RESPIRATORY ACIDOSIS

Prepared By:
Riezel Umaming
Kathleen Testado
Hazel Alarilla
Contents

 Definition
 Risk Factors
 Causes
 Signs and Symptoms
 Pathophysiology
 Diagnostic Tests
 Treatment
 Nursing Interventions
 Prevention
What is Respiratory Acidosis?
 Respiratory acidosis is a condition that occurs when the
lungs can’t remove enough of the carbon dioxide (CO2)
produced by the body.

 Excess CO2 causes the pH of blood and other bodily

fluids to decrease, making them too acidic. Normally, the
body is able to balance the ions that control acidity.

This balance is measured on a pH scale from 0 to 14.

Acidosis occurs when the pH of the blood falls below
7.35.
(normal blood pH is between 7.35 and 7.45)
Types of Respiratory Acidosis
There are two types of respiratory acidosis:

1.Acute respiratory acidosis the PaCO2 is elevated above

the upper limit of the reference range (ie, >45 mm Hg) with
an accompanying acidemia (ie, pH < 7.35. Occurs when an
abrupt failure of ventilation occurs.

2.Chronic respiratory acidosis the PaCO2 is elevated

above the upper limit of the reference range, with a normal
pH (7.35-7.45) or near-normal secondary to renal
compensation and an elevated serum bicarbonate levels (ie,
>30 mEq/L).
Risk Factors

 Chronic Obstructive Pulmonary Disease

 Asthma
 Sleep apnea
 Pneumonia
 Stroke
 Obesity
 Causes
 Chronic obstructive respiratory
disorders: emphysema, chronic
bronchitis
 Chest wall trauma
 Pulmonary edema
 Atelectasis
 Pneumothorax
 Drug Overdose
 Pneumonia
 Guillain-Barre syndrome
 Signs and Symptoms
 CNS disturbances:
restlessness, confusion, and
apprehension to somnolence
with fine flapping tremor, or
coma.
 Headache
 Dyspnea
 Tachypnea
 Decrease in blood pressure
 Mental cloudiness and
feeling of fullness in head
 Weakness
Pathophysiology
Non-modifiable Modifiable
-Gender - Lung Disorders
-Heredity -Sleep Disordered Breathing
-Age -Overdose of Drugs
-Diseases of the
nerves/muscles of the chest

Hypoventilation

Excess CO2 production

Decreased pH level (<7.35)

Increased PaCO2 level (>44mmHg)

 Diagnostic Tests
 Blood gas measurement
Blood gas is a series of tests used to measure
oxygen and CO2 in the blood. A healthcare
provider will take a sample of blood from your
artery. High levels of CO2 can indicate acidosis.
 Electrolytes
Electrolyte testing is a group of tests that
measure levels of Na+ (sodium), K+ (potassium),
Cl- (chloride), and bicarbonate. One or more of
the electrolytes will be increased or decreased
in people with acid-base disorders such as
respiratory acidosis.
 Lung function tests
Spirometry is the most common lung function test.
It measures how much and how quickly you can
move air out of your lungs. Many people with
this condition have reduced lung function.
 Continuation…
 Chest X-ray
X-rays can help doctors see injuries or other problems likely to
cause acidosis.

 Other tests
Based on these tests, your doctor may also perform other tests
to help diagnose the underlying condition that’s causing the
acidosis. (Another condition, known as metabolic acidosis, may
cause similar symptoms, and the doctor may order tests to be
sure the problem is solely respiratory. These tests measure the
amount of acid in your body, which may be caused by kidney
failure, diabetes, or other conditions, and include glucose,
lactate, and ketones.) Other tests include drug testing, a
complete blood count (CBC), and a urinalysis (urine test).
Treatment
 Bronchodilators: such as beta agonists (eg, albuterol and
salmeterol), anticholinergic agents (eg, ipratropium bromide and
tiotropium), and methylxanthines (eg, theophylline) are helpful in
treating patients with obstructive airway disease and severe
bronchospasm. Theophylline may improve diaphragm muscle
contractility and may stimulate the respiratory center.

 Oxygen Therapy - Oxygen therapy is employed to prevent the

sequela of long-standing hypoxemia.
Patients with COPD who meet the criteria for oxygen therapy
have been shown to have decreased mortality when treated
with continuous oxygen therapy.
Continuation…
 Ventilatory Support – Therapeutic measures that may be
lifesaving in severe hypercapnia and respiratory acidosis
include endotracheal intubation with mechanical ventilation
(invasive) and noninvasive positive pressure ventilation (NIPPV)
delivered through a non invasive interface(face mask, nasal
mask or nasal plugs) techniques such as Continuous positive-
airway pressure ventilation (CPAP) and Bi-level positive airway
pressure ventilation (BPAP)
Endotracheal Intubation w/ Mechanical Ventilation Non invasive positive pressure ventilation (NIPPV)
Nursing Interventions
 Remain alert for critical changes in patient’s respiratory, CNS
and cardiovascular functions. Report such changes as well as
any variations in ABG values or electrolyte status immediately.
 Maintain adequate hydration.
 Maintain patent airway and provide humidification if acidosis
requires mechanical ventilation. Perform tracheal suctioning
frequently and vigorous chest physiotherapy, if ordered.
 Institute safety measures and assist patient with positioning.

 Continuously monitor arterial blood gases.

Prevention
 Do not smoke. Smoking leads to the development of many
severe lung diseases that can cause respiratory acidosis.

 Losing weight may help prevent respiratory acidosis due to

obesity (obesity-hypoventilation syndrome).

 Be careful about taking sedating medicines, and never

combine these medicines with alcohol.

 Use your CPAP device regularly if it's been prescribed for you
END

hazel