Certified Pediatric Nurse (CPN)

Which treatment is a priority for a child diagnosed with respiratory acidosis?

1. Have a child slow his breathing by breathing into a paper bag

2. Administer oxygen and monitor the child's work of breathing

3. Administer bicarbonate via IV infusion

4. Have the child's mother help calm the child

The correct answer is: Administer oxygen and monitor the child's work of breathing

When addressing respiratory acidosis in a pediatric patient, the primary treatment focus is to improve oxygenation and support effective ventilation. Administering oxygen helps increase the oxygen levels in the blood, which may be critically low in respiratory acidosis. Monitoring the child's work of breathing is also crucial, as it provides immediate feedback on the effectiveness of the chosen interventions and allows healthcare providers to assess whether the child is exhibiting signs of respiratory distress or fatigue. In cases of respiratory acidosis, the underlying issue is often inadequate ventilation leading to carbon dioxide retention. Therefore, addressing any hypoxemia and assessing the child's respiratory effort is essential for stabilizing the patient. While the other options may provide some benefit in specific contexts, they do not address the immediate needs of a child experiencing respiratory acidosis as effectively as providing oxygen and monitoring respiratory status. For instance, slowing breathing with a paper bag may worsen the situation by further increasing carbon dioxide levels. Administering bicarbonate may not be effective as a first-line treatment and is typically reserved for cases where metabolic acidosis is involved or as a secondary intervention. Calming the child can support overall comfort, but it does not directly impact the physiological problems associated with respiratory acidosis.