Chapter 26: Accumulation of Fluid in the Interstitial Space

Respiratory alkalosis
Results when carbon dioxide is eliminated from the body faster than it is produced. This is called hyperventilation, and results in the blood becoming more alkaline. Often due to stress or pain.
Possibles causes of respiratory alkalosis
Strong emotions: pain, anxiety, fear, panic attack. Hypoxemia: asthma, pneumonia, high altitude; represents effort to raise Po2 at the expense of excessive CO2 excretion. Brain tumor or injury: abnormal respiratory.
Chemical profile for respiratory alkalosis
Pco2< 35mm hg; pH> 7.35
Respiratory acidosis
Common cause of acid based imbalance. It most often occurs when a person breathes shallowly or when gas exchange is hampered by disease. Under such conditions, CO2 accumulates in the blood.
Characterization of respiratory acidosis
Falling blood pH and rising P co2
Possible causes of respiratory acidosis
Impaired lung function: chronic bronchitis, cystic fibrosis, emphysema; impaired gas exchange or alveolar ventilation. Impaired ventilatory movement: paralyzed respiratory muscle, chest injury, extreme obesity. Narcotic or barbiturate overdose or injury to brain stem: depression of respiratory centers, resulting in hypoventilation and respiratory arrest.
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Chemical profile for respiratory acidosis
Pco2 > 45mm Hg; pH < 7.35
An increase in the rate and depth of breathing that exceeds the body’s need to remove CO2. As they blow off CO2, the low CO2 levels in the blood (hypocapnia) constrict cerebral blood vessels. This reduces brain perfusion.
Symptoms of hyperventilation
Dizziness, fainting, tingling, involuntary muscle spasms (tetany) in the hands and face.
How to avert symptoms of hyperventilation
Breathing into a paper bag. The air being inspired from the bag is expired air, rich in carbon dioxide, which causes carbon dioxide to be retained in the blood.
An atypical accumulation of fluid in the interstitial space, leading to tissue swelling.
A condition of unusually low levels of plasma proteins, results in tissue edema because protein-deficient plasma has an abnormally low colloid osmotic pressure.
Causes of edema
Protein malnutrition, liver disease, glomerulonephritis, blocked or removed lymphatic vessels
Problems with fluid, electrolyte, and acid-base balance are most common in infancy. Why?
Low residual lung volume; high rate of fluid intake and output; high metablic rate, yielding more metabolic wastes; high rate of insensible water loss; inefficiency of kidneys, especially during first month; 1st month newborns risk dehydration and acidosis.
Results of elderly being unresponsive to thirst cues
At risk for dehydration; risk of congestive heart failure and diabetes mellitus that cause fluid, electrolyte or acid base problems.