Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

N 4300 Exam 2 > Acute Respiratory Failure > Flashcards

Acute Respiratory Failure Flashcards

1
Q

What are the levels of PaO2, PaCO2, Ph in ARF?

A

less than 60 mm hg(80-100 mm hg normal), greater than 50 mm hg(35-45 mm hg norm.), less than or equal to 7.30(7.35-7.45 norm.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Examples of failure of oxygenation by hypoventilation, ventilation/perfusion mismatch, diffusion defects?

A

sedation, pain, ab/chest surgery, neuro pts; pulm. Embolism; increase intrastial fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Examples of failure of oxygenation by low Co, low hemoglobin, tissue hypoxia?

A

MI, HF, a fib, shock, sepsis; anemia; left sided shift of oxyhemoglobin dissociation curve.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What shows the earliest signs of hypercapnia and hypoxia?

A

change in neuro status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some signs of hypoxia? Hypercapnia?

A

confusion, restless, anxious; sleep, lethargic, coma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

In unilateral lung disease how do you position pt?

A

Good lung down when laying on side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What nursing intervention helps maximize airway clearance?

A

reposition every 2 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

ARDS ends in?

A

Respiratory failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why do you apply PEEP?

A

to keep airways open

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is ARDS?

A

Noncardiogenic pulmonary edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the diagnostic criteria for ARDS?

A

acute onset within one week on injury, PaO2/FiO2 ratio less than 200, bilateral infiltrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

ARDS PEEP requirements?

A

greater than 5 cm H2O

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Possible direct causes for ARDS?

A

aspiration, diffuse pneumonia, fat embolism, near drowning, neurogenic pulmonary edema, oxygen toxicity, pulm. Contusion, trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Possible indirect causes for ARDS?

A

sepsis, cardiopulmonary bypass, anaphylaxis, DIC, drug OD, fractures, transfusion related lung injury (traly), eclampsia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is some patho behind ARDS?

A

insult: systemic inflammatory response syndrome, damage alveolar cap. Membrane, increased cap. Permeability, pulm. Edema, atelectasis, decreased lung compliance, impaired gas exchange, V/Q mismatch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What should we be concerned about with ARDS?

A

renal failure and MODS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which patients have a high risk for ARDS?

A

Pneumonia, Aspiration, Trauma, Sepsis, COPD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

In ARDS you will see hypercapnia, why?

A

trying to compensate for respiratory alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

T/F in ARDs we should check Na, may have hypernatremia.

A

FALSE : hypercalcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are some symptoms of ARDS?

A

dyspnea, tachypnea, hyperventilation w. normal BS (early), increase temp and pulse, increased PIP on ventilation, white out chest xray, hypoxemia, crackles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Tx for ARDS?

A

higher PEEP, lung preventative strategies, vent: high freq (because prone to resp. acidosis), pressure control, and inverse-ratio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How much should tidal vol. of ARDS patient be?

A

6 ml/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

T/F it is important to manage sedation and pain relief in ARDS pts.

A

TRUE

24
Q

What positon is good for ARDS patients why?

A

relieve pressure off of lungs, increase perfusion, promotes expelling secretions.

25
Q

What are concerns with prone position?

A

aspiration, keep airway, skin breakdown, padding bony prominences.

26
Q

Too much PEEP can cause?

A

Increased ITP could lead to pneumothorax, decreased CO and venous return, Increased ICP

27
Q

T/F Adequate nutrition and fluid and electrolyte balance are important in ARDS patients?

A

TRUE

28
Q

What are some Physiological changes in COPD?

A

mucous hypersecretion, ciliary dysfunction, chronic airway inflammation, airway remodeling, thickening of pulmonary vessels (decreases gas exchange ability)

29
Q

T/F in COPD pts are prone to left side HF

A

FALSE: right

30
Q

What are some clinical manifestations of COPD?

