Respiratory Acidosis on the NCLEX
Causes (hypoventilation), interpretation, compensation, treatment.
Respiratory acidosis is high CO2 from hypoventilation. NCLEX tests recognition and causes.
ABG pattern
pH <7.35, CO2 >45. HCO3 normal acutely; elevated if chronic compensation.
Causes
Respiratory depression (opioids, sedatives), COPD, pneumonia, ARDS, neuromuscular weakness, sleep apnea.
Compensation
Kidneys retain HCO3 over days. Chronic respiratory acidosis has near-normal pH with high CO2 + high HCO3.
Treatment
Treat cause. Improve ventilation (positioning, suctioning, BiPAP, intubation). Reverse opioids if applicable.
Frequently asked
ROME mnemonic?
Respiratory Opposite (pH and CO2 move opposite), Metabolic Equal (pH and HCO3 move same direction).
Why not high O2 in COPD respiratory acidosis?
Can blunt hypoxic drive. Target SpO2 88-92%.
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