respiratory alkalosis, an abnormal condition characterized by a high plasma pH resulting from increased alveolar ventilation. The consequent acceleration of carbon dioxide excretion lowers the plasma level of carbonic acid, thus raising plasma pH. The hyperventilation may be caused by pulmonary and nonpulmonary problems. Some pulmonary causes are acute asthma, pulmonary vascular disease, and pneumonia. Some nonpulmonary causes are aspirin toxicity, anxiety, fever, metabolic acidosis, inflammation of the central nervous system, gram-negative septicemia, and hepatic failure. Compare metabolic alkalosis. See also metabolic acidosis, respiratory acidosis. ▪ OBSERVATIONS: Deep and rapid breathing at rates as high as 40 breaths per minute is a major sign of respiratory alkalosis. Other symptoms are light-headedness, dizziness, peripheral paresthesia, tingling of the hands and feet, muscle weakness, tetany, and cardiac arrhythmia. Confirming diagnosis is often based on a PaCO2 below 35 mm Hg and a pH greater than 7.45. PaO2 may be higher than 100. In the acute stage, blood pH rises in proportion to the fall in PaCO2, but in the chronic stage it remains within the normal range of 7.35 to 7.45. The carbonic acid concentration is normal in the acute stage of this condition but below normal in the chronic stage. ▪ INTERVENTIONS: Treatment of respiratory alkalosis concentrates on removing the underlying causes. Severe cases, especially those caused by extreme anxiety, may be treated by having the patient breathe into a paper bag and inhale exhaled carbon dioxide to compensate for the deficit being created by hyperventilation. Sedatives may also be administered to decrease the ventilation rate. ▪ PATIENT CARE CONSIDERATIONS: The nurse monitors neurological, neuromuscular, and cardiovascular functions, arterial blood gases, and serum electrolyte levels. The patient benefits from explanations of laboratory tests and treatment.
