Question

The last patient the nurse sees today presents to the ED with a complaint of chest tightness, tingling in the hands, and headache. He has noticeable trembling of the hands. He states, "I swear I think I am having a heart attack!" His vital signs are BP 162/88 – 104 – 32 and afebrile. The ED provider orders laboratory work including cardiac panel, chemistry panel, CBC, and arterial blood gases (ABGs). The provider tells the nurse "I think he is having an anxiety attack." 1. What would the nurse anticipate the ABG results to be if this diagnosis is correct? What disorder would be present and what are the possible increased or decreased values? 2. What interventions would the nurse use to assist the patient to compensate for this acid-base disorder?

Answer 1

1 aif the diagnosis is correct the ABG results of the patient will be Respiratory alkalosis.In respiratory alkalosis there will be numbness,tingling,confusion and often occurs in panic attacks .

b Respiratory stimulation is a common event in panic attacks.The respiratory abnormality in panic disorders is increased carbondioxide sensitivity,which has given rise to the hypothesis of fundamental abnormalities in the physiological mechanisms that control breathing in panic disorders.Panic disorder patients with dominant respiratory symptoms are more sensitive to respiratory tests.Patients with panic disordertend to hyperventillate and to panic in response to respiratory stimulants such as carbondioxide,triggering the activation of a hypersensitive fear network.the disorder could possibly be one of the respiratory subtype of Panic disorder or the hyper ventillation syndrome.

2 Nursing interventions

• Monitor for signs of respiratory distress.
• Assess level of consciousness for CNS depression.
• Monitor intake and output chart.
• Prepare to administer solutions intravenously as prescribed to increase the buffer base.
• Initiate safety and seizure precautions.