A client in the emergency department is experiencing a severe panic attack and is visibly hyperventilating. Which of the following assessment findings and laboratory values indicate the client is developing respiratory alkalosis? Select all that apply.
- Arterial blood pH of 7.52Answer
- Partial pressure of arterial carbon dioxide (PaCO2) of 28 mm HgAnswer
- Client reports tingling and numbness in the handsAnswer
- DPartial pressure of arterial carbon dioxide (PaCO2) of 48 mm Hg
- EClient exhibits a depressed respiratory rate of 10 breaths per minute
Answer
The findings that indicate respiratory alkalosis are an arterial blood pH of 7.52, a PaCO2 of 28 mm Hg, and client reports of tingling and numbness in the hands.
Hyperventilation, common during severe panic attacks, leads to the excessive "blowing off" of carbon dioxide. Because carbon dioxide functions as an acid in the bloodstream, its rapid depletion causes the blood pH to rise above the normal upper limit of 7.45 (alkalosis) and the PaCO2 to fall below the normal lower limit of 35 mm Hg. Additionally, an alkalotic state increases the binding of circulating calcium to albumin, resulting in a functional hypocalcemia. This drop in ionized calcium triggers neuromuscular excitability, which frequently presents as tingling and numbness in the extremities.
Step-by-Step Solution
Key Concept
Respiratory alkalosis occurs when hyperventilation causes excessive elimination of carbon dioxide, leading to a decreased PaCO2, an elevated pH, and secondary hypocalcemia causing neuromuscular symptoms.
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