Are you studying respiratory alkalosis and need to know a mnemonic on how to remember the causes? This article will give you a clever mnemonic and simplify the signs and symptoms and nursing interventions on how to remember respiratory alkalosis for nursing lecture exams and NCLEX.
In addition, you will learn how to differentiate respiratory alkalosis from respiratory acidosis. Don’t forget to take the respiratory acidosis and respiratory alkalosis quiz.
This article will cover:
- Sequence of normal breathing
- Patho of respiratory alkalosis
- Causes of respiratory alkalosis
- Signs and symptoms of respiratory alkalosis
- Nursing interventions for respiratory alkalosis
Lecture on Respiratory Alkalosis
What’s involved:…let’s look at normal breathing:
- Oxygen enters through the mouth or nose
- down through the Pharynx
- into the Larynx (the throat)
- then into the Trachea
- and the Bronchus (right and left) which branches into the bronchioles and ends in alveoli sac
*The alveolar sacs are where gas exchange takes place (oxygen and carbon dioxide diffuse across the membrane). The oxygen enters into your blood stream and CARBON DIOXIDE CO2 is exhaled through your nose or mouth.
The diaphragm also plays a role in allowing lungs into inflate and deflate.
Note: if there is any problem with the patient breathing rate (too fast), alveolar sacs (damaged), hyperventilation, or a brain injury that affects the respiratory center a patient is at risk for respiratory alkalosis
*Main cause of respiratory alkalosis is tachypnea (fast respiratory rate >20 bpm which causes CO2 to decrease in the lungs)
When this happens the following lab values are affected:
- Blood pH increases (>7.45)
- Carbon dioxide levels increase (<35)
- **To compensate for this the Kidneys start to excrete bicarbonate (HCO3) to hopefully decrease the blood’s pH back to normal…..so HCO3 becomes <22.
REMEMBER (memorize) these lab values:
- pH 7.35-7.45
- PaCO2 35-45
- HCO3 22-26
Causes of Respiratory Alkalosis
Remember: TACHYPNEA (fast breathing leads to “hyperventilation” which leads to respiratory alkalosis)
Temperature increase (fever) due to increased metabolic needs of the body which causes the respiratory center (medulla and pons) to try to compensate by making the respiratory rate increased…hence exhaling too much carbon dioxide (CO2)
Aspirin toxicity: too much aspirin in the body leads to hyperventilation due to the stimulation of the respiratory center and fever
Controlled ventilation (excessive usage)…mechanical ventilation****hyperventilates the patient with too much oxygen and depletes carbon dioxide
Hyperventilation (excessive respirations) expelling too much carbon dioxide
hYsteria (anxiety) leads to rapid breathing and expelling of carbon dioxide
Pain…rapid breathing (blowing off too much carbon dioxide), Pregnancy (especially in 3rd trimester due to changes of the respiratory tract), Pneumonia
Neurological injuries from a head injury or stroke (affects the respiration system of the brain which is located in the medulla and pons)
Embolism or Edema in the lungs
Asthma due to hyperventilation (however, asthma can cause respiratory acidosis as well due to bronchospasms which is causing the alveoli to not properly deflate)
Signs and Symptoms of Respiratory Alkalosis
- ***Classic Assessment Sign is fast respiratory rate (normal for adult is 12-20) TACHYPNEA (>20 bpm)
- Neuro changes: Tired, lethargy, fast heart rate
- **Tetany, dysrhythmias, muscle cramps, positive Chvostek’s sign due to hypocalcemia and hypokalemia
Nursing Interventions for Respiratory Alkalosis
- Teach patient breathing techniques to slow down breathing, holding breath…”rebreathing into a paper bag or re-breather mask
- Watch potassium levels (hypokalemia..remember hyperkalemia in respiratory acidosis & hypocalcemia) and for signs and symptoms of low calcium and potassium levels.
- **Closely watch patients on mechanical ventilation to ensure breaths are not hyperventilating the patient