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CASE ...
Mr. Worried is a 52-year-old widow. He is retired and
living alone. He enters the ED complaining of shortness of
breath and tingling in fingers. His breathing is shallow and
rapid. He denies diabetes; blood sugar is normal. There are
no ECG changes. He has no significant respiratory or cardiac
history. He takes several antianxiety medications. He says
he has had anxiety attacks before. While being worked up
for chest pain an ABG is done:
ABG results are:
pH = 7,48
PaCO2 = 28
HCO3 = 22
PaO2 = 85

Can you identify the problem

and solution for this case ?

The diagnose of this case

is

Respiratory
Alkalosis

Respiratory alkalosis
is a condition where the
blood is alkaline because
rapid breathing and in
causing carbon dioxide
levels in the blood is low.

CAUSE . . .
Rapid breathing and in the so-called
hyperventilation, which leads to too many amount of
carbon dioxide released from the bloodstream. The
cause hyperventilation, which is the most common
anxiety.

Other causes of respiratory alkalosis is:

- Pain
- Cirrhosis of the liver
- Low blood oxygen levels
- Fever
- An overdose of aspirin.

THE SYMPTOMS
Respiratory
alkalosis
can
make
people feel anxious and can cause
itching around the lips and face. If the
situation gets worse, it could happen
muscle
spasms
and
loss
of
consciousness.

DIAGNOSIS
Diagnosis based on the results of
measurements of the levels of carbon
dioxide in arterial blood. blood pH is
also often increased.

THE TREATMENT
Usually the only treatment needed is slow breathing. If the
cause is anxiety, slow breathing can alleviate this disease.
If the cause is a pain, given pain medication.
Breath in a paper bag (not plastic bags) can help increase
levels of carbon dioxide after the patient inhaling carbon
dioxide breath back.
Another option is to teach the patient to hold his breath as
long as possible, then breathe shallow and hold back his
breath as long as possible. This is done repeatedly in a
series as much as 6-10 times. If carbon dioxide levels rise,
hyperventilation symptoms will improve, thus reducing
patient anxiety and stop attacks respiratory alkalosis.

NURSING INTERVENTIONS
1. Independent
a. Monitor the amount of breathing, depth and effort /
difficulty breathing patients (nostrils, ETC.)
b. Make sure the cause hyperventilation if possible such as
anxiety, pain
c. Assess the level of awareness and record the status of
neuromuscular
d. Teach patients how to breathe correctly and help if the
patient on a ventilator, for example masks
e. Help the patient to be calm
f. Give safety when necessary, eg the bed is lowered, the
barrier beds and frequent observation

2. Collaboration
a.Help to identify / treat in accordance
with the cause
b.Monitor blood gas analysis
c. Monitor serum potassium
d.Give sedative if indicated
e.Use a respirator mask to maintain /
restore CO2. Reduce respiratory rate /
tidal volume with ventilator tools

Thank
You