Nurse Nacole ◂ Nursing Resources

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Wed, 10 Jun 2026 12:00:00 +0000

Category: Critical Care Nursing
The treatment of metabolic acidosis involves treatment of the underlying disorder. Except in specific circumstances, there is no scientific evidence to support treating a metabolic or respiratory acidosis with sodium bicarbonate.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Tue, 09 Jun 2026 12:00:00 +0000

Category: Critical Care Nursing
The first reported in children and then recognized also in adults, prolonged high-dose propofol (>100 μg/kg/min) is associated with the “propofol infusion syndrome” characterized by rhabdomyolysis, metabolic acidosis and renal/cardiac failure.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Mon, 08 Jun 2026 12:00:00 +0000

Category: Critical Care Nursing
Long-term use of lorazepam can result in the accumulation of propylene glycol, resulting in AKI, metabolic acidosis and altered mental status. Propylene glycol toxicity is typically observed after prolonged, high-dose lorazepam infusion.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sun, 07 Jun 2026 12:00:00 +0000

Category: Critical Care Nursing
In patients with an unexplained anion gap metabolic acidosis, drugs such as salicylates, methanol or ethyleneglycol toxicity should be considered. Accumulation of 5-oxoproline related to the use of acetaminophen is also a rare cause.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sat, 06 Jun 2026 12:00:00 +0000

Category: Critical Care Nursing
Severe metabolic acidosis requires an aggressive approach to treat the underlying causes. In most patients, the causes are obvious, with lactic acidosis (tissue hypoxia or sepsis), ketoacidosis and acute kidney injury being the most common.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Fri, 05 Jun 2026 12:00:00 +0000

Category: Critical Care Nursing
Severe metabolic acidosis results in myocardial depression with a reduction in cardiac output, blood pressure and decreased hepatic and renal blood flows. The cardiovascular system also becomes less responsive to vasopressor agents.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Thu, 04 Jun 2026 12:00:00 +0000

Category: Critical Care Nursing
It is possible for a patient to have an acid-base disorder with normal pH, PaCO2 and HCO3-, with the only clue to an acid-base disorder being an increased anion gap (AG). If the AG is > 15 mEq/L, the patient most likely has a metabolic acidosis.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Wed, 03 Jun 2026 12:00:00 +0000

Category: Critical Care Nursing
In non anion gap metabolic acidosis, H+ is accompanied by Cl- (a measured anion). Therefore, there is no change in anion gap. Acid-base disorders may present as two or three coexisting disorders.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Tue, 02 Jun 2026 12:00:00 +0000

Category: Critical Care Nursing
In high anion gap metabolic acidosis, acid dissociates into H+ and an unmeasured anion. H+ is buffered by HCO3-, and the unmeasured anion accumulates in the serum, resulting in an increase in anion gap.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Mon, 01 Jun 2026 12:00:00 +0000

Category: Critical Care Nursing
Any alteration in acid-base equilibrium sets into motion a compensatory response by either the lungs or kidneys. The compensatory response attempts to return the ratio between PaCO2 and HCO3- to normal with subsequent normalization of pH.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sun, 31 May 2026 12:00:00 +0000

Category: Critical Care Nursing
Patients with chronic obstructive pulmonary disease could have chronic respiratory acidosis because of CO2 accumulation counterbalanced by metabolic alkalosis, resulting in a normal pH.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sat, 30 May 2026 12:00:00 +0000

Category: Critical Care Nursing
The history and physical examination can often give clues as to the underlying acid-base disorder. For example, severe diarrhea could lead to loss of HCO3- with subsequent non-anion gap metabolic acidosis.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Fri, 29 May 2026 12:00:00 +0000

Category: Critical Care Nursing
In electrochemical neutrality, total cations must equal total anions. With this, a number is derived from the difference. When cations are in excess, mathematically, this “gap” (anion gap) is filled with anions to preserve electrochemical neutrality.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Thu, 28 May 2026 12:00:00 +0000

