Respiratory Alkalosis

Signs & Symptoms

rapid respiratory rate; count for 1 FULL minute light-headedness (due to vasoconstriction & decreased cerebral blood flow) inability to concentrate; decreased LOC numbness & tingling of fingers/toes tachycardia (increased heart rate) carpopedal spasms & tetany (r/t decreased Ca)

Treat the underlying disorder by...

removing causative agent if salicylate poisoning, stop meds if anxiety, pt may need sedative or antianxiety agent if pain, treat it

Respiratory Alkalosis

carbonic acid (CO2) deficit *always caused by HYPERVENTILATION* rapid breathing releases more CO2(acid) anxiety, high fever, salicylate poisoning, nicotine, pain, hypoxemia, mechanical ventilation (too fast or too deep) *Think of Fuller as the 16yr old in class!!

*Respiratory Alkalosis*

*increased pH *decreased CO2 *decreased HCO3

Medical Management

*want breathing to slow down* correct rapid respiratory rate breath in a bag or cupped hands; to rebreathe blown off CO2 (treats hyperventilation) e-breather mask sedation decrease rate of resp on ventilator monitor VS & ABGs monitor electrolytes (could need to be replaced)

Chemoreceptors in the Medulla...

-sense the increased pH and decreased CO2 -stimulate the body to breathe more slowly or less deeply (to hold on to H+) *if this goes on for more than 6hrs the kidneys get involved by excreting more HCO3 and holding more H+

Diagnostic Findings

ABGs ph above 7.45 CO2 below 35 kidneys compensate by excreting HCO3 to restore pH (takes long time) electrolytes (K & Ca) toxicology screen (salicylates) *EKG changes may occur b/c of hypokalemia or hypocalcemia

In a patient with respiratory alkalosis you will see...

HYPERVENTILATION seizures deep, rapid breathing confusion hypokalemia light-headedness tingling of extremities increased pH, decreased CO2