Acute Respiratory Failure Flashcards

1
Q

What is Acute Respiratory Failure?

A

Impairment in Gas Exchange

Not a disease but a symptom

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2
Q

Hypoxemic ARF:

A

PaO2<60 on 60% O2

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3
Q

Hypercapnic ARF:

A

PaCO2>45

pH<7.35

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4
Q

Hypoxemic/Oxygenation Failure is? and examples?

A
V/Q mismatch, Shunting, Impaired diffusion
• Pneumonia
• Pulmonary Embolism
• Pulmonary Edema
• ARDS
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5
Q

Hypercapnic/Ventilatory Failure is? and examples?

A
Impaired ventilation, Impaired chest wall
movement
• Asthma
• COPD
• Pain
• Drug overdose
• Neurological disorders
– MG
– GB
– MS
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6
Q

Failure of Oxygenation

Hypoxemic Failure

A
Ventilation-perfusion mismatch (V/Q
mismatch)
– Intrapulmonary shunting
– Increased dead space ventilation
• Diffusion defects
• Low cardiac output
• Low hemoglobin level
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7
Q

Anatomic Shunt:

A

Blood passes through an
anatomic channel in the
heart bypassing the lungs.

Ventricular septal defect

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8
Q

Physiologic Shunt:

A

Blood flows through the
pulmonary capillaries
without participating in
gas exchange….(Low V/Q)

Pneumonia
ARDS

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9
Q

Diffusion Limitations

A

Thickened alveolar/capillary
membrane impairs gas exchange …

Greater distance CO2 and O2 have to travel.

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10
Q

Failure of Ventilation

Hypercapnic Failure

A

Alveolar hypoventilation

  • Respiratory muscle fatigue
  • CNS depressants
  • Head injury
  • Chest wall abnormalities
  • Neuromuscular conditions
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11
Q

Hypoxemia Manifestations

A
  • Tachycardic/Tachypneic
  • Increased BP
  • Restless
  • Confusion
  • Anxiety
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12
Q

Hypercapnia Manifestations

A
  • Tachycardic/Tachypneic
  • Headache
  • Decreased LOC
  • Increased somnolence
  • Dizzy
  • Flushed
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13
Q

ARF Manifestations:

A
•Pursed-lip breathing
• Retractions
• Orthopnea
• Tripod position – increases AP
diameter – decreases work of
breathing
• Inability to speak in full sentences
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14
Q

Diagnosis

A
• History
• Chest x-ray
• Blood work
– Arterial blood gases
– SvO2
– H &amp; H
– Sputum cultures
• Pulse oximetry
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15
Q

Medical Management

A
  • Oxygen/Respiratory Management
  • Bronchodilators
  • Corticosteroids
  • Diuretics
  • Hydration
  • Nutrition
  • Treatment of underlying cause
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16
Q

Respiratory Management:

Oxygen delivery devices

A
• Nasal cannula: 1st line 
• Face mask
• Venturi mask: Color-coded to indicate
FiO2
• Non-rebreather

Noninvasive PPV
• BiPAP
• CPAP
Positive pressure ventilation (PPV): can do invasively and non invasive

17
Q

Nursing assessment

A
• Assessment
– VS/SpO2
– ABGs/Svo2
– Neurological assessment
– Breath sounds
– Cardiac monitoring
18
Q

Nursing Actions

A
  • Oxygen management
  • Medication management
• Secretion management
   -Chest physical therapy
   -Airway suctioning/effective coughing
   -Positioning – elevate HOB, OOB,
       • Good lung down

• Hydration and humidification

  • Adequate fluid intake
  • IV hydration/humidification
  • Humidification devices