic respiratory acidosis or alkalosis. 4. Now if u identify a metabolic component ,chk whether it is high anion or normal anion gap M.Acidosis 5. Chk wether the respiratory system is adequetly compensating for this primary metabolic disorder. 6. Now u identify a high anion gap M.A,chk the corrected HCO3 level,y we do this coz to know wether there was a intial primary disorder ,before this new metabolic disorder developed. VERY IMPO FORMULAS :- U have to learn the formulas byheart) In Metabolic acidosis pH and HCO3 (DECREASES) So to compensate for every 1 mmol/l of drop in HCO3 , 1.2mmhg of PCO2 shld decrease So to compensate for every 1 mmol/l of increase HCO3, 0.07 mmhg of pco2 will increase. In Resp .Acidosis (PH - DECREAS Continue reading >>

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  1. martinus

    From http://hereditarian.wordpress.com/2013/01/05/327/, here is his TL;DR:
    I agree that leptin resistance is a downstream effect and plays no aetiological role in common obesity. I agree that VLC diets are the most clinically effective diets. I disagree that adaptive thermogenesis secondary to leptin insufficiency following significant weight reduction will not occur on a long-term ketogenic diet.

  2. gogge

    The idea that there's a "massive" reduction in metabolic rate above what's to be expected for weight loss doesn't seem to hold up when following the referenced studies. He cites Table 1 in this study:
    Rosenbaum M, Leibel RL "Adaptive thermogenesis in humans." Int J Obes (Lond). 2010 Oct;34 Suppl 1:S47-55. doi: 10.1038/ijo.2010.184.
    Which cites another paper, that states:
    Accordingly, 24-hour energy expenditure was estimated as the weight-stabilizing (+/- 50 g/d) daily caloric intake of a defined liquid diet in a cross-sectional study of ten reduced-obese subjects after a 23.2% +/- 9.4% weight loss and 18 obese subjects at baseline weight.
    ...
    In these six subjects the RMR was 97.4% +/- 7.5% of that predicted for the decreased FFM, suggesting that essentially all the energy savings relative to FFM in the reduced-obese state occurred in nonresting energy expenditure.
    Weigle DS, et al. "Weight loss leads to a marked decrease in nonresting energy expenditure in ambulatory human subjects" Metabolism. 1988 Oct;37(10):930-6.
    So the RMR didn't change much (which is in line with other studies), just the energy expended on activity. So the "metabolic crash" doesn't affect REE, just activity level? This does sound a bit strange. Looking at how they determine the total energy expenditure leaves some questions on the validity of that measure:
    Accordingly, 24-hour energy expenditure was estimated as the weight-stabilizing (+/- 50 g/d) daily caloric intake of a defined liquid diet in a cross-sectional study of ten reduced-obese subjects after a 23.2% +/- 9.4% weight loss and 18 obese subjects at baseline weight.
    He also says:
    "Credit where credit is due, his classic NEJM paper showed the devastating metabolic burnout following weight loss before the role of leptin in all this was elucidated, proving that it wasn’t just gluttony, stupidity and return of “bad habits” (you mean eating to satiety?) that led to weight regain."
    This "devastating metabolic burnout" in the paper he refers to is a drop of 137 kcal over expected values in one group dropping 10% weight, in the group dropping 20% it's only 79 kcal. For the non-obese this drop is 54 kcal.
    Table.
    He seems to have some personal experience bias affecting his conclusions. And the effect on metabolic rate seems to be around 5-10% at most, and it's not clear how long or even if this persists. And I didn't see any studies showing the effect of ketogenic diets on this, other studies seem to speculate that the fat regain is based on impaired fat metabolism which keto or exercise might be able to help with.

  3. gupe

    Interesting article but a bit depressing regarding the difficulty of maintaining weight-loss over the long-term on a ketogenic diet: the author states that similar metabolic slow-downs and associated lethargy can be expected as in any other weight-loss diets.
    I for one have been at my goal weight for months and haven't experienced any problems like dips in energy.
    It would be good to see further proper studies done regarding this.

