Module 9 - Acute resp disorders

Question 1

What is atelectasis

Answer 1

collapse of the alveoli that prevents normal gas exchange between carbon dioxide and oxygen

Question 2

Define hypoventilation

Answer 2

Ventilation is inadequate to meet the body’s oxygen demand or to eliminate sufficient carbon dioxide

Question 3

Identify and describe the 2 main types of sleep apnea

Answer 3

1. Obstructive (OSA) – upper airway; partial or complete collapse of the pharyngeal airway
2. Central – CNS disorder in which the brainstem fails to signal respiratory muscles to facilitate inhalation

Question 4

What is sleep apnea

Answer 4

Disorder in which ppl stop breathing for a period of at least 10 seconds while asleep

Question 5

What are some risk factors for sleep apnea?

Answer 5

• Male – OSA may affect middle-aged men more frequently, particularly if they’re obese
• Family history – OSA more common in Asians than Caucasians
• Use alcohol or sedatives – can impair tissue oxygenation
• Obesity
• Large neck
• Small airways
• Elderly
Hypertension

Question 6

What are treatments for sleep apnea?

Answer 6

• Weight loss
• Continuous positive airway pressure (CPAP)
• Dental/oral applicances
• Surgery

Question 7

What is Acute Respiratory Failure (ARF)?

Answer 7

• Inadequate ventilation resulting from the inability of the lungs to adequately maintain arterial oxygenation or eliminate carbon dioxide
• Lungs cannot adequately remove carbon dioxide from the blood or when oxygen is not released into the blood effectively
(Can not get oxygen and can not expel CO2)

Question 8

What are signs and symptoms of respiratory distress?

Answer 8

• Diminished or absent breath sounds
• Adventitious breath sounds (Wheezes with asthma; Crackles with pulmonary edema)
• Changes in mental status, confusion, somnolence
• Cyanosis of the oral mucosa, lips, and nail beds
• Increased RR
• Pursed lip breathing
• Nasal flaring

Question 9

Discuss why patients may require an endotracheal tube

Answer 9

used as short-term artificial airway to administer mechanical ventilation, relieve upper airway obstruction, protect against aspiration, or clear secretions.

Question 10

Outline common complications associated with ET tubes and manual ventilation

Answer 10

1. Artificial airway
• Infection 
• Necrosis: tissue death 
2. Oxygen toxicity: too much oxygen 
• Nitrogen washout, causing atelectasis 
• Oxygen free radicals cause lung injury 
3. High airway pressure 
• Pneumothorax

Question 11

Discuss why patients would require mechanical ventilation

Answer 11

Respiratory Failure: apnea/respiratory arrest; inadequate ventilation (acute or chronic); inadequate oxygenation; chronic respiratory insufficiency
- Cardiac Insufficiency:
eliminate work of breathing, reduce oxygen consumption
- Neurologic dysfunction:
central hypoventilation/ frequent apnea; Comatose patient comatose; inability to protect airway

Question 12

Describe the role a practical nurse would play in the care of a ventilated client.

Answer 12

o Monitor the settings ordered by the doctor
o Make sure the alarms are turned on, and understand what the alarms mean
o Assess client frequently for respiratory status
o Do not let water collect in the ventilator tubing
o Ensure there is a for the conscious client to communicate
• Frequent mouth care
• Repositioning q 2 h; HOB at ≥30 degrees