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Respiratory Acidosis/Alkalosis

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Causes of Respiratory Acidosis
COPD, CNS depressants, chest wall abnormalities, Atelectasis, Brain Tramas, Bronchiectasis, Bronchitis Emphysema, Hypoventilaation, Pulmonary Edema, Pneumonia, Pulmonary Emboli, Underventilation/mechanical
Causes of Respiratory Alkalosis
Hyperventilation caused by hypoxia, fear, fever, pain, exercise, anxiety, pulmonary embolus, hysteria, overventilation/mechanical,Stimulated respiratory center caused by septiceemia, encephalities, brain injury, salicylate poisoning, hypokalemia, salicylate poisoning
Respiratory Acidosis Signs and Symptoms
Drowsiness, Disorientation, Altered mental status Dizziness, Headache, Coma, Seizures, Papilledema, Decreased LOC, Low BP, Hypotension, Heart block, Tackycardia, Ventricular fibrillation(related to hyperkalemia from compensation) Warm/flushed skin(related to peripheral vasodilation, Peaked T waves, Prolonged PR, Widened QRS, Dypsnea, Hypoventilation w/hypoxia(lungs are unable to compensate when there is a respiratory problem)
Respiratory Alkalosis Signs and Symptoms
Lethargy, Light-headedness, Dizziness, Confusion, Tachycardia, Increase sinsitivity to digitalis preperations, Dysrhythmias(related to hypokalemia from compensaation), Nausea, Vomiting, Epigastric pain, Tetany, Panic, Anxiety, Numbness/tingling of extremities(hypocalcemia), Hyperreflexia, Sseizures, Blured vision, Rapid/shallow breath, Hyperventilation(lungs aare unable to compensate when there is a respiratory problem)
Respiratory Acidosis compensation
Increased rate and depth of respirations to blow off CO2.
Kidneys eliminate H+ ions and retain HCO3-(urine pH less than 6)
HCO3- levels rise when the body is compensating for the acidosis
Respiratory Alkalosis compenssation
Kidneys conserve H+ and excrete HCO3-(urine pH greater than 6)
Low HCO3- indicats the body is attempting to compensate
Respiratory Acidosis Labs
ph decreased below 7.35
PaCO2 greater than 45 mm Hg
Hyperkalemia
Respiratory Alkalosis Labs
High pH(greater than 7.45)
Low PaCO2(less than 35 mm Hg)
Hypolalemia
Hypocalcemia
Respiratory Acidosis Assessment
In an attempt ot compensate, the kidneys retain bicarbonate and excrete excess H+ ions into the urine
Respiratory Alkalosis Assessment
Initially the hyperventilation and respiratory stimulation caause abnormal rapid respirations(tachypnea); in an attempt to compensate, the kidneys excrete excess circulation bicarbonate into the urine.
Respiratory Acidosis Description
The total concentration of buffer base is lower than normal, with a relative increase in hydrogen ion concentration; thus a greater number of hydrogen ions is circulating in the blood than can be absorbed by the buffer system.
Respiratory Alkalosis Description
A deficit of carbonic acid and a decrease in hydrogen ion concentration that results from the accumulation of base or from a loss of acid without a comparable loss of base in the body fluids.
Respiratory Alkalosis Interventions
1.Monitor for signs of respiratory distress.
2.Provide emotional support and reassurance to the client.
3.Encourage appropriate breathing patterns.
4.Assist with breathing techniques and breathing aids as prescribed.
a.Encourage voluntary holding of the breath if appropriate
b.Provide use of a rebreathing mask as prescribed
c.Provide carbon dioxide breaths as prescribed (rebreathing into a paper bag)
5.Provide cautious care with ventilator clients so that they are not forced to take breaths too deeply or rapidly.
6.Monitor electrolyte values, particularly potassium and calcium levels.

7.Administer medications as prescribed.
8.Prepare to administer calcium gluconate for tetany as prescribed.
Respiratory Acidosis Interventions
1.Monitor for signs of respiratory distress.
2.Administer oxygen as prescribed.
3.Place the client in a semi-Fowler's position, unless contraindicated.
4.Encourage and assist the client to turn, cough, and deep-breathe.
5.Prepare to administer respiratory treatments as prescribed.
6.Encourage hydration to thin secretions, unless excess fluid intake is contraindicated.
7.Suction the client's airway, if necessary and if not contraindicated.
8.Reduce restlessness by improving ventilation rather than by administering tranquilizers, sedatives, or opioids because these medications further depress respirations.