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Metabolic Acidosis Lab Values

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10 arterial blood gas problems worked using the tic-tac-toe method.

Abg (arterial Blood Gas) Practice Quizzes With Tic Tac Toe Method

ABG (Arterial Blood Gas) Practice Quizzes with Tic Tac Toe Method This ABG practice quiz has 10 questions that will test your knowledge about metabolic and respiratory disorders. In addition, you will be tested on if the disorder is partially compensated or uncompensated based on the lab values. In order to easily solve arterial blood gas problems, the Tic Tac Toe method is the best way for doing this. If you are unfamiliar with the Tic Tac Toe method for ABGs to read the recommended article to learn how to do it. This ABG practice test will examine your knowledge about respiratory and metabolic disorders when interpreting lab values. 1. Lab values: pH 7.56, paCo2 20, HCO3 20* 2. Lab values: pH 7.23, paCo2 37, HCO3 18* 3. Lab values: pH 7.31, paCo2 34, HCO3 21* 4. Lab values: pH 7.50, paCo2 32, HCO3 24* 5. Lab values: pH 7.46, paCo2 36, HCO3 32* 6. Lab values: pH 7.52, paCo2 48, HCO3 28* 7. Lab values: pH 7.25, paCo2 60, HCO3 27* 8. Lab values: pH 7.55, paCo2 47, HCO3 30* 9. Lab values: pH 7.20, paCo2 49, HCO3 25* 10. Lab values: pH 7.30, paCo2 36, HCO3 16* 11. Lab values: pH 7.41, paCo2 26, HCO3 17* 12. Lab values: pH 7.39, paCo2 48, HCO3 28* Dont forget to tell your friends abou Continue reading >>

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  1. sweetsarabear

    High blood sugar

    Does anybody eles out there in diabetes land feel this way when your blood sugar is high ?
    My joints get so painful and achy its an effort to move. I asked my doctor about this and he said its just one of those things that comes with high blood sugar.
    Thanks
    Joanna

  2. NottsLad

    mine feel exactly the same....
    worse in my legs though... when i know im going high and should take some insulin!

  3. Bellasgramma

    Wow, I did not know that. Have had about 200 or more for the last 3 or 4 days, every test, and also felt like the flu was coming on. I knew the shoulder pain was associated with diabetes but not the rest. That explains it.
    Fasting this morning was back to 90, and felt good, still do, so maybe...
    Anyway, time to talk to doc about meds adjustment Maybe that would help you as well??

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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":

Lab Values: Abgs, Electrolytes, Acid Base Balance, Metabolic Panel, Cbc, Coagulation

PaCO2: 35-45 mmHg (Respiratory component) PaO2: 80-100 mmHg (Respiratory component) Serum bicarbonate HCO3-: 22-26 mEq/L (Metabolic Component) Acidosis: < 7.35: H+ diffuses into cells and drives out K+, elevating K+ concentration in ECF Alkalosis: >7.45: H+ diffuses out of cells and K+ diffuses in Respiratory Regulation of Acid Base Balance: - Eliminating or retaining CO2 by the lungs also regulates acid-base balance. - The response is rapid, occur within minutes by altering the rate and depth of respiration - CO2 is a powerful stimulator of the respiratory system - Increasing ventilation increases pH by eliminating CO2 - Decreasing ventilation decreases pH by retaining CO2. - An acute rise in PCO2 is a powerful stimulant to respiration Renal (Metabolic) Regulation of Acid Base Balance: - The ultimate long-term regulator of acid-base balance - Slower to respond, but response is more permanent and selective - Maintain acid-base balance by excreting or conserving bicarbonate and hydrogen ions - When pH decreases, H+ ions are excreted, and HCO3- ions are formed and retained. - When pH increases, H+ are retained, and HCO3- are excreted - Excess loss of bicarbonate via kidneys/GI Continue reading >>

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  1. GMX

    I've been ketoing now almost 5 weeks but have been struggling to get my fasting blood glucose down. This morning my blood ketones registered at .8 but my blood glucose was 122. I'm eating about 90-100g protein a day but I weigh 217. Is it still just too much protein? Carb intake is negligible. Fat intake is probably 250g a day. Any thoughts? Thanks.

  2. Mare

    For your weight, that does not seem like a lot of protein to me. I weigh 145, and I've calculated my minimum protein at 60g and can go as high as 100g.
    As to blood glucose, there's a phenomenon with ketosis where fasting BG is elevated, but it is benign. Peter at Hyperlipid had a post on his blog some time ago that provided the science behind this, but I could not follow it. This may be what you're experiencing.

    My endo told me that this is true, and he goes by my A1C rather than my fasting because of this.

  3. carolT

    Protein could be lower if you are female (sorry, can't tell) and/or not exercising, but the ketone level indicates you are accessing some fat overnight.

    Have you taken glucose readings at night or before your main meal? Are they lower? You may be experiencing "dawn phenomenon" where glucose is higher in the morning because 1.) the same hormones that wake you up also give you some extra glucose to start the day or 2.) your glucose dropped overnight and your body reacts by making more of it. Also, if you happen to get up in the middle of the night, you could see what your glucose is doing before your normal waking time.

