Nursing 211

N211: Health Differences Across the Lifespan I Respiratory Alkalosis (pH↑>7.45, CO2↓<35) is anything which makes the body lose CO2, decreases acid, which then increases the pH level. The decrease in PaCO2 (hypocapnia) develops when a strong respiratory stimulus causes the respiratory system to remove more carbon dioxide than is produced metabolically in the tissues. This occurs with hyperventilation and leads to a decreased level of CO2. Common causes include: Anxiety, Fever, Hyperventilation, Any lung disease that leads to shortness of breath can also cause respiratory alkalosis, Fever, Being at a high altitude, Lack of oxygen, Liver disease, Salicylate poisoning, infection, and excessive mechanical ventilation. Nursing Assessment Includes increased heart rate, dyspnea, chest tightness, dizziness, anxiety, tetany, seizures, blurred vision and increased sensitivity to digitalis. Diagnostics • High pH • Low PaCO2 • Hypokalemia • Hypocalcemia Compensation • Kidneys conserve hydrogen and excrete bicarbonate (urine pH greater than 6) • Low bicarbonate indicates body is attempting to compensate • The kidneys help to compensate for respiratory alkalosis by decreasing the rate of hydrogen ions secretion into the urine and the rate of bicarbonate ion reabsorption. Nursing Interventions Include treating the underlying cause. Assist client to breathe more slowly, if necessary, have client rebreathe CO2 by using a rebreather mask or a paper bag, give oxygen therapy if client is hypoxic, medicate with anti-anxiety drugs, provide support monitor vital signs and ABGs. Protect client from injury. 2.4 Metabolic Alkalosis Metabolic Alkalosis (pH↑>7.45, HCO3 ↑>26) is anything which increases sodium bicarbonate (HCO3), increases the base which increases the pH level. This occurs with vomiting or nasogastric suctioning and with ingestion of bicarbonate-based antacids. Metabolic alkalosis occurs when HCO3- is increased, usually as the result of excessive loss of metabolic acids. Causes of metabolic alkalosis include diuretics, secretory adenoma of the colon, emesis, hyperaldosteronism, Cushing's syndrome, and exogenous steroids. Nursing Assessment

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