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CCM > ARDS > Flashcards

ARDS Flashcards

1
Q

acute respiratory failure is the failure of

A

oxygenation, ventilation, or both

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2
Q

if a pt vomits/aspirates (direct injury) we have a problem with oxygenation or ventilation

A

ventilation?

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3
Q

hypoxemia/hypoxic PaO2 values

A
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4
Q

metabolic hypercapnia PaCO2 value

A

PaCO2 >50mmHg

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5
Q

acidotic value

A

pH

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6
Q

how failure of oxygenation happens

A 
hypo-ventilation
intrapulmonary shunting*** no oxygenation going on
ventilation-perfusion mismatch
diffusion defects
low cardiac output
low hemoglobin level
tissue hypoxia
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7
Q

intrapulmonary shunting results in

A

ards

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8
Q

what is hypo-ventilation

A

increased CO2

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9
Q

what causes hypo-ventilation

A

drug overdose
neurological disorders (SCI - trauma)
abd/thoracic surgery r/t pain
low cardiac output

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10
Q

what is intrapulmonary shunting

A

blood shunted from rt to lt side of heart w/o oxygenation

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11
Q

what causes intrapulmonary shunting

A

pneumonia, pulmonary edema

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12
Q

***why doesn’t oxygen administrations help shunt disorder

A

no connection/transfer with aveoli

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13
Q

what is ventilation/perfusion mismatch

A

ventilation or perfusion is decreased it causes mismatch

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14
Q

what causes ventilation/perfusion mismatch

A

clot - prevent

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15
Q

what is a diffusion defect

A

fluid in alveoli - towards end of ARDS

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16
Q

what causes low cardiac output

A

low cardiac output, low hemoglobin (95% of oxygen is bound)

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17
Q

what is necessary to transport oxygen

A

hemoglobin

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18
Q

tissue hypoxia results in

A

anaerobic metabolism and lactic acidosis

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19
Q

respiratory failure secondary to hypo-ventilation with

A

neuromuscular disease

20
Q

what is failure of ventilation

A

hypercapnia - elevated carbon dioxide r/t decreased ventilation causing mismatch

21
Q

when assessing respiratory failure look for these signs

A 
hypoxemia (restlessness, anxiousness)
respiratory (tachypnea)
cardiovascular (increased HR)
metabolic expenditure - feed patients!
ABG's
Pulse Ox
22
Q

interventions for resp. failure

A 
maintain airway
ensure oxygenation
identify/trt cause
prevent complications
pain relief
bed rest
high fowlers position
23
Q

mgmt of resp failure

A

bronchodilators
O2
steroids (reduce inflammation)

24
Q

resp failure concerns

A

improve O2 delivery; decrease O2 demands

25
Q

what does pt look like in resp failure

A

tachycardia
diaphoresis
nasal flare
muscle working

26
Q

to maximize airway clearance

A

re-position pt every 2 hrs (mobilize secretions)

27
Q

*what is good lung down

A

fluids/inflammation in lungs - allows oxygenation to occur

mobilizes secretions

28
Q

how to calculate ratio to determine acute resp distress

A

PaO2/FiO2

29
Q

what is ARDS

A

noncardiogenic pulmonary edema

30
Q

dx criteria for ARDS

A

bilateral infiltrates

PaO2/FiO2 less than 200

31
Q

if a chest xray shows bilateral “white out’ how do we trt

A

intubate (on our way to MODS)

32
Q

ARDS patho

A 
SIRS
stiff lungs
release of mediators/histamines
pulmonary edema
damage to alveolar-capillary membrane
increased capillary permeability
shunting
33
Q

whose at risk for ARDS

A

smoker w/trauma accident

elderly

34
Q

**s/s of ARDS

A 
hyperventilation
dyspnea and tachypnea
resp alkalosis
increased temp/pulse
white out on xray
severe hypoxemia
35
Q

trt of ARDS

A 
trt cause
oxygenation and ventilation (peep)
start w/non-invasive first
trt pain/anxiety
position (prone - good lung down)
fluid/electrolyte balance
support nutrition
36
Q

normal value for peep

A

5-10

37
Q

pressure on the lungs causes decreased cardiac output with peep, what is end result

A

hypotension

38
Q

complications of ARDS

A

DIC
renal failure
MODS

39
Q

the most avoidable preventable processes

A

VAP - ventilator assisted pneumonia

proper hand-washing*

40
Q

cause of VAP

A

dental plaque
oral bacteria
cross-colonization of hand/glove

41
Q

***VAP Bundle

A 
elevate HOB 30-45 degrees
awaken daily to assess readiness to wean/extubate (cough/deep breath)
trt stress ulcers 
oral care (chlorhexedine 2x's/day)
hand washing
embolism prophylaxis
42
Q

what does pt look like with resp acidosis

A

anxiety

restlessness

43
Q

*what does pt look like with resp alkalosis

A 
hyperventilation
dizzy 
confused
light-headed
dry mouth
SOB
44
Q

what does pt look like with metabolic acidosis

A

dehydrated

cause (liver/alcohol)

45
Q

what does pt look like with metabolic alkalosis

A

n/v

CCM (13 decks)

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