A client is experiencing confusion and tremors is admitted to a nursing unit. An initial ABG report indicates that the PaCO2 level is 72 mm Hg, whereas the PaO2 level is 64 mm Hg. A nurse interprets that the client is most likely experiencing:
A. Carbon monoxide poisoning
B. Carbon dioxide narcosis
C. Respiratory alkalosis
D. Metabolic acidosis
Correct Answer: B. Carbon dioxide narcosis
Carbon dioxide narcosis is a condition that results from extreme hypercapnia, with carbon dioxide levels in excess of 70 mm Hg. The client experiences symptoms such as confusion and tremors, which may progress to convulsions and possible coma. The delineating feature of CO2 narcosis is a depressed level of consciousness. It is essential to recognize impending or current CO2 narcosis; if left untreated, it can result in coma or death.
Option A: Carbon monoxide toxicity occurs after breathing in excessive levels of carbon monoxide. This is a tasteless, odorless, and colorless gas and victims are usually unconscious before they realize they are being poisoned.
Option C: Respiratory alkalosis is 1 of the 4 basic classifications of blood pH imbalances. Normal human physiological pH is 7.35 to 7.45. A decrease in pH below this range is acidosis, an increase above this range is alkalosis. Respiratory alkalosis is by definition a disease state where the body’s pH is elevated to greater than 7.45 secondary to some respiratory or pulmonary process.
Option D: Metabolic acidosis is characterized by an increase in the hydrogen ion concentration in the systemic circulation resulting in a serum HCO3 less than 24 mEq/L. Metabolic acidosis is not a benign condition and signifies an underlying disorder that needs to be corrected to minimize morbidity and mortality.
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