ABGs

• Respiratory Acidosis Risk Factors:

  Decreased CO2 elimination: 

  • Respiratory Failure 
  • Over sedation 
  • Neuro-muscular disease  

  Hypoventilation causes excess CO2 leading to hypoxia; can be from: 

  • Acute CHF 
  • Acute decompensation of COPD 
  • Overdose 
  • Chronic COPD 
  • Obesity  
• Respiratory Alkalosis Risk Factors:

  Hyperventilation because of anxiety, pain 
• Respiratory acidosis Assessment Findings:

  • Restlessness progresses to depressed LOC 
  • Headache 
  • Dyspnea 
  • (pH < 7.35); (CO2 > 45) 
  • Associated hypoxia, hyperkalemia  
• Nursing Interventions for Respiratory Acidosis:

  Treat underlying cause! 

  • Give O2 or reversal agents 
  • Monitor... Respiratory, Rhythm, SPO2,LOC 
  • stimulate to breathe w/ bag valve mask on bipap  
  • Give antidote if indicated
• What is the causes of respiratory alkalosis?

  hyperventilation because of anxiety, pain
• What kind of assessment findings are present in respiratory alkalosis?

  • Lightheadedness, dizzy 
  • Numbness/tingling of fingers & toes, twitching = hypocalcemia  
  • Arrhythmias d/t hypokalemia  
  • (pH > 7.45); (CO2 < 35) 
• What are the interventions for respiratory alkalosis?

  Treat underlying cause! 

  • Manage pain, anxiety  
  • Rebreathe pt’s own CO2 thru NRB or brown bag 
  • Therapeutic communication
• What are the risk factors for metabolic acidosis?

  1. Renal failure 
  2. DKA 
  3. Sepsis 
  4. Diarrhea 
• What assessment findings will you see in metabolic acidosis?

  Hyperventilation,  

  Altered mental status: confusion, lethargy tachycardia; arrhythmias d/t hypkalemia 

  Tachypnea 
• What are some interventions for metabolic acidosis?

  Treat underlying cause  

  Monitor VS, Rhythm  

   

  Give insulin, do dialysis; antidiarrheals may give supplemental bicarb  

  Measurement of anion gap 

  Serum CO2 blood test 
• What are the risk factors for metabolic alkalosis?

  1. Vomiting 
  2. Gastric suction 
  3. Diuretics 
• What are assessment findings seen in metabolic alkalosis?

  • Altered mental status: confusion 
  • Neuromuscular sx (muscle weakness, paresthesia, twitching)
  • lethargy, slow respirations 
  • Arrhythmias d/t hypokalemia, hypocalcemia