Acute Respiratory Failure Flashcards
ARF ABGS room air
PaO2 < 60 mm Hg
PaCO2 > 50 mm Hg
pH ≤ 7.30
Hypoxia
Low oxygen in tissues
Hypoxemia
Low oxygen in blood
Hypoxemia leads to
Hypoxia
results from impaired has exchange
Extrapulmonary
Cause is outside of lungs
Brain, spinal cord, neuromuscular system
*HYPOventilation
Intrapulmonary
Caused by factors INSIDE the lungs
*Lower airways, alveoli, pulmonary circulation
Secondary Causes
Decrease in ventilatory drive
* Decreased muscle strength
*Change in chest wall elasticity (compliance)
*Change in lung’s ability to maintain gas exchange
*Increase in airway resistance or increase in metabolic oxygen demands
PAIN SEDATION
hypoventilation
Increased CO2 created by tissues is able to be delivered to the lungs, but not released
Normal Ventilation V
4 L/min
Normal perfusion Q
5 L/min
Normal V/Q
4/5
Intrapulmonary shunting
Blood gets to arteries but no gas exchange occurs.
Atelectasis, pneumonia, pulmonary edema
The first sign in respiratory failure
Change in LOC
Treatment ARF
Correct hypoxemia
SIMV - synchronous intermittent mandatory ventilation mode
Frequency of mandatory ventilator
breaths is slowly decreased which
requires the patient to gradually take
over their own work of breathing
PSV - pressure support
Provides positive pressure during
the inspiratory phase to support tidal
volumes and decrease work of
breathing
Pharmacology for ARF
Mucolytics, Bronchodilators, Corticosteroids, sedation, neuromuscular blocker, transfusion
Complications of Hypoxemia/ Ventilation
Ischemia, Cardiac Dysrhythmia, Thromboembolism, GI bleeding, VAP
Nursing for VAP
HOB 30-45
Assess readiness to extubate
GI stress ulcer
Oral care
