Acid-base: Respiratory Alkalosis Flashcards
What is the pathophysiology of acute respiratory alkalosis?
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.
What is the most common cause of respiratory alkalosis?
Anxiety-based hyperventilation
What are some other causes of respiratory alkalosis?
- high fever
- hypoxia
- gram-negative bacteriaemia
- Thyrotoxicosis
- aspirin overdose
- anesthesia
- Mechanical ventilation
What happens to the kidneys in chronic respiratory alkalosis?
the kidneys compensate which eliminates bicarbonate causing bicarb levels to be lower than normal
What happens to the body because of alkalosis?
- increases binding of extracellular calcium to albumin
- neuromuscular excitability increases
- Manifestations similar to hypocalcemia develop
- Low CO2 levels cause vasoconstriction of cerebral vessels
What are the risk factors for respiratory alkalosis?
- anxiety disorders
- mechanical ventilation settings (breaths per minute too high, peak pressure too high)
- fear
- PE’s
- hyperventilation
What are the clinical manifestations of respiratory alkalosis?
- light-headedness
- feeling of panic and difficulty concentrating
- Circumoral and distal extremity paresthesias
- Tremors
- Positive Chvostek sign
- Trousseau sign
- tinnitus
- the sensation of chest tightness and palpitations
- seizures and loss of consciousness
- hypokalemia
- nausea/vomiting
- tachycardia
What indicates that a patient has a positive chvostek sign and how does a nurse assess for this?
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)
What is a trousseau sign and how does a nurse assess for this?
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.
What types of medications are typically given for respiratory alkalosis?
antianxiety agents
What are some respiratory therapy options that can be used for respiratory alkalosis?
- paper bags
- breathing exercises
- encourage stress reduction
Why can paper bags be used for respiratory alkalosis?
It Will help raise CO2
What breathing techniques can patients with respiratory alkalosis use?
- take slow regular breaths
2. breathe into cupped hands
What things put infants and children at risk for respiratory alkalosis?
- hypoxia
- sepsis
- pneumonia
- meningitis
- Brain trauma/lesions
- salicylate poisoning
What are some ways to calm down an infant?
swaddling, calming touch, and a quiet voice