Acid-base: Respiratory Acidosis Flashcards
Describe what is happening to the body with respiratory acidosis
The body is not able to get rid of enough CO2 for some reason, resulting in CO2 retention which causes the body to become acidic.
What are some things that can cause respiratory acidosis?
- chest trauma
- aspiration of a foreign body
- Acute pneumonia
- Overdose of narcotics or sedatives
- COPD
- Emphysema
What is chronic respiratory acidosis often associated with?
chronic respiratory or neuromuscular conditions that affect alveolar ventilation
What electrolyte imbalance often occurs with respiratory acidosis?
Hypercapnia
What are the risk factors for Respiratory acidosis?
- acute lung disease
- Chronic lung disease
- Trauma
- Narcotic analgesics
- airway obstruction
- neuromuscular disease
What are the clinical manifestations of acute respiratory acidosis?
- PaCO2 levels rise rapidly
- manifestations of hypercapnia (cerebral vasodilation, LOC progressively decreases)
- Rapid changes in ABGs
- Skin warm and flushed
- elevated pulse
What are the clinical manifestations of chronic respiratory acidosis?
- weakness
- dull headache
- sleep disturbances
- impaired memory
- personality changes
What happens to the bicarbonate levels in acute and chronic respiratory acidosis?
Acute: initially normal
Chronic: may be significantly elevated trying to compensate for the amount of acidity in the body
What diagnostic tests are typically ordered for Respiratory acidosis?
- Serum electrolytes: for chloride and calcium levels
- Pulmonary function tests: Determine whether the chronic lung disease is the underlying cause
- Chest x-ray
- sputum studies
- serum levels of suspected drugs
What medications are typically given for respiratory acidosis?
- bronchodilators
- antibiotics for respiratory infections
- narcotic antagonists if caused by narcotic usage
What respiratory support is typically given for respiratory acidosis?
- focus on improving alveolar ventilation and gas exchange
- Severe acidosis and hypoxemia: intubation and mechanical ventilation
- PaCO2 level lowered slowly
- O2 administered cautiously
- Pulmonary hygiene
- Adequate hydration
What things put children at risk for having respiratory acidosis?
- asthma
- pneumonia
- Airway obstruction
- Acute pulmonary edema
- ARDS
- Head trauma
- Poisoning
- influenza
What is the nursing management for children with respiratory acidosis?
- assess mental and respiratory status
- positioning
- suctioning as needed
- encouraging deep breathing
What things put older adults at risk for respiratory acidosis?
- COPD
- Chest wall abnormalities
- Pneumonia
- Respiratory muscle weakness
What are some things that a nurse can teach parents who have kids that are at risk for respiratory acidosis?
- deep breathing exercises several times/day
- Signs of infection
- positioning to facilitate chest expansion
- Medication administration (as appropriate)
- Use of ordered devices (home respirators or nebulizers)
What are some interventions to promote gas exchange?
- promptly evaluate and report ABG results
- Place in semi-Fowler or Fowler position as tolerated
- Administer O2 as ordered
- Monitor response to O2
- Immediately report increasing somnolence
What are some interventions to promote effective airway clearance?
- frequently auscultate breath sounds
- Encourage pursed-lip breathing
3 Frequently reposition and encourage ambulation - Encourage fluid intake
- Administer medications
- Provide percussion, vibration, postural drainage as ordered
What are some interventions to reduce anxiety levels?
- result of hypoxia and hypercapnia
- remain with patient and monitor
- Explain procedures and treatments
- Reduce environmental stimuli
- use calm, reassuring manners
- Allow supportive family members to remain with patient as much as possible
What are some interventions to reduce the risk for injury?
- Be aware that patients may experience blurred vision and altered LOC
- Assess LOC, mental status, orientation frequently
- Place call alarm controls within reach
- Manage rest, activity patterns
- Administer supplemental O2 as needed
What are some things to tell the patent to prepare them for discharge?
- teach the patient and family about preventive measures and equipment
- refer the patient to substance abuse treatment if needed
- Encourage the patient to receive immunizations
- Provide instructions when the respiratory status is compromised
- Alert to early symptoms that warrant immediate attention
