What intervention is appropriate for a patient experiencing respiratory alkalosis?
Explanation & Rationale
A. Administer diuretics: Diuretics are primarily used to treat fluid volume excess or hypertension by increasing renal excretion of water and sodium. They do not address the underlying cause of respiratory alkalosis, which is an excessive loss of carbon dioxide. They are inappropriate for managing primary acid-base disturbances of respiratory origin. B. Initiate fluid restriction: Restricting fluid intake is a management strategy for conditions like SIADH or congestive heart failure. It has no impact on the partial pressure of arterial carbon dioxide or the alveolar ventilation rate. This intervention is unrelated to the physiological correction of alkalotic pH levels. C. Encourage the patient to breathe into a paper bag: Respiratory alkalosis is caused by hyperventilation, which leads to hypocapnia and an elevated blood pH. Rebreathing exhaled air increases the inspiratory concentration of carbon dioxide, helping to restore normal PaCO2 and pH. This is a classic intervention for non-organic, anxiety-induced hyperventilation. D. Provide supplemental oxygen therapy: Oxygen is indicated for hypoxemia but does not correct a high pH caused by low carbon dioxide levels. In some cases, providing high-flow oxygen can actually encourage further hyperventilation if not monitored correctly. The primary goal in alkalosis is carbon dioxide retention rather than oxygen supplementation.