In this video I'm going to break down exactly what metabolic acidosis is, and what you need
to know about it for nursing school.
Let's do it!
Hey there, friend, Christina here with nursingschoolofsuccess.com, here to help you raise your grades and have
more free time in nursing school.
And today we're talking all about metabolic acidosis.
Metabolic acidosis is one of the 4 main categories you need to know about in nursing school:
metabolic acidosis, respiratory acidosis, metabolic alkalosis, and respiratory alkalosis.
We'll talk about the other 3 in the other videos in this series.
So metabolic acidosis can mean 2 things: there is too much acid in the body, or not enough
base.
And the way to determine if the blood is acidic or not is to look at the pH value on your
patients arterial blood gas (or ABG) panel.
A normal pH value is between 7.35 and 7.45.
That is a number you need to memorize.
Sorry about that, I know we don't like memorizing things, but that's just one you'll need to
commit to memory.
7.35 to 7.45.
When the pH is less than 7.4, it's more ACIDIC.
When the pH is greater than 7.4, it's more BASIC.
So during metabolic acidosis, it's acidosis, meaning the pH is more acidic, or less than
7.4.
Now, there are 2 key players you need to know about when you're learning about metabolic
acidosis, or arterial blood gases in nursing school: you've got the LUNGS and the KIDNEYS.
When you see the word METABOLIC when it refers to ABGs, I want you to immediately think of
the KIDNEYS.
The KIDNEYS are the problem in metabolic acidosis!
We'll call them the party poopers.
They are the one's causing the metabolic acidosis to happen.
So here's what's happening during metabolic acidosis, the blood is becoming more and more
acidic, meaning the pH is dropping below 7.4, below 7.35 because the KIDNEYS are not giving
enough bicarbonate (or enough BASE) to compensate.
The kidneys are responsible for making bicarbonate, which is a base.
So when the blood becomes acidic, the kidneys are supposed to give more and more bicarbonate
to help balance out the pH.
But during metabplic acidosis, the kidneys aren't doing their job well, they aren't giving
enough bicarbonate to help keep the pH in balance, which causes metabolic acidosis to
occur.
A normal bicarbonate level (or HCO3) is between 22-26 milliequivalents per liter (mEq/L).
And during metabolic acidosis, the HCO3 level will be lower than normal.
Some common causes of metabolic acidosis are: kidney disease, (including chronic kidney
disease or acute kidney injury), severe diarrhea, diabetes, and diabetic ketoacidosis.
In these cases, the kidneys can't make or retain enough bicarbonate to balance out the
increasing acidity of the blood.
Now here's where you might get stuck on this topic: Metabolic acidosis is different than
RESPIRATORY acidosis.
In metabolic acidosis, like we talked about here, the KIDNEYS aren't giving enough bicarbonate
to make up for the increased acid in the body.
So because the kidneys aren't doing their job, it's causing metabolic acidosis.
On the other hand, if the LUNGS were the problem, we would call it RESPIRATORY acidosis.
In that case, the lungs would be retaining too much CO2 or too much acid, it doesn't
have much to do with bicarbonate, because RESPIRATORY acidosis is not a kidney problem,
it's a LUNG problem.
So remember, when you hear the term METABOLIC when it's referred to ABGs, think KIDNEYS.
And during metabolic acidosis, that means the kidneys are not giving enough bicarbonate
to the body to help bring the pH up.
Now, if you want a step-by-step guide for interpreting ABGs, be sure to check out the
video we have for you on that.
I put that link in the description for you to check out.
Now go become the nurse that God created only YOU to be.
And I'll catch you in the next video.