First you have to decide whether the situation you are seeing is acidosis or

First you have to decide whether the situation you

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First you have to decide whether the situation you are seeing is acidosis or alkalosis Next you have to figure out whether it is respiratory or nonrespiratory. If the CO 2 levels agree with the pH it will be called “respiratory” If the CO 2 levels do not “agree with” (or explain) the pH then it will be called “nonrespiratory” or “metabolic”
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Bicarbonate Levels You can also check bicarbonate levels when investigating the cause of an acid-base imbalance. Bicarbonate is a base so the pH should vary directly with the bicarbonate levels if the bicarbonate is causing the problems (i.e., low pH with low bicarbonate levels and high pH with high bicarbonate levels)
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Bicarbonate Ion and pH, Example 1. In severe diarrhea there is a loss of bicarbonate and this loss of base creates a low pH. This is not caused by excess CO 2 so it is not a respiratory acidosis rather this is a case of metabolic acidosis. A cure for this problem, besides stopping the diarrhea, is to provide intravenous bicarbonate. CO 2 + H 2 O H 2 CO 3 H + HCO 3 - +
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Bicarb and pH, Example 2 In the case of vomiting there is a loss of H + and there is lot of excess bicarbonate left around in the plasma. This is a metabolic alkalosis because the problem is not due to a low CO 2 . The cure for the problem is to stop the loss of the H + . CO 2 + H 2 O H 2 CO 3 H + HCO 3 - +
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Thinking about pH After spending several anxious hours waiting to begin the Anatomy and Physiology exam, a student collapses. In the emergency room the blood results show an elevated pH and a low CO 2 . What is the problem? 1. The pH is higher than normal , so this is a case of alkalosis 2. In this case venous CO 2 is low which leads to small amounts H + and a high pH. The CO 2 and the pH agree which is to say that the low CO 2 is causing the problem. This must be a respiratory alkalosis . The person has likely hyperventilated since that is by far the commonest cause of this finding.
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Another pH Problem Later that evening after the highly stressful but stimulating and rewarding A&P exam the same student is found semiconscious outside of residence clutching a half- consumed bottle of peach schnapps mumbling the lyrics to “Can’t Stop the Feeling”. Since they can’t just “dance, dance, dance” EFRT helps the student back to the ER. The results of the blood work show low pH , a low CO 2 and low bicarbonate . What is the problem?
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Another pH Solution. 1. There is low pH , so this is a case of acidosis. 2. There is low CO 2 so that cannot be causing the acidosis thus it must be a nonrespiratory (metabolic) acidosis. The low CO 2 is a result of compensation by the respiratory system. The low CO 2 likely means this person was breathing deeply.
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