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PCC4 > Acid-base: Respiratory Alkalosis > Flashcards

Acid-base: Respiratory Alkalosis Flashcards

1
Q

What is the pathophysiology of acute respiratory alkalosis?

A

Individual is getting rid of too much CO2 which causes the pH to rise. The kidneys are unable to adapt quickly which makes the bicarbonate levels remain in normal limits.

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2
Q

What is the most common cause of respiratory alkalosis?

A

Anxiety-based hyperventilation

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3
Q

What are some other causes of respiratory alkalosis?

A
  1. high fever
  2. hypoxia
  3. gram-negative bacteriaemia
  4. Thyrotoxicosis
  5. aspirin overdose
  6. anesthesia
  7. Mechanical ventilation
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4
Q

What happens to the kidneys in chronic respiratory alkalosis?

A

the kidneys compensate which eliminates bicarbonate causing bicarb levels to be lower than normal

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5
Q

What happens to the body because of alkalosis?

A
  1. increases binding of extracellular calcium to albumin
  2. neuromuscular excitability increases
  3. Manifestations similar to hypocalcemia develop
  4. Low CO2 levels cause vasoconstriction of cerebral vessels
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6
Q

What are the risk factors for respiratory alkalosis?

A
  1. anxiety disorders
  2. mechanical ventilation settings (breaths per minute too high, peak pressure too high)
  3. fear
  4. PE’s
  5. hyperventilation
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7
Q

What are the clinical manifestations of respiratory alkalosis?

A
  1. light-headedness
  2. feeling of panic and difficulty concentrating
  3. Circumoral and distal extremity paresthesias
  4. Tremors
  5. Positive Chvostek sign
  6. Trousseau sign
  7. tinnitus
  8. the sensation of chest tightness and palpitations
  9. seizures and loss of consciousness
  10. hypokalemia
  11. nausea/vomiting
  12. tachycardia
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8
Q

What indicates that a patient has a positive chvostek sign and how does a nurse assess for this?

A

Increased irritability of the facial nerve manifested by twitching of the ipsilateral facial muscles on percussion over the branches of the facial nerve

Tap the skin over the facial nerve about 2 cm anterior to the external auditory meatus (ear)

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9
Q

What is a trousseau sign and how does a nurse assess for this?

A

Involuntary contraction of the muscles in the hand and wrist that occurs after the compression of the upper arm with a blood pressure cuff

Inflate a blood pressure cuff around the patient’s arm and watch for the contraction of the hand and wrist.

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10
Q

What types of medications are typically given for respiratory alkalosis?

A

antianxiety agents

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11
Q

What are some respiratory therapy options that can be used for respiratory alkalosis?

A
  1. paper bags
  2. breathing exercises
  3. encourage stress reduction
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12
Q

Why can paper bags be used for respiratory alkalosis?

A

It Will help raise CO2

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13
Q

What breathing techniques can patients with respiratory alkalosis use?

A
  1. take slow regular breaths

2. breathe into cupped hands

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14
Q

What things put infants and children at risk for respiratory alkalosis?

A
  1. hypoxia
  2. sepsis
  3. pneumonia
  4. meningitis
  5. Brain trauma/lesions
  6. salicylate poisoning
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15
Q

What are some ways to calm down an infant?

A

swaddling, calming touch, and a quiet voice

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16
Q

What are some ways to calm down toddlers and preschoolers?

A

stuffed animal, sing songs with parent/caregiver, talk quietly about feelings

17
Q

What are some ways to calm down young-school-aged children?

A

talking, reading a familiar book, supportive listening

18
Q

What are some ways to calm down older children and adolescents?

A

typical coping mechanisms, reassurance, music or videos

19
Q

What are some important things to remember about older adults at risk for respiratory alkalosis?

A
  1. respiratory distress and chest pain
  2. Hyperventilation increases CO2 excretion
  3. Compensatory HCO3 excretion of the kidneys
  4. Inpatient care is usually not needed
  5. Use pharmacotherapy with caution
  6. rule out serious problems before discharge
  7. outcome depends on the nature of the illness, early diagnosis/treatment
20
Q

What are some important nursing interventions to include?

A
  1. assess respiratory rate, depth, and ease
  2. monitor vital signs and skin color
  3. obtain subjective assessment data (circumstances leading to current situation, current health and recent illnesses, medication use, current manifestations)
  4. reassure patient that this is not a heart attack
  5. Instruct patient to maintain eye contact and breathe with a nurse to slow respiratory rate
  6. protect patient from injury
  7. refer for counseling
21
Q

What are some planning and teaching interventions for home care directed toward the underlying cause of hyperventilation?

A
  1. discuss anxiety and stress management strategies
  2. teach patient how to identify a hyperventilation reaction
  3. Teach patient to provide self-care
  4. Teach patient when to seek medical intervention

PCC4 (38 decks)

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