RESPIRATORY
RESPIRATORY
ALKALOSIS
ALKALOSIS
Presentation by:
BSN 3A
OVERVIEW
Respiratory alkalosis
-occurs when the levels of
carbon dioxide and oxygen in the
blood are not balanced. When
you breathe too fast or too deep
and carbon dioxide levels drop
too low.
Note:
The arterial blood
profile seen in
respiratory
alkalosis is:
•
•
•
INCREASE IN PH
DECREASE IN HCO3
DECREASE IN PCO2
What is Hyperventilation?
Hyperventilation is rapid or deep breathing, usually
caused by anxiety or panic. This over breathing, as it is
sometimes called, may actually leave you feeling
breathless.
When you breathe, you inhale oxygen and exhale carbon
dioxide. Excessive breathing may lead to low levels of
carbon dioxide in your blood, which causes many of the
symptoms that you may feel if you hyperventilate.
CLASSIFIED IN TWO CATEGORIES:
Acute respiratory alkalosis- the PaCO2 level is
below the lower limit of normal and the serum pH
is alkalemic.
Chronic respiratory alkalosis- the PaCO2 level is
below the lower limit of normal, but the pH level is
relatively normal or near normal due to
compensatory mechanisms.
MNEMONIC OF TACHYPNEA
Temperature increase (fever)
Aspirin toxicity
Controlled ventilation
Hyperventilation (excessive respirations)
HYsteria (anxiety)
Pain, Pregnancy,Pneumonia
Neurological injuries from a head injury or
Embolism or Edema in the lungs
Asthma due to hyperventilation
stroke
PATHOPHYSIOLOGY
SIGNS AND SYMPTOMS
What are the symptoms of respiratory alkalosis?
You may experience:
Breathlessness
Dizziness
Numbness and /or tingling in your fingertips, toes and lips
Irritability
Nausea
Muscle spasms or twitching
Fatigue
Dizziness/lightheadedness
Fainting (syncope)
Chest discomfort
Shortness of breath
Tremors
Confusion
DIAGNOSTIC TEST/EXAM
Arterial Blood Gas
Basic Metabolic
Panel
Chest X-ray
Pulmonary Function
Tests
DIAGNOSTIC TEST/EXAM
The following laboratory studies that may be helpful are:
Serum chemistries
Complete blood count (CBC)
Liver function test
Cultures of blood, sputum, urine, and other sites
Thyroid testing
Beta-human chorionic hormone levels
Drug screens and theophylline and salicylate levels
DIAGNOSTIC TEST/EXAM
Imaging studies
These include the following:
Chest radiography - Should be performed to help rule out pulmonary
disease as a cause of hypocapnia and respiratory alkalosis
Computerized tomography (CT) scanning of the chest - May be
performed if chest radiography findings are inconclusive or a pulmonary
disorder is strongly considered as a differential diagnosis
Ventilation perfusion scanning - Can be considered in patients who are
unable to undergo an intravenous contrast injection associated with CT
scanning to assess the patient for pulmonary embolism
Brain magnetic resonance imaging (MRI) - Can be considered if a
central cause of hyperventilation and respiratory alkalosis is suggested
and the initial brain CT scan findings are negative or inconclusive
NURSING MANAGEMENT
Monitor vital signs
Monitor ABGs, primarily PaCO2; a value less than 35
mmHg indicates too little CO2 (carbonic acid)
Be alert for signs of changes in neurologic,
neuromuscular or cardiovascular functions.
Encourage the anxious patient to verbalize fears
Encourage the patient to take deep, slow breaths or
breathe into a brown paper bag (inspire CO2).
Keep the patient warm and dry
MEDICAL MANAGEMENT
For management of Panic and anxiety:
Administer sedation as ordered to relax the
patient and to reduce the intensity of panic
attacks.
Institute safety measures for the patient with
vertigo or the unconscious patient.
PHARMACOLOGIC MANAGEMENT
Treatment for respiratory alkalosis depends on the underlying cause to
reduce hyperventilation.
Depending on the severity, your doctor may also prescribe medication.
Examples of medications for hyperventilation include:
Alprazolam (Xanax)- used to treat generalized anxiety disorder,
symptoms of anxiety in the short term, panic disorder
Doxepin- It is a prescription drug and used to treat mood disorders,
such as depression and anxiety.
Paroxetine (Paxil)- an oral tablet that can be used to treat
depressive disorder, obsessive-compulsive disorder, panic disorder,
social anxiety disorder, generalized anxiety disorder, post-traumatic
stress disorder, and premenstrual dysphoric disorder.
Thank you
for listening!
REFERENCES
https://emedicine.medscape.com/article/301680-overview
https://my.clevelandclinic.org/health/diseases/21657-respiratoryalkalosis#:~:
text=Respiratory%20alkalosis%20occurs%20when%20high,
reduce%20the%20risk%20of%20hyperventilation.
https://www.registerednursern.com/respiratory-alkalosis-nclexreview-notes-with-mnemonic-quiz-acid-base-imbalance-notes/
https://nurseslabs.com/respiratory-alkalosis-nursingmanagement/
https://www.slideshare.net/SiddharthSingh314/
alkalosis-77344859