A

wheezes, barrel chest, anxious, chronic cough, crackles, clubbing, hypercapnia.

31
Q

What is important for tx of stable COPD?

A

broncho dilator, flu shot, quit smoking.

32
Q

What are some causes of ARF in COPD?

A

acute exacerbations, CHF/pulm. Edema, dysrhythmias, pneumonia, dehydration, electrolyte imbalances

33
Q

Progress RF in COPD leads to decreased O2 and increased CO2 causing?

A

uncompensated respiratory acidosis.

34
Q

What are some signs of uncompensated respiratory acidosis?

A

increase WOB, increase in abnormal BS, tachycardia, decreased CO, ABG worsen, PaO2 less than 60

35
Q

What should we be cautious with in COPD patient?

A

over oxygenating them

36
Q

What are some effects of exacerbation of Asthma?

A

hyperventilation with air trapping results in respiratory acidosis, severe hypoxemia

37
Q

What is an alternative medication management of asthma?

A

heliox: helium and O2, NPPV

38
Q

How do we know asthma patients airway is improving?

A

less or more wheezing depending on pt, can speak more, blood gases better

39
Q

Who are at increased risk for pneumonia?

A

elderly, smoker, alcoholic, chronic diseases, head injury, immunosuppression

40
Q

what are the core measures for pneumonia?

A

oral care, 1st dose antibiotics within 6-8 hrs of admit, 1st 24 hours blood cultures, talk about flu and pneumonia vaccine, smoking cessation.

41
Q

What are some s/s of pneumonia?

A

fever, cough, purulent sputum, hemoptysis(blood in sputum), dyspnea/tachypnea, chest pain, adventitious BS

42
Q

What are some alterations in blood gases in pneumonia?

A

hypoxemia, respiratory alkalosis.

43
Q

Why is it easier for patients on a ventilator to get pneumonia?

A

When you are ventilated epiglottis moves out of the way and can’t defend against aspiration of bacteria; cuff of ventilator doesn’t work as well to prevent aspiration.

44
Q

What is the VAP bundle (what you should do for patient)?

A

elevate HOB 30-45 degrees, awake daily and assess readiness to wean, stress ulcer disease prophylaxis, venous thromboembolism (VTE) prophylaxis, oral care

45
Q

Why do we avoid normal saline during suctioning?

A

because wash bacteria in lower airways.

46
Q

In VAP what are ways to prevent infection and aspiration?

A

avoid re-intubation, oral intubation, ETT with continuous aspiration of subglottic secretions, sedation and weaning protocols, aseptic suctioning of ET tube.

47
Q

In pulmonary embolism what is the virchows triad?

A

venous stasis, altered coagulability, damage to vessel walls

48
Q

PE patients are prone to?

A

pulm. Htn and right ventricular failure.

49
Q

What are some s/s of PE?

A

symptoms of DVT, acute dyspnea, great sense of doom, tachycardia, cough, hemoptysis, crackles, wheezes, hypoxemia

50
Q

What are some ways to diagnosis PE?

A

CT angiography(noninvasive), Pulm. angiogram, MRI,

51
Q

What kind of heparin do you give PE patients?

A

molecular-weight heparin

52
Q

What are some prevention measures of PE?

A

compression devices, position changes, tx dysrhythmias, prophylactic anticoag. therapy, avoid pillows under knees.

53
Q

What are some complications of PE?

A

HF, obstructive shock, Death

54
Q

What are some nursing implications for PE?

A

monitor coag levels, switch to oral anticoag, assess for signs of pulm. htn which may lead to RVF, JVP, peripheral edema, assess CO.

55
Q

Normal PTT? INR?

A

21-35 sec, less than 2.

56
Q

What is PTT therapeutic range? INR?

A

46-80 sec; 2-3; increase both causes slower clotting.

57
Q

What is antidote for Heparin? Coumadin?

A

Protamine Sulfate; Vit. K

N 4300 Exam 2 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions