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How to Interpret Acid Base Disorders

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How to Interpret Acid Base Disorders

How to Interpret Acid Base Disorders

Interpreting the Acidic-lemon and Baking-soda-base with a Disorder
Picmonic
Interpreting Acid-Base disorders is an essential nursing skill that involves a three-step process: checking the pH, partial pressure of carbon dioxide in the blood (pCO₂), and bicarbonate levels (HCO₃). These indicators will allow you to determine the type of disorder.
12 KEY FACTS
pH, pCO₂, HCO₃ (Bicarbonate)
pH-strip, Partial-pressure-gauge CO₂, and Bi-car-bomb

Mastering quick interpretation of acid-base lab values is a key element to the success of the Nurse. Three components are included in typical lab value assessment: pH, pCO₂, and HCO₃ (Bicarbonate).

STEP 1
pH
pH-strip

The first step to acid-base lab value interpretation is to look at pH. Blood pH is normally 7.35-7.45. pH is determined by the amount of hydrogen ions contained in the blood.

Acidosis
Acidic-lemon

A pH of less than 7.35 is termed acidosis. Acidosis indicates a buildup of carbonic acid in the blood.

Alkalosis
Elk-loser

A pH higher than 7.45 is termed alkalosis. Alkalosis indicates a buildup of bicarbonate (bases) and/or a general decrease in carbonic acid in the blood.

STEP 2
pCO₂
Partial-pressure-gauge CO₂

The second step is to examine the partial pressure of carbon dioxide in the blood. pCO₂ is normally 35-45 mmHg and is regulated primarily through respiration.

Opposite Direction as pH
Showing the Opposite Direction on pH-strip

Opposite Respiratory and pH directions indicate a respiratory disorder. If the pCO₂ is not in the opposite direction of the pH, then check the HCO₃ next.

Respiratory Acidosis
Respirator Acidic-lemon

Respiratory acidosis is often indicated by a pH of less than 7.35 and a pCO₂ of higher than 45 mmHg.

Respiratory Alkalosis
Respirator Elk-loser

Respiratory Alkalosis is indicated by a pH of more than 7.45 and a pCO₂ of less than 35 mmHg.

STEP 3
HCO₃ (Bicarbonate)
Bi-car-bomb

The normal value of bicarbonate is 22-26 mmol/L. The amount of the base HCO₃, bicarbonate, in the blood is regulated in the kidneys.

Same Direction as pH
Showing the Same Direction as pH-strip

If the HCO₃ (bicarbonate) is going in the same direction as pH, then the problem is most likely a metabolic problem.

Metabolic Acidosis
Metal-ball Acidic-lemon

The patient with Metabolic acidosis can grossly be determined as Down, Down, Down (Decreased pH, Decreased pCO₂, Decreased HCO₃).

Metabolic Alkalosis
Metal-ball Elk-loser

Metabolic alkalosis can grossly be determined as UP, UP, UP (Increased pH, Increased pCO₂, Increased HCO₃).

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