Renal #5 (Acid Base Disorders)

Question 1

What are the normal values for the following things:
-pH:
-PCO2:
-HCO3:
-Anion Gap:

Answer 1

-Ph: 7.35-7.45
PCO2: 35-45
HCO3: 22-26
Anion Gap: 10-12

Question 2

What is the first step in determining the acid base disorder?

Answer 2

Look at the pH

-If < 7.35: Acidosis
-If > 7.45: Alkalosis

Question 3

Then, look at PCO2. How do you determine what is what?

Answer 3

If PCO2 is in the opposite direction as pH = respiratory

Question 4

Then look at HCO3. How do you determine what is what?

Answer 4

If HCO3 is in the same direction as pH = metabolic

Question 5

What acronym should you remember for this?

Answer 5

ROME
-Respiratory opposite, Metabolic equal

Question 6

Only if the patient is in _______ should you calculate anion gap. How do you do this?

What does compensated mean?

Answer 6

-Metabolic acidosis

Na - (Cl + HCO3)

> 2 = compensated

Question 7

What are some causes of metabolic acidosis?

Answer 7

-Anion Gap: DKA, Methanol, Isoniazid, Renal Failure
-Non Anion Gap: Acetazolamide, Diarrhea

Question 8

What are some causes of metabolic alkalosis?

Answer 8

-Vomiting/NG suction, diarrhea, loop diuretics

Question 9

What are some causes of respiratory acidosis?

Answer 9

-CNS depression (opioids, sedatives, trauma), PNA, CVA
-COPD, obesity, myasthenia gravis, Guillan-Barre Syndrome

Question 10

What are some causes of respiratory alkalosis?

Answer 10

Hyperventilation: Pain, anxiety, pregnancy, hepatic failure, PNA, asthma