Question

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Acidosis and Alkalosis

Hypoventilation- conditions, expected ABGs?

Hyperventilation- Condition, expected abgS?

identify patient at risk

patient presentation and nursing care?

Answer 1

Hypoventilation: Hypoventilation will occur, when there is any obstruction in the respiratory passage. It will lead to decreased supply of oxygen to the lungs. Due to obstruction in the airway, carbon di oxide is retained inside the respiratory system. Due to excess accumulation of carbon di oxide inside the respiratory system,the hydrogen ion concentration will increase. So it develops acidic state in our body . So the expected ABG will be, decreased pH, increased Pco2, decreased PaO2 and increased potassium ions. In all acidotic conditions, the electrolytes levels are increased.

Hypoventilation will occur in obstructive conditions like asthma, bronchitis, bronchiectasis, emphysema, atelectasis, pneumonia and pulmonary edema. In these disease conditions, airway gets constricted or obstructed leads to decreased oxygen supply and accumulation of excess carbon di oxide leads to acidosis .

Nursing care :

1. Assess the patient's respiratory problems such as dyspnea, any distress, cough, chest retraction etc .

2. To increase the oxygen level, administer oxygen if needed.

3. Educate the patient to do deep breathing and coughing exercises .

4. Administer comfortable position or fowlers position to ease breathing .

5. Give steam inhalation if needed .

6. Encourage the patient to take more fluids, to improve the hydration level of the patient .

7. Assist the patient in giving physiotherapy.

8. Provide respiratory treatment and respiratory therapy as prescribed by the physician.

Hyperventilation : Hyperventilation will occur , when there is shallow and rapid respiration. It leads to increased expiration of carbon di oxide. So the carbon di oxide level in the respiratory system is decreased. Decreased level of carbon di oxide leads to decreased levels of carbonic acid. So the Ph level is increased will develop alkalotic condition in our body. Hyperventilation will occur in the conditions of increased respiratory rate which is shallow, excessive expiration of carbon di oxide, improper administration of mechanical ventilation and excessive supply of oxygen which depletes the carbon di oxide level. So the expected ABG will have increased Ph, decreased Paco2 and normal PaO2 level. The potassium ions are decreased. In all alkalotic conditions, the electrolyte levels are decreased.

Nursing care :

1. Assess the patient's respiratory condition .

2. Encourage the patient to do holding of breath voluntarily to retain the Carbon di oxide.

3. Use rebreathing mask to increase the level of carbon di oxide .

4. Assist the patient in respiratory therapy and breathing techniques.

5. Periodically check the electrolyte levels to maintain in a normal level.