For each of the following sets of blood values, name the acid-base imbalance (acidosis or alkalo

For each of the following sets of blood values, name the...

Key Concepts

Compensatory Mechanisms

The body employs compensatory responses to counteract primary acid-base disturbances. In metabolic disorders, respiratory compensation occurs as the lungs adjust the rate and depth of breathing to modify carbon dioxide levels, while in respiratory disorders, the kidneys adjust bicarbonate reabsorption and hydrogen ion secretion to help normalize pH. The presence and degree of compensation provide important clues about the chronicity and severity of the disorder.

Differentiating Metabolic and Respiratory Imbalances

Acid-base disturbances are primarily classified into metabolic or respiratory origins. Metabolic imbalances are characterized by alterations in bicarbonate levels due to renal dysfunction, ingestion of toxins, or other metabolic processes, whereas respiratory imbalances result from changes in carbon dioxide levels due to issues with ventilation or lung function. The direction of change in pH combined with the altered value of either pCO2 or bicarbonate helps in identifying the primary disorder.

Acid-Base Homeostasis

This concept involves the regulation of blood pH within a narrow range essential for normal cellular functions. The balance of acids and bases is maintained through buffers in the blood, as well as respiratory and renal mechanisms that adjust the levels of carbon dioxide (a volatile acid) and bicarbonate (a base), respectively. An imbalance in this system results in conditions known as acidosis or alkalosis.

Transcript

0:00 Hello everyone.

00:01 Today i will be reviewing how to evaluate lab values and determine if the patient is in astidosis or alkalosis and also how to determine the cost of this acid base imbalance.

01:06 Now to be able to interpret lab values, we need to know the normal lab value ranges.

01:13 So i am going to, upload a picture of the lab values.

01:22 So it makes it a little bit easier.

01:40 That way we have that information on hand in case you do not remember.

01:44 But it is very important to remember the normal lab values to quickly determine and interpret if the patient is inacidosis or alkalosis.

01:58 So we have the lab values here.

02:01 And i am going to go step by step on the things that you have to, the steps that you have to take in order to determine if the patient is an acidosis or alkalosis and the cause of this acid base imbalance.

02:16 So the first step is to look at the ph and this will quickly tell you if the patient is an acidosis or alkylosis.

02:26 So the first step is to note the, ph.

02:36 So if we look here at the normal ranges in plasma, the normal range of ph is between 7 .35 to 7 .45.

02:49 So in acidosis, we will have a ph below 7 .35.

03:13 And in alkalosis, ph is above 7 .45.

03:23 So once we look at that ph, we will quickly know if it's acidosis or alkalosis.

03:31 Now, the next step would be to check the pco2.

03:42 Now, when we check the pco2 to see if this is causing the acid -based imbalance, the pco2 may indicate that the respiratory system is either causing the condition or compensating for it.

03:58 So, for example, if the ph indicates acidosis and the pco2 is over 45 millimeters of mercury, then the respiratory system is the cause of the problem and the condition is respiratory acidosis.

04:17 Now, if we had the contrary where the pco2 is below the normal limits, in this case, it's below 35, then the respiratory system is not causing the acidity.

04:30 The acidosis, but it is compensating for it.

04:35 Now, if the pco2 is within normal limits, then the condition is neither caused nor compensated by the respiratory system.

04:43 So that would be, it would mean a person in acidosis with a ph of below 7 .35 and a pco2 within normal limit, then it would be metabolic acidosis and the respiratory system.

05:00 System is not compensated for it.

05:08 So if we have co2 4545 universe of mercury respiratory system is the cost pco2 below 35 respiratory system is not the cost p .c .o .2 normal but compensating.

06:52 And this is if there was acidosis.

07:02 We would look at these values.

07:03 So we see that a value, ph value less than 7 .35, that is acidosis.

07:13 So we have to see what the cost of this acidosis is.

07:18 So if we want to know if it's the acidosis is respiratory acidosis, we look at the pco2.

07:25 Above 45, the respiratory system is the cost.

07:30 A pco2 below 35, the respiratory system is not the cost, but it's low.

07:36 So that means that the respiratory system is trying to compensate.

07:39 Now, a normal pco2 in acidosis, the respiratory system is not the cost, nor is it trying to compensate.

07:49 Now, the third step, would be to check the bicarbonate level.

08:11 So if step two proves that the respiratory system is not responsible for the imbalance, then the condition is metabolic, like i had mentioned before, and should be reflected in increased or decreased bicarbonate levels.

08:28 So bicarbonate values below 22 indicate metabolic acidosis, and values over 26.

08:37 Indicate metabolic acylosis.

08:40 And notice that whereas co2 levels vary inversely with blood ph, so pco2 rises that blood ph falls, bicarp levels vary directly with blood ph.

08:57 So increased bicarb levels result in increase ph and vice versa.

09:05 Decrease ph results, you will notice decreased bicarb levels.

09:15 I hope that makes sense...

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