Acid Base NCLEX Review
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This week, we will be covering the Acid Base Module from our Online NCLEX Review. The topics covered in this review are Acid Base Physiology, Acid Base Interpretation, and Acid Base Imbalances.
Acid Base Physiology
The priorities for Acid Base are Assessment and Management
Assessment parameters to detect acid base imbalances
- Vital signs
- Level of consciousness
- Respiratory effort
- Lung sounds
Management treats cause of the problem and the imbalance
- IV fluid
- Respiratory interventions
The flashcard above shows acid base physiology. One area that is not covered in detail here, though, is the effects on potassium.
- Hydrogen and potassium will always exchange for each other in the cell.
- When the patient becomes acidotic, some of the hydrogen moves into the cell and pushes the potassium out.
- As acidosis is corrected, or when the patient is in alkalosis, the hydrogen will move out of the cell and potassium will move back in.
Acid Base Interpretation
An easy way for you to remember acid base interpretation during your NCLEX is to use the acronym ROME.
R = Respiratory
pH ↑ PCO2 ↓ = Respiratory alkalosis
O = Opposite
pH ↓ PCO2 ↑ = Respiratory acidosis
M = Metabolic
pH ↑ HCO3 ↑ = Metabolic alkalosis
E = Equal
pH ↓ HCO3 ↓ = Metabolic acidosis
You can also remember the “Quick and dirty” rule: If the pH and Bicarbonate are Both in the same direction, then it is a metabolic problem.
For more information, check out this video.
Acid Base Imbalances
So, let’s conclude with a sample question that you can expect during your NCLEX Exam.
Pause here (Don’t cheat!!) and read this slide before scrolling down to get the answer.
Got your answer? Read the slide below for the answer and explanation.
Metabolic Acidosis Assessment:
- ↑ Respiratory rate (Kussmaul’s)
- ↑ Potassium
- ↓ Blood pressure
- ↓ LOC and disorientation
Potential causes are:
- Renal failure
- Diabetic ketoacidosis
- Late shock
- Aspirin overdose
The nurse should treat the cause and may need to give bicarbonate in some situations.
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