Question

Scenario: You are caring for a patient in severe pain with a RR of 28. Which acid-base imbalance do you expect to see, and why? What is the anticipated treatment?

Answer 1

Answer:

The normal respiratory rate in an adult range from 12 to 18 breaths per minute. A change in the respiratory rate indicates the sign of deterioration as the body makes an effort to maintain the oxygen delivery to the tissues.

Increased respiratory rate is called Tachypnea which is characterized by shortness of breath, discolored fingers and lips and gasping for breath. It is also related to metabolic imbalances and or central nervous system disorders.

The acid base balance in the body is contributed by the respiratory system by the regulation of carbonic acid which is formed by the reaction of carbon dioxide with water. When the respiratory rate of an individual is increased, excess of carbon dioxide is exhaled. The excess loss of carbon dioxide results in the pH becoming more alkaline and leads to a condition known as respiratory alkalosis. Cause of respiratory alkalosis include hyperventilation, anxiety, fever and pain.

Respiratory alkalosis can be acute or chronic. The treatments include:

• Providing adequate oxygen.
• Rebreathing air that has been exhaled into a paper bag.
• Administration of an opioid or an anti-anxiety medication to reduce hyperventilation.
• Correction of any heart rhythm abnormalities.
• If it is caused due to a ventilator setting, the settings can be modified to adjust to the breathing.