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Metabolic Acidosis Pco2

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Rules For Respiratory Acid-base Disorders

Rule 1 : The 1 for 10 Rule for Acute Respiratory Acidosis * For every 10 mmHg increase in pCO2 (above 40 mmHg) Comment:The increase in CO2 shifts the equilibrium between CO2 and HCO3 to result in an acute increase in HCO3. This is a simple physicochemical event and occurs almost immediately. Example: A patient with an acute respiratory acidosis (pCO2 60mmHg) has an actual [HCO3] of 31mmol/l. The expected [HCO3] for this acute elevation of pCO2 is 24 + 2 = 26mmol/l. The actual measured value is higher than this indicating that a metabolic alkalosis must also be present. Rule 2 : The 4 for 10 Rule for Chronic Respiratory Acidosis The [HCO3] will increase by 4 mmol/l for every 10 mmHg elevation in pCO2 above 40mmHg. Expected [HCO3] = 24 + 4 { (Actual pCO2 - 40) / 10} Comment: With chronic acidosis, the kidneys respond by retaining HCO3, that is, renal compensation occurs. This takes a few days to reach its maximal value. Example: A patient with a chronic respiratory acidosis (pCO2 60mmHg) has an actual [HCO3] of 31mmol/l. The expected [HCO3] for this chronic elevation of pCO2 is 24 + 8 = 32mmol/l. The actual measured value is extremely close to this so renal compensation is maximal a Continue reading >>

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Popular Questions

  1. sonias

    3 This is my topic for this week in nursing school, respiratory & metabolic acidosis/ alkalosis. I am having trouble breaking it down. Can someone please help me understand this please? Any and all help is greatly appreciated.

  2. Esme12

    Normal values:
    PH = 7.35 - 7.45
    C02 = 35 - 45
    HC03 = 21-26
    Respiratory acidosis = low ph and high C02
    hypoventilation (eg: COPD, narcs or sedatives, atelectasis)
    *Compensated by metabolic alkalosis (increased HC03)
    For example:
    ph 7.20 C02 60 HC03 24 (uncompensated respiratory acidosis)
    ph 7.33 C02 55 HC03 29 (partially compensated respiratory acidosis)
    ph 7.37 C02 60 HC03 37 (compensated respiratory acidosis)
    Respiratory alkalosis : high ph and low C02
    hyperventilation (eg: anxiety, PE, pain, sepsis, brain injury)
    *Compensated by metabolic acidosis (decreased HC03)
    examples:
    ph 7.51 C02 26 HC03 25 (uncompensated respiratory alkalosis)
    ph 7.47 C02 32 HC03 20 (partially compensated respiratory alkalosis)
    ph 7.43 C02 30 HC03 19 (compensated respiratory alkalosis)
    Metabolic acidosis : low ph and low HC03
    diabetic ketoacidosis, starvation, severe diarrhea
    *Compensated by respiratory alkalosis (decreased C02)
    examples:
    ph 7.23 C02 36 HC03 14 (uncompensated metabolic acidosis)
    ph 7.31 C02 30 HC03 17 (partially compensated metabolic acidosis)
    ph 7.38 C02 26 HC03 20 (compensated metabolic acidosis)
    Metabloic alkalosis = high ph and high HC03
    severe vomiting, potassium deficit, diuretics
    *Compensated by respiratory acidosis (increased C02)
    example:
    ph 7.54 C02 44 HC03 29 (uncompensated metabolic alkalosis)
    ph 7.50 C02 49 HC03 32 (partially compensated metabolic alkalosis)
    ph 7.44 C02 52 HC02 35 (compensated metabolic alkalosis)
    *Remember that compensation corrects the ph.
    Now a simple way to remember this......
    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<7.35 = acidosis
    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).
    Here is 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.

  3. Esme12

    Check out this tutorial
    Interactive Online ABG's acid base

  4. -> Continue reading
read more
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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 mamma

Metabolic Acidosis Flashcards | Quizlet

pH = pKa(6.10) + log([HCO3-]/(0.03 x PCO2)) Will cause a respiratory compensation that causes the PCO2 to change in the *same direction* as the serum HCO3 to mitigate the change in pH The renal compensation will cause the HCO3 to change in the *same direction* as the PCO2 to lessen the pH change Will compensation return the arterial pH to normal? No. *A normal pH with an abnormal pCO2 and HCO3 indicates the presence of a mixed disorder* How do we know if there is a mixed or single disorder? If the change in HCO3 or PCO2 is less or more than would be expected as compensation then there is a mixed acid/base disorder present. Compensatory responses in chronic states: Compensatory responses can return the pH to a high-normal range with chronic respiratory alkalosis and to a low-normal range with chronic respiratory acidosis. What is the respiratory compensation in Metabolic Acidosis? For every *1 mEq/L* decrease in HCO3, we will get a *1.2 mmHG* decrease in PCO2 *arterial PCO2 should be similar to the decimal digits of the arterial pH. For example, if the serum bicarb is 11 and the arterial pH is 7.25, the arterial pCO2 should be 25. The degree to which the anion gap rises in relation Continue reading >>

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Popular Questions

  1. sonias

    3 This is my topic for this week in nursing school, respiratory & metabolic acidosis/ alkalosis. I am having trouble breaking it down. Can someone please help me understand this please? Any and all help is greatly appreciated.

