Chapter 68 Nursing Management: Respiratory Failure and Acute Respiratory Distress Syndrome

Question 1

acute lung injury (ALI), p. 1665

Answer 1

a condition that occurs when the patient’s PaO2/FIO2 ratio is 200–300 (e.g., 86/0.4 = 215).

Question 2

acute respiratory distress syndrome (ARDS), p. 1665

Answer 2

a sudden and progressive form of acute respiratory failure in which the alveolar-capillary membrane becomes damaged and more permeable to intravascular fluid.

Question 3

alveolar hypoventilation, p. 1657

Answer 3

is a generalized decrease in ventilation that results in an increase in the PaCO2 and a consequent decrease in PaO2.

Question 4

hypercapnia, p. 1654

Answer 4

greater than normal amounts of carbon dioxide in the blood; also called hypercarbia.

Question 5

hypercapnic respiratory failure, p. 1655

Answer 5

a condition in which the PaCO2 is above normal in combination with acidemia.

Question 6

hypoxemia, p. 1654

Answer 6

low oxygen tension in the blood characterized by a variety of nonspecific clinical signs and symptoms.

Question 7

hypoxemic respiratory failure, p. 1655

Answer 7

a condition in which the PaO2 is 60 mm Hg or less when the patient is receiving an inspired oxygen concentration of 60% or greater.

Question 8

hypoxia, p. 1658

Answer 8

the state in which the PaO2 has fallen sufficiently to cause signs and symptoms of inadequate oxygenation.

Question 9

refractory hypoxemia, p. 1666

Answer 9

Severe V/Q mismatch and shunting of pulmonary capillary blood result in hypoxemia unresponsive to increasing con­centrations of O2

Question 10

shunt, p. 1656

Answer 10

occurs when blood exits the heart without having participated in gas exchange. A shunt can be viewed as an extreme V/Q mismatch. There are two types of shunt: anatomic and intrapulmonary.

An anatomic shunt occurs when blood passes through an anatomic channel in the heart (e.g., a ventricular septal defect) and bypasses the lungs.

An intrapulmonary shunt occurs when blood flows through the pulmonary capillaries without participating in gas exchange. Intrapulmonary shunt is seen in conditions in which the alveoli fill with fluid (e.g., acute respiratory distress syndrome [ARDS], pneumonia).

Question 11

work of breathing (WOB), p. 1659

Answer 11

the effort used for muscle contraction during inhalation to accomplish lung ventilation.
The patient may be able to lie down (mild distress),
be able to lie down but prefer to sit (moderate distress),
or be unable to breathe unless sitting upright (severe distress).