Acidosis caused by inadequate ventilation and the subsequent retention of carbon dioxide.

SYN: carbon dioxide acidosis

PATIENT CARE
The patient suspected of developing acute respiratory acidosis is monitored using arterial blood gases, level of consciousness, and orientation to time, place, and person. The patient is also evaluated for diaphoresis, a fine or flapping tremor (asterixis), depressed reflexes, and cardiac dysrhythmias. Vital signs and ventilatory effort are monitored, and ventilatory difficulties such as dyspnea are documented. Prescribed intravenous fluids are given to maintain hydration. The patient is oriented as often as necessary, and information and reassurance are given to allay the patient's and family's fears and concerns. Prescribed therapies for associated hypoxemia and underlying conditions are provided, responses are evaluated, and related patient education is given.

The respiratory therapist (RT) works with the attending physician to determine when to intubate and mechanically ventilate the patient with acute respiratory acidosis. Once the patient is intubated and is receiving mechanical ventilation, the RT monitors and maintains the patient's airway and tolerance of the positive pressure ventilation. This requires the RT to perform frequent q1-2m assessments of the patient and the ventilator and report side effects to the attending physician. Some patients with advanced chronic obstructive lung disease develop chronic respiratory acidosis (as a result of CO₂ retention), usually with a compensatory metabolic (renal) alkalosis.

Acute respiratory acidosis is a medical emergency in which immediate efforts to improve ventilation are required.

Main entry:
acidosis