For each of the following sets of blood values, name the acid-base imbalance (acidosis or alkalosis), determine its cause (metabolic or respiratory), decide whether the condition is being compensated, and cite at least one possible cause of the imbalance. Problem 1: pH 7.63; Pco₂ 19 mm Hg; Hco₃⁻ 19.5 mEq/L Problem 2: pH 7.22; Pco₂ 30 mm Hg; Hco₃⁻ 12.0 mEq/L

Video transcript

Hi, everyone. Welcome back. Let's look at our next question. A person has the following blood values. Ph seven point OP CO2, 32 millimeters, mercury HCO three minus 10.0 milli equivalents per liter. Which form of acid base imbalance is the person experiencing a metabolic acidosis b, respiratory acidosis, c, metabolic alkalosis or D respiratory alkalosis. Well, in order to analyze these values to see what form of imbalance we have, we first need to look at what normal blood values are so we can compare them. So normal values for PH are 7.32 to 7. for the carbon dioxide level P CO2 would be 35 to 45 millimeters of mercury. And for the amount of bicarbonate HCO three minus, you'd expect to see 22 to 26 milli equivalents per liter. So first let's start with PH because that's going to tell us is the person experiencing acidosis or alkalosis. So RPH value is 7.0 which is low Ph and that means the person is experiencing acidosis. So we can eliminate choices C and D metabolic and respiratory alkalosis. So now we need to look at what type of acidosis is this? So for that first, we'll turn to the carbon dioxide level and respiratory acidosis. The lungs are not performing efficient gas exchange and CO2 levels will be high, the CO2 will be rising. It's not gonna eliminate the way it should. And the CO2 levels, since carbon dioxide is acidic, once it's dissolved in blood, you will see the CO2 levels high and that's what's causing the acidity. But in our case, our P CO2 of 32 is lower than that normal range of 35 to 45. So we actually have a low carbon dioxide level. So that means it is not respiratory. So we can cross out choice B and we know that our answer must be choice. A metabolic acidosis. But why would that carbon dioxide level be low because it's not just within a normal range as we know, not being high is telling us it's not respiratory. That's because in the case of metabolic acidosis, the body tries to bring the ph back up by a mechanism called compensatory hyperventilation or breathing very quickly as the body is trying to eliminate CO2 and bring up the PH. So that's what we'd expect to see kind of low CO2 levels because of that mechanism. And finally, our final clue that this is indeed a metabolic acidosis is that we look at our bicarbonate levels, they are definitely low and milo covens per liter compared to that range of 22 to 26. And that is because the acidosis is caused by excess hydrogen ions in the blood. There's a number of different things that can cause that. There's a lot of processes in the blood that generate protons. And the kidneys are always working to excrete those hydrogen ions. And if something goes wrong with that process, the excess hydrogen ions kind of soak up. I say use up the bicarbonate molecules because bicarbonate is the buffer that tries to keep the ph level the same all the time. So if you have a ton of extra H plus floating around that H plus is busy combining with our barc carbonate buffer. And so you'll see bicarbonate levels being driven down. So all those things point to our person is experiencing an acid base imbalance with these blood values. The type they're experiencing is choice a metabolic acidosis. See you in the next video.