MEDizzy - A child with a history of asthma presents to an emergency

Feed Library Learning Discuss Leaderboard Journal

Altered Fluid and Electrolytes

A child with a history of asthma presents to an emergency room and is treated with epinephrine. The child is agitated, sweating profusely while sitting up, and has an oxygen saturation of less than 91% and a respiratory rate of less than 30 breaths per minute. Breath sounds are diminished, and wheezing is absent. Based on this information, which acid-base imbalance should a nurse anticipate?

ExplanationThe nurse should anticipate respiratory acidosis. This child is most likely in status asthmaticus with continued respiratory distress despite treatment. Even though the child has a high respiratory rate, there is hypoventilation as a result of bronchoconstriction, which results in carbon dioxide retention. High PaCO2 (greater than 42 mm Hg) will result in a lowering of pH or an acidotic state, resulting from primary changes to the respiratory system. Respiratory alkalosis would occur if excess carbon dioxide is blown off with hyperventilation. The client’s symptoms are associated with a respiratory and not a metabolic problem; thus, metabolic alkalosis and acidosis are incorrect.