Oxygenation/Gas Exchange Flashcards
Hypoxemia
Insufficient O2 transfer to blood
Hypercapnia
Inadequate CO2 removal
S/S of Acute Respiratory Failure (ARF)
- Dyspnea/SOB
- Tachypnea
- Orthopnea
- Tachycardia
- Confusion/altered mental status
- Irritability/agitation
- Restlessness
ARF PaO2
<60 mmHg
ARF PaCO2
> 45 mmHg
Examples of non-cardiogenic pulmonary edema
- Pneumonia
- Acute respiratory distress syndrome
- Sepsis
- DIC
- Inhaling harmful fumes
- High altitude pulmonary edema
Examples of cardiogenic pulmonary edema
- CHF
- Dysrhythmias
- Shock
Increased ventilation perfusion mismatch (V/Q mismatch)
Areas of the lung receive O2, but decreased or no blood flow
Example of increased V/Q mismatch
Pulmonary emboli
S/S of increased V/Q mismatch
- Severe dyspnea
- Tachypnea
- Pain
- Cough
- Hemoptysis
Decreased V/Q mismatch
Receive blood flow, but no or compromised oxygen exchange
Example of decreased V/Q mismatch
- Mucous plug
- Secretion in airway
- Pneumonia
- Asthma
- Atelectasis
Shunt extreme V/Q mismatch
Blood flows through the pulmonary capillaries without gas exchange - good blood flow shunting away from poorly ventilated alveoli
Examples of shunt extreme V/Q mismatch
- Alveoli filled with fluid
- