Page 278 - Saunders Comprehensive Review For NCLEX-RN

respiratory acidosis.
IV. Respiratory Alkalosis
A. Description: A deficit of carbonic acid and a decrease in hydrogen
ion concentration that results from the accumulation of base or
from a loss of acid without a comparable loss of base in the body
fluids.

B. Causes: Respiratory alkalosis results from conditions that

cause overstimulation of the respiratory system (Box 9-2).

C. Assessment (Table 9-2)

D. Interventions
1. Monitor for signs of respiratory distress.
2. Provide emotional support and reassurance to the
client.
3. Encourage appropriate breathing patterns.
4. Assist with breathing techniques and breathing aids if
needed and as prescribed (voluntary holding of
breath, using a rebreathing mask, CO breaths with
2
rebreathing into a paper bag).
5. Provide cautious care with ventilator clients so that
they are not forced to take breaths too deeply or
rapidly.
6. Prepare to administer calcium gluconate for tetany as
prescribed.
V. Metabolic Acidosis
A. Description: A total concentration of buffer base that is lower than
normal, with a relative increase in the hydrogen ion concentration,
resulting from loss of too much base and/or retention of too much
acid.

B. Causes (Box 9-3)

An insufficient supply of insulin in a client with diabetes mellitus can result in

metabolic acidosis known as diabetic ketoacidosis.

C. Assessment (see Table 9-1)

D. Interventions
1. Monitor for signs of respiratory distress.
2. Monitor intake and output and assist with fluid and
electrolyte replacement as prescribed.
3. Prepare to administer solutions intravenously as
prescribed to increase the buffer base.
4. Initiate seizure precautions.

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