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Anion gap usmle - anion gap metabolic acidosis normal anion gap metabolic acidosis

Metabolic Acidosis - Endocrine And Metabolic Disorders - Merck Manuals Professional Edition

(Video) Overview of Acid-Base Maps and Compensatory Mechanisms By James L. Lewis, III, MD, Attending Physician, Brookwood Baptist Health and Saint Vincent’s Ascension Health, Birmingham Metabolic acidosis is primary reduction in bicarbonate (HCO3−), typically with compensatory reduction in carbon dioxide partial pressure (Pco2); pH may be markedly low or slightly subnormal. Metabolic acidoses are categorized as high or normal anion gap based on the presence or absence of unmeasured anions in serum. Causes include accumulation of ketones and lactic acid, renal failure, and drug or toxin ingestion (high anion gap) and GI or renal HCO3− loss (normal anion gap). Symptoms and signs in severe cases include nausea and vomiting, lethargy, and hyperpnea. Diagnosis is clinical and with ABG and serum electrolyte measurement. The cause is treated; IV sodium bicarbonate may be indicated when pH is very low. Metabolic acidosis is acid accumulation due to Increased acid production or acid ingestion Acidemia (arterial pH < 7.35) results when acid load overwhelms respiratory compensation. Causes are classified by their effect on the anion gap (see The Anion Gap and see Table: Causes of Metab Continue reading >>

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  1. manohman

    Why can't fat be converted into Glucose?

    So the reason cited is that beta oxidation/metabolism of fats leads to formation of acetyl coa, a 2 carbon molecule, and that because of that it cannot be converted back into glucose.
    Why exactly is that the case?
    If Glucogenic amino acids can be converted into citric acid cycle intermediates and then turn back into glucose via gluconeogensis, then why cant Fatty Acids which yield Acetyl Coa. Can't you just have Acetyl Coa enter the citric acid cycle and produce the same intermediates that the glucogenic amino acids creat?

  2. Czarcasm

    manohman said: ↑
    So the reason cited is that beta oxidation/metabolism of fats leads to formation of acetyl coa, a 2 carbon molecule, and that because of that it cannot be converted back into glucose.
    Why exactly is that the case?
    If Glucogenic amino acids can be converted into citric acid cycle intermediates and then turn back into glucose via gluconeogensis, then why cant Fatty Acids which yield Acetyl Coa. Can't you just have Acetyl Coa enter the citric acid cycle and produce the same intermediates that the glucogenic amino acids creat?
    Click to expand... Both glucose and fatty acids can be stored in the body as either glycogen for glucose (stored mainly in the liver or skeletal cells) or for FA's, as triacylglycerides (stored in adipose cells). We cannot store excess protein. It's either used to make other proteins, or flushed out of the body if in excess; that's generally the case but we try to make use of some of that energy instead of throwing it all away.
    When a person is deprived of nutrition for a period of time and glycogen stores are depleted, the body will immediately seek out alternative energy sources. Fats (stored for use) are the first priority over protein (which requires the breakdown of tissues such as muscle). We can mobilize these FA's to the liver and convert them to Acetyl-CoA to be used in the TCA cycle and generate much needed energy. On the contrary, when a person eats in excess (a fatty meal high in protein), it's more efficient to store fatty acids as TAG's over glycogen simply because glycogen is extremely hydrophilic and attracts excess water weight; fatty acids are largely stored anhydrously and so you essentially get more bang for your buck. This is evolutionary significant and why birds are able to stay light weight but fly for periods at a time, or why bears are able to hibernate for months at a time. Proteins on the other hand may be used anabolically to build up active tissues (such as when your working out those muscles), unless you live a sedentary lifestyle (less anabolism and therefore, less use of the proteins). As part of the excretion process, protein must be broken down to urea to avoid toxic ammonia and in doing so, the Liver can extract some of that usable energy for storage as glycogen.
    Also, it is worth noting that it is indeed possible to convert FA's to glucose but the pathway can be a little complex and so in terms of energy storage, is not very efficient. The process involves converting Acetyl-CoA to Acetone (transported out of mitochondria to cytosol) where it's converted to Pyruvate which can then be used in the Gluconeogenesis pathway to make Glucose and eventually stored as Glycogen. Have a look for yourself if your interested: http://www.ploscompbiol.org/article/info:doi/10.1371/journal.pcbi.1002116.g003/originalimage (and this excludes the whole glycogenesis pathway, which hasn't even begun yet).
    TLDR: it's because proteins have no ability to be stored in the body, but we can convert them to glycogen for storage during the breakdown process for excretion. Also, in terms of energy, it's a more efficient process than converting FA's to glycogen for storage.

  3. soccerman93

    This is where biochem comes in handy. Czarcasm gives a really good in depth answer, but a simpler approach is to count carbons. The first step of gluconeogenesis(formation of glucose) requires pyruvate, a 3 carbon molecule. Acetyl Co-A is a 2 carbon molecule, and most animals lack the enzymes (malate synthase and isocitrate lyase) required to convert acetyl co-A into a 3 carbon molecule suitable for the gluconeogenesis pathway. The ketogenic pathway is not efficient, as czarcasm pointed out. While acetyl co-A can indeed be used to form citric acid intermediates, these intermediates will be used in forming ATP, not glucose. Fatty acid oxidation does not yield suitable amounts of pyruvate, which is required for gluconeogenesis. This is part of why losing weight is fairly difficult for those that are overweight, we can't efficiently directly convert fat to glucose, which we need a fairly constant supply of. Sorry, that got a little long-winded

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