The nurse is assessing a patient for the presence of metabolic acidosis. In addition to the arterial blood gases, the nurse should also assess:
1. Na+ – (Cl- + HCO3).
2. K+ – (Na++ HCO3).
3. The creatinine and BUN.
4. All electrolytes and blood glucose.
Na+ – (Cl- + HCO3).
Rationale: In addition to the arterial blood gases, metabolic acidosis can be assessed using the result of the anion gap. The anion gap is calculated using the following formula: Sodium – (Chloride + Bicarbonate). The anion gap will be high in metabolic acidosis. The creatinine and BUN would reflect renal function, but not specifically metabolic acidosis. Electrolytes and blood glucose would also be important assessments, but are too general to reflect metabolic acidosis.
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