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What is BASAL METABOLIC RATE? What does BASAL METABOLIC RATE mean? BASAL METABOLIC RATE meaning - BASAL METABOLIC RATE definition - BASAL METABOLIC RATE explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. Basal metabolic rate (BMR) is the minimal rate of energy expenditure per unit time by endothermic animals at rest. It is reported in energy units per unit time ranging from watt (joule/second) to ml O2/min or joule per hour per kg body mass J/(hkg)). Proper measurement requires a strict set of criteria be met. These criteria include being in a physically and psychologically undisturbed state, in a thermally neutral environment, while in the post-absorptive state (i.e., not actively digesting food). In bradymetabolic animals, such as fish and reptiles, the equivalent term standard metabolic rate (SMR) is used. It follows the same criteria as BMR, but requires the documentation of the temperature at which the metabolic rate was measured. This makes BMR a variant of standard metabolic rate measurement that excludes the temperature data, a practice that has led to problems in defining "standard" rates of metabolism for many mammals. Metabolism comprises the processes that the body needs to function. Basal metabolic rate is the amount of energy expressed in calories that a person needs to keep the body functioning at rest. Some of those processes are breathing, blood circulation, controlling body temperature, cell growth, brain and nerve function, and contraction of muscles. Basal metabolic rate (BMR) affects the rate that a person burns calories and ultimately whether that individual maintains, gains, or loses weight. The basal metabolic rate accounts for about 60 to 75% of the daily calorie expenditure by individuals. It is influenced by several factors. BMR typically declines by 12% per decade after age 20, mostly due to loss of fat-free mass, although the variability between individuals is high. The body's generation of heat is known as thermogenesis and it can be measured to determine the amount of energy expended. BMR generally decreases with age and with the decrease in lean body mass (as may happen with aging). Increasing muscle mass has the effect of increasing BMR. Aerobic (resistance) fitness level, a product of cardiovascular exercise, while previously thought to have effect on BMR, has been shown in the 1990s not to correlate with BMR when adjusted for fat-free body mass. But anaerobic exercise does increase resting energy consumption (see "aerobic vs. anaerobic exercise"). Illness, previously consumed food and beverages, environmental temperature, and stress levels can affect one's overall energy expenditure as well as one's BMR. BMR is measured under very restrictive circumstances when a person is awake. An accurate BMR measurement requires that the person's sympathetic nervous system not be stimulated, a condition which requires complete rest. A more common measurement, which uses less strict criteria, is resting metabolic rate (RMR).

Metabolic Acidosis

Patient professional reference Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find one of our health articles more useful. See also separate Lactic Acidosis and Arterial Blood Gases - Indications and Interpretations articles. Description Metabolic acidosis is defined as an arterial blood pH <7.35 with plasma bicarbonate <22 mmol/L. Respiratory compensation occurs normally immediately, unless there is respiratory pathology. Pure metabolic acidosis is a term used to describe when there is not another primary acid-base derangement - ie there is not a mixed acid-base disorder. Compensation may be partial (very early in time course, limited by other acid-base derangements, or the acidosis exceeds the maximum compensation possible) or full. The Winter formula can be helpful here - the formula allows calculation of the expected compensating pCO2: If the measured pCO2 is >expected pCO2 then additional respiratory acidosis may also be present. It is important to remember that metabolic acidosis is not a diagnosis; rather, it is a metabolic derangement that in Continue reading >>

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  1. BobbyS

    Can insulin resistance truly be reversed?

    I'm a bit unclear on what "insulin resistance reversal" or "diabetes reversal" really means.
    I was diagnosed as prediabetic about 3 weeks ago. I got a blood meter and my first test was postprandial and showed 191.
    I have been water fasting and eating LCHF since then...except for 3 days which is where I get the following info:
    It appears that "real food carbs" (e.g. carrots, onions, etc.) have virtually no effect on me. A meal with ~ 80 grams of real food carbs moved my blood glucose from 83 to 89.
    It also appears that eating LCHF keeps my blood glucose well < 100 but a single sugar/starch/refined flour meal will spike my blood sugar anywhere from 150 to 160 (I've eaten 2 such meals is where I get this data) and it takes a couple of days for my blood sugar to drop back below 100 (at least at my "dawn phenomenon" readings).
    Is "insulin resistance reversal" truly possible or can insulin resistance only be managed as long as sugar/starch/refined is avoided like the plague?
    I know I can't go back to eating like I used to eat...but it would be nice to hope that one day I will be able to "splurge occasionally" and keep normal blood sugar numbers...

  2. qsefthuko

    You might. Some people can some people can't.

  3. qsefthuko

    Apparently LCHF causes a degree of insulin resistance or something. If you have been eating LCHF for a bit and then eat a carby meal it can and probably will raise you higher than you might expect.

