RESPIRATORY ALKALOSIS - RESPIRATORY ALKALOSIS (PRIMARY...

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RESPIRATORY ALKALOSIS (PRIMARY CARBONIC ACID DEFICIT) Respiratory alkalosis is a loss of carbon dioxide (P CO 2 < 35 mm Hg) with a resultant decrease of carbonic acid (H 2 CO 3 ) due to a marked increase in the rate of respirations. The two primary mechanisms that trigger hyperventilation are (1) hypoxemia and (2) direct stimulation of the central respiratory center of the brain (such as occur with high fever, head trauma/CNS lesions, early salicylate intoxication). Compensatory mechanisms include decreased respiratory rate (if the body is able to respond to the drop in Pa CO 2 ), increased renal excretion of bicarbonate, and retention of hydrogen. It is the most frequently occurring acid-base imbalance in hospitalized patients, with the elderly at increased risk because of high incidence of pulmonary disorders and alterations in neurological status. CARE SETTING This condition does not occur in isolation, but rather is a complication of a broader problem and usually requires inpatient care in a medical/surgical or subacute unit. RELATED CONCERNS Plans of care specific to predisposing factors, e.g.: Anemias (iron deficiency, pernicious, aplastic, hemolytic) Cirrhosis of the liver Craniocerebral trauma Hyperthyroidism Fluid and electrolyte imbalances Heart failure: chronic Pneumonia: microbial Sepsis/septicemia Ventilatory assistance (mechanical) OTHER CONCERNS Metabolic acidosis Metabolic alkalosis Patient Assessment Database Dependent on underlying cause. CIRCULATION May report: History/presence of anemia Palpitations May exhibit: Hypotension Tachycardia, irregular pulse/dysrhythmias EGO INTEGRITY May exhibit: Extreme anxiety (most common cause of hyperventilation) FOOD/FLUID May report: Dry mouth Nausea/vomiting May exhibit: Abdominal distension (elevating diaphragm as with ascites, pregnancy) Vomiting NEUROSENSORY May report: Headache, tinnitus
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RESPIRATORY ALKALOSIS - RESPIRATORY ALKALOSIS (PRIMARY...

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