respiratory acidosis/alkalosis

[TSHELTON2005]

can anyone recommend a web site or a way to understand respiratory acidosis/alkalosis?

[Daytonite, BSN, RN]

you will find some information and links in this thread:

https://allnurses.com/forums/f205/pathophysiology-p-fluid-electrolyte-resources-145201.html - pathophysiology/a & p/fluid & electrolyte resources (in nursing student assistant forum)

respiratory acidosis: big symptom to remember is the patients have a lot of trouble breathing because of pulmonary congestion, but note the symptoms of the breathing compared to the breathing symptoms of respiratory alkalosis. you'll hear them say things like, "i can't catch my breath." you see this when there has been chest trauma, airway obstruction, pulmonary edema, drug overdose, neuromuscular diseases and in copd. the basic pathophysiology of this is that the patient is not clearing carbon dioxide from their body. hypoventilation (reduced rate and depth of breathing) causes an increase in carbon dioxide throughout the cells and tissues of the body. the hypoventilation results in pulmonary congestion and airway obstruction which leads to all the breathing difficulties.

symptoms are:

• ph below 7.35 and pco2 over 45mmhg
  
• rapid, shallow respirations
  
• hypoventilation
  
• dyspnea
  
• elevated blood pressure
  
• headache
  
• hyperkalemia
  
• disorientation
  
• elevated cardiac output
  
• muscle weakness
  
• hypoxia

respiratory alkalosis: hyperventilation, rapid rate of breathing, causes too much carbon dioxide to be exhaled and the ph of the body rises. the cardinal sign of respiratory alkalosis is the deep, rapid breathing, more than 40 breaths per minute, that is similar to kussmaul's respirations (seen in metabolic acidosis). this kind of breathing leads to neuromuscular and central nervous system disturbances. this will occur in pulmonary diseases such as asthma, as well as in pregnancy, fever, at high altitudes and with acute anxiety. think of the things that would cause a person to breathe very rapidly and cause large losses of carbon dioxide.

symptoms are:

• ph elevated above 7.45 and pco2 below 35mmhg
  
• rapid, deep breathing
  
• hyperventilation
  
• agitation
  
• paresthesias
  
• seizures
  
• confusion
  
• hypokalemia
  
• lightheadedness
  
• dizziness
  
• tingling of the extremities

hope this helps.

[TexasTac]

the rome mnemonic has always been helpful to me:

r respiratory

o opposite

ph up pco2 down = alkalosis

ph down pco2 up = acidosis

m metabolic

e equal

ph up hco2 up = alkalosis

ph down hcos down = acidosis

[Beech1184]

The main thing to remember is that the lungs are the major way we dispose of acid products of metabolism in the form of CO2 and water vapor or CO3. 13,000 meq of acid are excreted versus 50 meq for the kidneys in 24 hrs. Anything that causes hypoventilation will thus cause acidosis. It can be life threatening especially in the very young and the old.

Respratory alkalosis is usually self limiting and much less common. The most common cause is hysteria.