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What is ALKALOSIS? What does ALKALOSIS mean? ALKALOSIS meaning - ALKALOSIS pronunciation - ALKALOSIS definition - ALKALOSIS explanation - How to pronounce ALKALOSIS? Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. SUBSCRIBE to our Google Earth flights channel - https://www.youtube.com/channel/UC6Uu... Alkalosis is the result of a process reducing hydrogen ion concentration of arterial blood plasma (alkalemia). In contrast to acidemia (serum pH 7.35 or lower), alkalemia occurs when the serum pH is higher than normal (7.45 or higher). Alkalosis is usually divided into the categories of respiratory alkalosis and metabolic alkalosis or a combined respiratory/metabolic alkalosis. Respiratory alkalosis is caused by hyperventilation, resulting in a loss of carbon dioxide. Compensatory mechanisms for this would include increased dissociation of the carbonic acid buffering intermediate into hydrogen ions, and the related excretion of bicarbonate, both of which lower blood pH. Hyperventilation-induced alkalosis can be seen in several deadly central nervous system diseases such as strokes or Rett syndrome. Metabolic alkalosis can be caused by repeated vomiting, resulting in a loss of hydrochloric acid within the stomach content. Severe dehydration, and the consumption of alkali are other causes. It can also be caused by administration of diuretics and endocrine disorders such as Cushing's syndrome. Compensatory mechanism for metabolic alkalosis involve slowed breathing by the lungs to increase serum carbon dioxide, a condition leaning toward respiratory acidosis. As respiratory acidosis often accompanies the compensation for metabolic alkalosis, and vice versa, a delicate balance is created between these two conditions. Metabolic alkalosis is usually accompanied by low blood potassium concentration, causing, e.g., muscular weakness, muscle pain, and muscle cramps (from disturbed function of the skeletal muscles), and muscle spasms (from disturbed function of smooth muscles). It may also cause low blood calcium concentration. As the blood pH increases, blood transport proteins, such as albumin, become more ionized into anions. This causes the free calcium present in blood to bind more strongly with albumin. If severe, it may cause tetany.

Metabolic Acidosis And Alkalosis

Page Index Metabolic Acidosis. Metabolic Alkalosis Emergency Therapy Treating Metabolic Acidosis Calculating the Dose Use Half the Calculated Dose Reasons to Limit the Bicarbonate Dose: Injected into Plasma Volume Fizzes with Acid Causes Respiratory Acidosis Raises Intracellular PCO2 Subsequent Residual Changes Metabolic Acidosis. The following is a brief summary. For additional information visit: E-Medicine (Christie Thomas) or Wikepedia Etiology: There are many causes of primary metabolic acidosis and they are commonly classified by the anion gap: Metabolic Acidosis with a Normal Anion Gap: Longstanding diarrhea (bicarbonate loss) Uretero-sigmoidostomy Pancreatic fistula Renal Tubular Acidosis Intoxication, e.g., ammonium chloride, acetazolamide, bile acid sequestrants Renal failure Metabolic Acidosis with an Elevated Anion Gap: lactic acidosis ketoacidosis chronic renal failure (accumulation of sulfates, phosphates, uric acid) intoxication, e.g., salicylates, ethanol, methanol, formaldehyde, ethylene glycol, paraldehyde, INH, toluene, sulfates, metformin. rhabdomyolysis For further details visit: E-Medicine (Christie Thomas). Treating Severe Metabolic Acidosis. The ideal treatme Continue reading >>

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  1. ItsCouldveNotCouldof

    So I get that with type 1 DM, the lack of insulin prevents the breakdown of glucose which leads the cells to look for other means of energy which are fats and proteins which in turn eventually turns into ketones. Ketones are acidic and using them for energy will eventually cause metabolic acidosis. The lungs will then compensate to get rid of CO2 which are acidic by doing kusmaul respiration.
    Why does kussmaul respiration occur specifically for this condition when the body usually compensates to metabolic acidosis by hyperventilating?

  2. auraseer

    Why does kussmaul respiration occur specifically for this condition when the body usually compensates to metabolic acidosis by hyperventilating?
    That is why. You seem to have typed out a decent explanation. I don't know what else you're asking.
    Kussmaul breathing is a type of hyperventilation characterized by breaths that are both rapid and deep. It is the response to any severe metabolic acidosis, of which DKA is the most common example. The body is responding to the low pH by increasing respiratory drive, attempting to blow off Co2 and thereby increase pH.

  3. ItsCouldveNotCouldof

    Thanks! I guess the better question would be why is it deeper respirations?

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