The nurse understands causes of respiratory acidosis include: (SELECT ALL THAT APPLY)
A.
asthma
B.
hyperventilation
C.
chronic obstructive pulmonary disease
D.
renal insufficiency
E.
pneumonia
The Correct Answer and Explanation is:
The correct answers are A. asthma, C. chronic obstructive pulmonary disease (COPD), D. renal insufficiency, and E. pneumonia.
Explanation:
Respiratory acidosis is a condition characterized by an increase in the concentration of carbon dioxide (CO₂) in the blood, which leads to a decrease in blood pH (acidosis). This occurs when the lungs are unable to effectively remove CO₂ from the bloodstream, resulting in its accumulation and subsequent increase in acidity. The causes of respiratory acidosis can be broadly categorized into acute and chronic conditions that impair the ability of the lungs to exchange gases effectively.
- Asthma (A): Asthma is a chronic respiratory condition characterized by airway inflammation and bronchoconstriction. During an asthma attack, the airways narrow and become obstructed, which impairs airflow and decreases the effectiveness of CO₂ removal from the body. This accumulation of CO₂ in the bloodstream can lead to respiratory acidosis. Asthma-induced respiratory acidosis is usually acute, occurring during or following an asthma exacerbation.
- Chronic Obstructive Pulmonary Disease (COPD) (C): COPD is a progressive lung disease that includes chronic bronchitis and emphysema. It is characterized by long-term airflow obstruction and impaired gas exchange. In COPD, the chronic obstruction of airflow leads to CO₂ retention and a gradual decline in the ability to maintain normal blood pH levels, resulting in respiratory acidosis. COPD-related respiratory acidosis is often chronic, with patients gradually developing more pronounced symptoms over time.
- Renal Insufficiency (D): Although primarily a cause of metabolic acidosis, renal insufficiency can contribute to respiratory acidosis when the kidneys are unable to compensate for acid-base imbalances by excreting acids effectively or by reabsorbing bicarbonate. In such cases, the resulting CO₂ accumulation can lead to a concurrent respiratory acidosis.
- Pneumonia (E): Pneumonia is an infection that inflames the alveoli in the lungs, leading to impaired gas exchange. This inflammation can result in CO₂ retention due to reduced surface area for gas exchange and impaired lung function. The accumulation of CO₂ from pneumonia can lead to respiratory acidosis, especially if the infection is severe or acute.
Hyperventilation (B) is incorrect as a cause of respiratory acidosis because it typically results in a decrease in CO₂ levels, leading to respiratory alkalosis, not acidosis. Hyperventilation increases the rate of CO₂ exhalation, which lowers CO₂ levels in the blood and raises blood pH.
In summary, asthma, COPD, renal insufficiency, and pneumonia are all conditions that can lead to respiratory acidosis due to their effects on CO₂ retention and gas exchange. Hyperventilation, on the other hand, does not contribute to respiratory acidosis but rather to respiratory alkalosis.