Saturday, October 31, 2009

Difference b/t Metaboloic & Respiratoray Alakosis & Acidosis?

I just graduated nursing school and am scheduled to take my nclex next wed the 15th. i have been practicing and studying thousands of questions the past couple weeks. i have noticed a lot of questions relating to metabolic acidosis and alkalosis and respiratory acidosis and alkalosis. Can anyone please explain to me the difference b/t them and help me better understand it better. After a while it just all seems to sound the same. Thanks
Answer:
Ok the guys ahaead of me did a preatty good job of telling you what it is..here is how to remember it...first you will have to know the ranges...
Respiratory Reversal...that the HCO3 and CO2 will be reversed of the pH.
acidosis...low ph, high HCO3 and High CO2
alkaloisi...high pH, Low HCO3 and Low CO2
Metabolic March...all three will be in the same direction...
Acidosis...low pH, low HCO3, Low CO2
Alkalosis..High pH, Hich HCO3, High CO2
so good luck
Before you tackle NCLEX, you should be murmuring "Henderson-Hasselbach" in your sleep.
As you know, normal pH is about 7.40. A pH of 7.30 or lower is a significant acidosis, and 7.50 or higher alkalosis. The main buffering system is among water and carbon dioxide, hydrogen and bicarbonate ions, and carbonic acid. Note that the pKa of the system is about 6.1, but it isn't a closed system. you blow off carbon dioxide with every breath.
The partial pressure of carbon dioxide in the blood runs about 40. Blowing off carbon dioxide tends to shift the pH to the basic side, so hyperventilation causes a metabolic acidosis primarily, and the same hard breathing as with Kussmaul respirations causes a partial compensation against metabolic acidosis.
Hypoventilation as with advanced lung disease or central nervous system depression (often from narcotic use or from head trauma) causes the carbon dioxide levels to rise, resulting in a respiratory acidosis. Note that there is no compensatory hypoventilation to compensate for metabolic alkalosis.
Metabolic acidosis is usually caused by endogenous production of acids, often from anaerobic metabolism, and as noted above is normally accompanied by a partial compensation. It's pretty quick and easy to drop the PCO2 by breathing hard.
Metabolic alkalosis is often a spurious and insignificant finding in people on diuretic therapy.
Note that some people with advanced COPD will have a chronic respiratory acidosis (CO2 "retainers"), and it takes some time, but there can be a metabolic compensation.
The term Alkalosis indicates an increase of the pH of the blood; Acidosis indicates its decrease. The term Respiratory indicates that the reason of the pH variation is an alteration of the levels of carbon dioxide in the blood: in particular, a reduction of the levels of carbon dioxide (as for polypnea)causes Respiratory Alkalosis; an increased level of carbon dioxide (as for hypopnea) causes Respiratory Acidosis. Instead, Metabolic Acidosis is caused by either an increase of acid compounds in the blood or a reduced loss of H+ and acid compounds with urination or diarrhaea; Metabolic Alkalosis is provoked by either a loss of acid compounds (ex. vomitation) or (rare) increase of basic compounds.

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