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Sunday, February 15, 2015

Respiratory Alkalosis Study Guide

Respiratory Alkalosis, ABGs, Arterial Blood Gases, Acid-Base Imbalance, Nursing school, Nurse, Student, NCLEX, lab values

Respiratory Alkalosis

Respiratory Alkalosis occurs when pH is high (above 7.45) and PaCO2 is low (below 35). This acid-base imbalance is due to hyperventilation. The patient's body is ridding itself of CO2 too fast which elevates the pH. This post will explore the common causes, symptoms, and treatments for respiratory alkalosis.

Quick Review

So you've drawn your patient's ABGs and the lab has just posted the results. Where do I start??

Well, I suggest checking out my post on The Ultimate Guide to ABGs and then coming back to this page. 

What are the norms?

  • pH should be between 7.35-7.45
  • HCO3 should be between 22-26
  • PaCO2 should be between 35-45
Here's a quick chart to review:

Respiratory, Metabolic, Alkalosis, Acidosis, pH, CO2, HCO3, ABGs, Acid-Base Imbalance, Nursing School, Nursing Student, NCLEX


Respiratory Alkalosis is cause by hyperventilation. So think, "What can cause my patient to hyperventilate?"

  • Anxiety
  • High Fever
  • Pulmonary Emboli
  • Excessive mechanical ventilation
So just think the next time your patient is going to have a procedure, this is a stressful event for him/her. Be sure to look out for anxiety so that they don't develop Respiratory Alkalosis.


  • Lightheadedness
  • Unable to concentrate (This makes me think of an old Patty Loveless song... I try to think about Elvis....I just can concentrate. You're all I think about these days.... Ok. I'll stop.)
  • Nausea/Vomiting
  • Sweating
  • Palpitations
  • Loss of consciousness
Just think about how you feel when you hyperventilate. You start to get dizzy. Lightheaded. You can't think. You're getting yourself all worked up (anxiety) and you start sweating. Now you might start feeling queezy, and having palpitations. If someone doesn't come in and help you calm down real soon, you'll pass out.
Does that help you picture this happening to one of your patients? Think you can recognize these signs when they occur?


If your patient is experiencing respiratory alkalosis due to anxiety, then you need to try to find a way to calm the patient down. Suggest having them breathe into a paper bag. This will increase the concentration of CO2 and begin to eliminate the other symptoms. Just be careful they done turn hypoxic. 

If your patient is experiencing respiratory alkalosis due to excessive mechanical ventilation then the ventilator settings need to be adjusted. This is most likely going to be done by the doctor or respiratory therapists. 

Ok folks! This was the last post of a five post series. Here are the links to the other posts in case you missed them!

Respiratory Acidosis

I didn't go into too many details on this post, so if you'd like more information I have an ebook on for $3.99 that explains everything so much better. I also work through practice problems with you- step by step. I know how confusing this can be. It took me four different teachers, and four different classes until I FINALLY learned acid-base imbalances the correct way. So check it out! Easy Guide to Interpret Acid-Base Imbalances. It's cheaper than your lunch, and you don't even need to have a kindle to read it!! Thanks!!

Feel free to leave me a comment with a topic you are struggling with in school. If you're struggling with something, I'm sure 90% of the others in your shoes are too. Leave me a comment below!!




  1. helped me understand easier!!!. thank you!!!...

  2. THANK YOU SO MUCH!! I just copied your cards onto my keyring flash cards. I already failed my Acid-Base Imbalances/F&E test because it was mainly ABG stuff which I did not prepare for :( wish I would've had this before then! But.... I still need to know it and this makes it super easy.

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