  2. Esme12

    Normal values:
    PH = 7.35 - 7.45
    C02 = 35 - 45
    HC03 = 21-26
    Respiratory acidosis = low ph and high C02
    hypoventilation (eg: COPD, narcs or sedatives, atelectasis)
    *Compensated by metabolic alkalosis (increased HC03)
    For example:
    ph 7.20 C02 60 HC03 24 (uncompensated respiratory acidosis)
    ph 7.33 C02 55 HC03 29 (partially compensated respiratory acidosis)
    ph 7.37 C02 60 HC03 37 (compensated respiratory acidosis)
    Respiratory alkalosis : high ph and low C02
    hyperventilation (eg: anxiety, PE, pain, sepsis, brain injury)
    *Compensated by metabolic acidosis (decreased HC03)
    examples:
    ph 7.51 C02 26 HC03 25 (uncompensated respiratory alkalosis)
    ph 7.47 C02 32 HC03 20 (partially compensated respiratory alkalosis)
    ph 7.43 C02 30 HC03 19 (compensated respiratory alkalosis)
    Metabolic acidosis : low ph and low HC03
    diabetic ketoacidosis, starvation, severe diarrhea
    *Compensated by respiratory alkalosis (decreased C02)
    examples:
    ph 7.23 C02 36 HC03 14 (uncompensated metabolic acidosis)
    ph 7.31 C02 30 HC03 17 (partially compensated metabolic acidosis)
    ph 7.38 C02 26 HC03 20 (compensated metabolic acidosis)
    Metabloic alkalosis = high ph and high HC03
    severe vomiting, potassium deficit, diuretics
    *Compensated by respiratory acidosis (increased C02)
    example:
    ph 7.54 C02 44 HC03 29 (uncompensated metabolic alkalosis)
    ph 7.50 C02 49 HC03 32 (partially compensated metabolic alkalosis)
    ph 7.44 C02 52 HC02 35 (compensated metabolic alkalosis)
    *Remember that compensation corrects the ph.
    Now a simple way to remember this......
    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<7.35 = acidosis
    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).
    Here is 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.

  3. Esme12

    Check out this tutorial
    Interactive Online ABG's acid base

  4. -> Continue reading
read more
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Pco2 And [k+]p In Metabolic Acidosis: Certainty For The First And Uncertainty For The Other

PCO2 and [K+]p in Metabolic Acidosis: Certainty for the First and Uncertainty for the Other *Department of Medicine, Renal Section, Baylor College of Medicine, The Methodist Hospital, and Veterans Affairs Medical Center, Houston, Texas; and Department of Medicine, Tufts University School of Medicine, Division of Nephrology, Caritas St. Elizabeths Medical Center, Boston, Massachusetts. Correspondence to Dr. Nicolaos E. Madias, Department of Medicine, Tufts University School of Medicine, Division of Nephrology, Caritas St. Elizabeths Medical Center, 736 Cambridge St., Boston, MA 02135. Phone: 617-562-7502; Fax: 617-562-7797; E-mail: nicolaos_madias{at}cchcs.org Studies by Schwartz and colleagues at Tufts University School of Medicine in the 1960s described the whole-body acid-base response (i.e., secondary changes in plasma [HCO3] to graded degrees of acute respiratory acidosis and acute respiratory alkalosis in humans ( 1,2 ). Corresponding data for acute metabolic acid-base disorders (i.e., secondary changes in PaCO2) are essentially unavailable: meager observations have been made in acute metabolic alkalosis, and no data exist for acute metabolic acidosis. The report by Wiedersei Continue reading >>

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Popular Questions

  1. sonias

    3 This is my topic for this week in nursing school, respiratory & metabolic acidosis/ alkalosis. I am having trouble breaking it down. Can someone please help me understand this please? Any and all help is greatly appreciated.

  2. Esme12

    Normal values:
    PH = 7.35 - 7.45
    C02 = 35 - 45
    HC03 = 21-26
    Respiratory acidosis = low ph and high C02
    hypoventilation (eg: COPD, narcs or sedatives, atelectasis)
    *Compensated by metabolic alkalosis (increased HC03)
    For example:
    ph 7.20 C02 60 HC03 24 (uncompensated respiratory acidosis)
    ph 7.33 C02 55 HC03 29 (partially compensated respiratory acidosis)
    ph 7.37 C02 60 HC03 37 (compensated respiratory acidosis)
    Respiratory alkalosis : high ph and low C02
    hyperventilation (eg: anxiety, PE, pain, sepsis, brain injury)
    *Compensated by metabolic acidosis (decreased HC03)
    examples:
    ph 7.51 C02 26 HC03 25 (uncompensated respiratory alkalosis)
    ph 7.47 C02 32 HC03 20 (partially compensated respiratory alkalosis)
    ph 7.43 C02 30 HC03 19 (compensated respiratory alkalosis)
    Metabolic acidosis : low ph and low HC03
    diabetic ketoacidosis, starvation, severe diarrhea
    *Compensated by respiratory alkalosis (decreased C02)
    examples:
    ph 7.23 C02 36 HC03 14 (uncompensated metabolic acidosis)
    ph 7.31 C02 30 HC03 17 (partially compensated metabolic acidosis)
    ph 7.38 C02 26 HC03 20 (compensated metabolic acidosis)
    Metabloic alkalosis = high ph and high HC03
    severe vomiting, potassium deficit, diuretics
    *Compensated by respiratory acidosis (increased C02)
    example:
    ph 7.54 C02 44 HC03 29 (uncompensated metabolic alkalosis)
    ph 7.50 C02 49 HC03 32 (partially compensated metabolic alkalosis)
    ph 7.44 C02 52 HC02 35 (compensated metabolic alkalosis)
    *Remember that compensation corrects the ph.
    Now a simple way to remember this......
    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<7.35 = acidosis
    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).
    Here is 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.

  3. Esme12

    Check out this tutorial
    Interactive Online ABG's acid base

  4. -> Continue reading
read more

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