 What comes in nursing school explained in this video on respiratory Arcolysis if you feel like you need a little bit of a deeper dive into looking into the physiology and how on how the body Regulates pH and homeostasis. Please check out my other video. I'll put it in the cards up here But here for a quick review. So in our body, we produce carbonic acid, which is H2CO3 That can be broken down by either the respiratory or the renal systems and the respiratory System simply breaks it down into carbon dioxide that we exhale and into water Which is the carbon dioxide here represents the acid and the water the base and then in terms of the renal or metabolic system The H2CO3 is broken down into HCO3 minus and H plus which is bicarbonate and Hydrogen ion and the way that the kidneys do that they regulate the amount of bicarbonate or hydrogen That they either reabsorb or excrete depending on what the pH requirements are and the normal value is this pH 7.35 through 7.45 where CO2 is 35 through 45 So you'll just leave the 7 out and then we have the same 35 and 45 and the bicarbonate normals are 22 through 26 and this acronym here Roam is very important and easy to remember when it comes to ABG interpretation Because what it stands for is respiratory opposite metabolic equal and that refers to the pH So when the pH is acidic the respiratory will be the opposite And so for respiratory alkalosis what that means and alkalosis the pH is high So it will be greater than 7.45 and because in respiratory Is as always opposite the pH the CO2 will be low So the respiratory is opposite of the pH in respiratory alkalosis and Then over here causes for respiratory alkalosis Anything that can cause hypoxemia and think about this if the body is starved for oxygen It's going to increase the respiratory rate So when we increase the respiratory rate, we breathe in more oxygen But at the same time we exhale more CO2 Which then let's the CO2 the acid leave the body which leaves us in an alkalotic state So it leads to a CO2 deficit and CO2 levels will be low as we discussed over here Now what can cause that acute pulmonary disorders think about a pulmonary embolism a severe pneumonia ARDS anything that affects the lungs ability to function and have a normal gas exchange Then we have hyperventilation and there could be several causes for that So think about somebody who's having an anxiety or panic attack They typically tend to hyperventilate which means that they're blowing off a lot of CO2 but it also occurs when We have a fever our respiratory rate will go up in in order to try and First of all get more oxygen in but also cool off the body And then other things here will be CNS lesions so think about tumors in the brain for example Pregnancy because the fetus As it grows puts a lot of pressure on the diaphragm and it kind of Impeats the woman's ability to take a nice deep breath Which in turn will up the respiratory rate to get the air in and then respiratory center disorders So this would be let's say a stroke of meningitis that affects the Respiratory centers of the brain to where it's not functioning properly leading to hyperventilation as well as liver failure And then also mechanical hyperventilation So if the patient is on a ventilator and the ventilator is not adjusted correctly and the respiratory rate is high It can lead to respiratory Calcolosis Signs and symptoms patient will have that increase in respiratory rate that we talked about here with that They'll be complained about being lightheaded that might be an altered level of consciousness Or they might have a headache as that CO2 builds up As that CO2 leaves the body and then that is going to be an increase in heart rate Just picture somebody who has a pneumonia is in respiratory distress the heart rate will go up also And then this rithmias because of low serum potassium levels and we'll look into that here a little bit nausea vomiting diarrhea numbness and tingling think about again having the person with the Anxiety attack they can get this numbness and tingling in the fingers and sometimes they can even have these carpal pedos spasms where The fingers just kind of lock up and then it can also lead to an increase in reflexes And so let's look at how metabolic. Um, sorry respiratory alkalosis leads to this rithmias So typically In an alkalotic state the bicarbonate here the base Of the blood content will be high So there's a high level of the bicarbonate and the low level of the acid the co2 in the blood So we have all this Hcu3 in the bloodstream here and a little bit of hydrogen only and then also some potassium recall that potassium is typically an Intracellular ion Well, the body tries to regulate that not only with the respiratory system by blowing off or increasing the co2 But it also can Exchange the hydrogen ion for the potassium So in the cell not only do we have potassium along with other electrolytes, but we also have hydrogen ion So in order to try and balance to increase that hydrogen ion and decrease the bicarbonate in the bloodstream The body is going to pull out the hydrogen ion from the cell But if something comes out something has to be exchanged in return and that will be the potassium So hydrogen ion comes out of the cell trying to balance out the bicarbonate in the bloodstream And in exchange the potassium moves from the intravascular into the intracellular space leaving the serum low in potassium Hence alkalosis leads to serum low potassium. And as we know with potassium abnormalities We always have to think about this rhythm. Yes For treatment, we always need to treat the underlying cause no Amount of hydrogen ion that we give the patient is going to help Do that if we don't treat the underlying cause so looking back here at The causes so hypoxemia of the patient is hypoxic certainly oxygen sounds like a good idea Acute pulmonary disorders pneumonia give them antibiotics pulmonary embolism What can be done to dissolve that that blood clot hyperventilation for somebody who has having an anxiety attack We coach them through deep breathing and we'll get a little bit more into this here If they have a fever we'll give them some anti-pyridics CNS lesions is a little bit more complicated if there's a tumor Maybe we need to remove that tumor or decrease the intracranial pressure Pregnancy not a whole lot we can do about that Other than delivering the baby, but that they all depends on the gestation of the woman And then certainly if there's a stroke there's treatment for that as well as meningitis And if the ventilator is hyperventilating the patient, we just need to reduce that Respiratory rate that the ventilator is controlling to bring the patient's ph balance down And then for nursing care always think about your ab's and c's and that helps you Not only here in acid-base disorders, but also for any kind of exam So airway protect the airway. So if this patient is Having an acute pulmonary embolism and they are being altered and they cannot maintain their airway They're going to need to be intubated Breathing so we want to give them O2 and in the case of hyperventilation You might have heard of somebody who's hyperventilating and we give them a plastic Sorry a paper bag to to breathe into Sometimes in the hospital or put the patient on a non-rebreather mask that we actually don't give them oxygen And it's just has that bag of that non-rebreather And so same function as the paper bag the patient exhales their co2 into that bag But if it gets contained in the bag on the non-rebreather, so they inhale the co2 bag Which will help us correct that co2 deficit Then for c circulation, we always need to have good IV access on these patients So we can give them the appropriate medications for pneumonia Stroke PE any of those things that we need to treat And certainly they need to be on a cardiac monitor because we know that we might have some potassium abnormalities And then certainly we want to monitor their vital signs very closely, especially the respiratory rate and depth because that is what's the underlying cause We want to keep a close eye on their abg's on their electrolytes again because of the potassium Do neural checks if one of those underlying causes is due to some neurologic disorder? And then liver function if liver failure is the cause So thank you for watching this video video on respiratory alkalosis Please also make sure to check out the videos on the other ph balance disturbances And i'll see you soon right here on nursing school explain. Thanks for watching