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Difficulty: EasyPhysiological Adaptation

A client is brought to the emergency department experiencing a severe panic attack. The client is visibly anxious, diaphoretic, and breathing rapidly at a rate of 34 breaths per minute. Which of the following arterial blood gas (ABG) values would the nurse anticipate for this client? Select all that apply.

  1. pH 7.52Answer
  2. PaCO2 28 mm HgAnswer
  3. C
    pH 7.31
  4. D
    PaCO2 48 mm Hg
  5. E
    HCO3- 18 mEq/L

Answer

The expected ABG values for a hyperventilating client are a pH greater than 7.45 (such as 7.52) and a PaCO2 less than 35 mm Hg (such as 28 mm Hg).
Acute hyperventilation from a panic attack causes the body to exhale excessive amounts of carbon dioxide. Because carbon dioxide functions as an acid in the blood, this rapid loss leads to a decrease in PaCO2 (below the normal baseline of 35 mm Hg) and a corresponding increase in blood pH (above the normal baseline of 7.45). This physiological state is known as respiratory alkalosis.

Step-by-Step Solution

1
Identify the primary clinical manifestation in the scenario.
The client is hyperventilating (breathing rapidly and deeply) due to a panic attack.
Recognizing the breathing pattern is essential to determine how carbon dioxide is being handled by the respiratory system.
2
Determine the physiological effect of hyperventilation on gas exchange.
Rapid breathing leads to excessive elimination of carbon dioxide (CO2) from the lungs.
CO2 acts as an acid in the blood; blowing it off reduces the total acid concentration in the body.
3
Correlate the physiological change to ABG values.
The loss of CO2 causes PaCO2 to decrease below 35 mm Hg, which subsequently increases the blood pH above 7.45.
This specific combination of a high pH and a low PaCO2 defines acute respiratory alkalosis.

Key Concept

Respiratory Alkalosis secondary to hyperventilation
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Topics

Physiological Adaptation

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