Category: Critical Care Nursing
Arterial oxygen tension decreases with age. For example, at age 60 years, with an FiO2 of 21%, and 1 atmospheric pressure, the PaO2 is 85-90 mm Hg. This value decreases to 80-85 mm Hg at the age of 80 years.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Wed, 27 May 2026 12:00:00 +0000

Category: Critical Care Nursing
Because the normal PaO2 in an adult breathing room air is 80-100 mm Hg, the normal value for PaO2/FiO2 ranges between 400-500 mm Hg. A PaO2/FiO2 ratio of less than 200 indicates a shunt of greater than 20% of total cardiac output.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Tue, 26 May 2026 12:00:00 +0000

Category: Critical Care Nursing
Clinically, the P/F ratio (PaO2/FiO2) is most commonly used to approximately quantitate the degree of venous admixture, composed of ventilation/perfusion mismatching (V/Q) and true shunt.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Mon, 25 May 2026 12:00:00 +0000

Category: Critical Care Nursing
The PaO2 is dependent on the fraction of inspired oxygen (FiO2), ventilation and perfusion matching (V/Q) and the mixed venous oxygen saturation (SmvO2). The PaO2 should be assessed alongside the inspired oxygen and age of the patient.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sun, 24 May 2026 12:00:00 +0000

Category: Critical Care Nursing
Tissue oxygenation depends on the delivery of oxygenated blood (both dissolved and bound to hemoglobin). The PaO2 is the partial pressure of oxygen in the blood and this dissolved fraction makes a very small direct contribution to oxygen delivery.<2 span="">

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sat, 23 May 2026 12:00:00 +0000

Category: Critical Care Nursing
In an ABG, the arterial CO2 partial pressure (PaCO2) reflects the CO2 content of the sample. The CO2 content basically is the balance between the quantity of CO2 produced and its excretion through alveolar ventilation.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Fri, 22 May 2026 12:00:00 +0000

Category: Critical Care Nursing
Acute respiratory insufficiency occurs when the lungs no longer meet the metabolic demands of the body, which by tradition is divided into two types: Type I, hypoxemic respiratory insufficiency and type II, hypercapnic respiratory insufficiency.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Thu, 21 May 2026 12:00:00 +0000

Category: Critical Care Nursing
Hypoxia is unlikely to occur in mild hypoxemia (PaO2 = 60-79 mm Hg) when cardiovascular reflexes remain intact. Moderate hypoxemia (PaO2 = 45-59 mm Hg) is associated with hypoxia in patients with anemia or cardiovascular dysfunction.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Wed, 20 May 2026 12:00:00 +0000

Category: Critical Care Nursing
Hypoxemia is a PaO2 of less than 80 mm Hg in adults breathing room air. Hypoxia is tissue- or cell-level decreases in oxygen availability. Thus hypoxia in patients with hypoxemia depends on the ability of the cardiovascular system to compensate.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Tue, 19 May 2026 12:00:00 +0000

Category: Critical Care Nursing
In an ABG, the PaO2 assess oxygenation and it is reliable within a range between 30 and 200 mm Hg. However, the reliability of the reported oxygen saturation of blood (SaO2) ranges within a much narrower range: between 30 and 60 mm Hg.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Mon, 18 May 2026 12:00:00 +0000

Category: Critical Care Nursing
Measuring the respiratory rate corresponding to the minute ventilation gives the clinician an indication of the central ventilatory drive, but it is influenced by respiratory system compliance and does not reflect the depth of the drive.

Nursing Tip of the Day! - Critical Care Nursing

noreply@blogger.com (Nurse Nacole) — Sun, 17 May 2026 12:00:00 +0000

Category: Critical Care Nursing
An rapid shallow breathing index (RSBI) threshold of less than 105 has both a high positive predictive value (0.78) and high negative predictive value (0.95) for the ability to maintain unassisted breathing.