Nursing 211

N211: Health Differences Across the Lifespan I Carbon dioxide (C02) is an acid and when there is not enough acid this makes the person go into alkalosis. If CO2 is low, its respiratory alkalosis, which means that for some reason they are breathing too much (or too fast) and breathing off too much CO2 (i.e. hyperventilation). Another cause for alkalosis is too much base. If HCO3 is high, its metabolic alkalosis (a number of disease conditions can cause this to happen). If the pH is normal or near normal, but the CO2 and HCO3 are high or low, the body will compensate for the problems in one system (such as the respiratory system) by creating more of the other component. If the CO2 and HCO3 are going the same direction (either both high and both low), it is a compensated process, such as partially compensated respiratory acidosis (both CO2 and HCO3 are high). In a nut shell: Look at pH and determine if it is high or low (alkalosis or acidosis) • If pH is low it is some type of acidosis • If CO2 is high, it’s respiratory acidosis • If HCO3 is low its metabolic acidosis • If pH is high it is some type of alkalosis • If CO2 is low, its respiratory alkalosis • If HCO3 is high, its metabolic alkalosis Anytime CO2 and HCO3 are going the same direction (either both high or both low), it is a compensated process, such as partially compensated respiratory acidosis (both CO2 and HCO3 are high) 2.6 Respiratory Failure (ARDS) Respiratory Failure (Acute Respiratory Distress) (ARDS) is when the exchange of oxygen for carbon dioxide in the lungs is inadequate for oxygen consumption and carbon dioxide production within the body’s cells. The respiratory system can’t adequately supply the body with the oxygen it needs or adequately remove carbon dioxide. The PO2 is less than or equal to 50 mm Hg or the PCO2 is greater than 50 mm Hg or with a pH of less than or equal to 7.25. The causes of respiratory failure include abdominal or thoracic surgery, anesthesia, atelectasis, brain tumors, pneumonia, tuberculosis, aspiration, inhaled toxin, fluid overload, DIC, shock, cerebrovascular accidents, COPD, drug overdose, encephalitis, flail chest, Guillain-Barre syndrome and head trauma. ARDS is characterized by hypoxemia that persists even when 100% oxygen is given; decreased pulmonary compliance; dyspnea; non-cardiac associated bilateral pulmonary edema and dense pulmonary infiltrates are seen on radiography. No abnormal lung sounds are present on auscultation because of the edema of ARDS occurs first in the interstitial spaces, not in the airways.

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