alkalosis and acidosis project-2

7/29/2019 Alkalosis and Acidosis Project-2

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Respiratory acidosis is a condition of accumulation of carbon

dioxide in the blood

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Produces a shift in the body's pH balance

Causes the body's system to become more acidic

Respiratory acidosis is an acid-base balance disturbance due to

alveolar hypoventilation

Production of carbon dioxide occurs rapidly and failure of

ventilation promptly increases the partial pressure of arterial

carbon dioxide (PaCO2)

The normal reference range for PaCO2 is 35-45 mm Hg

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Respiratory acidosis it is most often caused by pulmonary

problems, although head injuries, drugs (especially anesthetics

and sedatives), and brain tumors can cause this acidemia

Pneumothorax, emphysema, chronic bronchitis, asthma,

severe pneumonia, and aspiration are among the most frequent

causes

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The clinical manifestations are often those of the underlyingdisorder, but can include:

Confusion

Easy fatigue

Lethargy

Shortness of breath

Sleepiness

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Poor organ function

Respiratory failure

Shock

Carbon dioxide narcosis

Muscle dysfunction

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Identifying the underlying cause is priority, a physical examcan be followed by:

Arterial blood gas, which measures oxygen and carbon

dioxide levels in the blood

Basic metabolic panel

Chest x-ray

Pulmonary function test

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Pharmacological Therapies

Bronchodilators

Respiratory stimulants

Drug antagonists

Bicarbonate

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Treatment should be directed at the underlying disorder


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Oxygen therapy

Ventilatory support

Stop smoking

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Do not smoke, smoking leads to the development of many

severe lung diseases that can cause respiratory acidosis

Losing weight may help prevent respiratory acidosis due to

obesity (obesity-hypoventilation syndrome)

Be careful about taking sedating medicines, and never

combine these medicines with alcohol

Take medication as ordered

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Monitor ABGs, to be redrawn every 2 hours

Monitor vital signs and respiratory status (including oxygen

saturation) every 15 minutes for the first hour then every hour

Assess color of skin, nail beds, and oral mucous membranes

every hour

Assess mental status and orientation every hour

Monitor anxiety level as evidenced by restlessness and

agitation

Maintain a calm, quiet environment

Provide reorientation and explain all activities

Keep side rails in place, and place call bell within reach

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Respiratory alkalosis is a condition where the amount ofcarbon dioxide found in the blood drops to a level below

normal range

This condition produces a shift in the body's pH balance and

causes the body's system to become more alkaline

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Respiratory alkalosis results from an elevation in

alveolar ventilation that causes a fall in the partial

pressure of dissolved carbon dioxide

Respiratory alkalosis can be acute or chronic

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Psychiatric causes: anxiety, hysteria and stress

CNS causes: stroke, subarachnoid hemorrhage, meningitis

Drug use: doxapram, aspirin, caffeine and coffee

Moving into high altitude areas, where the low atmospheric

pressure of oxygen stimulates increased ventilation

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Lung disease such as pneumonia, where a hypoxic drivegoverns breathing more than CO2 levels (the normal

determinant)

CO2 level, which stimulates the respiratory center in thebrainstem

Pregnancy

High levels of NH4+ leading to brain swelling and decreased

blood flow to the brain

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Dizziness

Bloating

Light-headedness

Numbness and/or muscle spasms in the extremities

Discomfort in the chest area

Confusion

Dry mouth

Heart palpitations

Feeling short of breath

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Arterial blood gas, which measures oxygen and carbondioxide levels in the blood

Basic metabolic panel

Chest x-ray

Pulmonary function test

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Treatment attempts to eradicate the underlying condition

Treating the condition is a matter of raising carbon dioxide

levels in the blood

Breathe into a paper bag

Get reassurance

Restrict oxygen intake into the lungs

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Sedatives and/or antidepressants should be reserved forpatients who have not responded to conservative

treatment

In mechanically ventilated patients who have

respiratory alkalosis, the tidal volume and/or

respiratory rate may need to be decreased

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Help patient identify factors that precipitate anxiety that leadsto hyperventilation

Help patient find coping mechanisms and activities that

promote relaxation

Breathing exercises, meditation, and regular exercise can also

be effective in prevention

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Watch for and report changes in neurologic, neuromuscular,and cardiovascular functioning

Monitor ABG serum and electrolyte levels closely

Report any variations immediately

Explain all procedures to the patient and allow ample time to

answer any questions

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pH PaCO2 HCO3

7.35 55 257.48 34 23

7.40 40 26

Results

Respiratory

Acidosis

RespiratoryAlkalosis

Normal

alkalosis and acidosis project-2

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