Respiratory Acidosis

Question 1

What are the causes of Respiratory Acidosis?

Answer 1

Hypoventilation
Retaining CO2

Any condition that interferes with gas exchange & effective breathing:

Acute / chronic respiratory problems
Meds that depress respirations
Brain injury can alter the respiratory center

Question 2

What meds depress respirations?

Answer 2

Sedatives, Opioids, Poisons, Anesthetics, Drug Overdose

Question 3

What is the acid-base ratio for Respiratory Acidosis?

Answer 3

More acid than base (2:20 Ratio)

Question 4

If you have respiratory acidosis, what ABG values are going to be abnormal?

Answer 4

pH is abnormally low

pCo2 is abnormally high

Question 5

If you have respiratory acidosis with renal compensation, what ABG values are going to be abnormal?

Answer 5

The pH is abnormally low

The pCo2 is abnormally high

The HCO3- is abnormally high

Question 6

Acute problems that can cause respiratory acidosis are-

Answer 6

Pneumonia
Post-Anesthesia
Over-Sedation
Drug Overdose
Head Injury

Question 7

Chronic problems that can cause respiratory acidosis are-

Answer 7

Chronic Obstructive Pulmonary Disease (COPD)
Asthma
Bronchitis
Emphysema

Question 8

What are all of the clinical manifestations of Respiratory Acidosis?

Answer 8

Tachycardia
Hypertension
Ventricular Fibrillation

Shallow, Rapid Breaths
Skin will be Pale or Cyanotic

Anxiety, Irritability, Confusion, Lethargy, and Coma

Question 9

What are the initial clinical manifestations of Respiratory Acidosis?

Answer 9

Tachycardia & Hypertension

Ventricular Fibrillation is the first indication if it’s caused by Anesthesia

Question 10

What are the clinical manifestations of Respiratory Acidosis as it worsens?

Answer 10

Bradycardia
Hypotension

Anxiety, Irritability, Confusion, Lethargy, & Coma are all possible

Question 11

What is Ventricular Fibrillation?

Answer 11

A Dysrhythmia of the Heart

Question 12

What should your nursing actions be focused for on a pt who has Respiratory Acidosis?

Answer 12

Improve Ventilation:

Oxygen, Maintain Patent Airway, Enhance Gas Exchange

Question 13

How does a nurse enhance gas exchange?

Answer 13

Reposition the pt

Raise the head of the bed

Breathing Techniques

Ventilatory Support (BIPAP’s, CPAP, Possibly a Ventilator)

Bronchodilators & Mucolytics

Assess Respiratory Status

Question 14

What are Bronchodilators?

Answer 14

Meds that dilate the Bronchi

Question 15

What are Mucolytics?

Answer 15

Meds that help to remove any mucus that can obstruct the airway

Question 16

What are some of the things that you do to assess a pt’s respiratory status?

Answer 16

Assess Lung Sounds, LOC

Assess patency of airway

Monitor ABG’s, Oxygen Saturation

Question 17

How does the body compensate for Respiratory Acidosis?

Answer 17

Chemical Buffers = The Hydrogen combines with a weak base to make a Weak Acid

Renal Compensation = Retain HCo3 / Excrete Hydrogen

Respiratory Compensation = None because the respiratory is the underlying issue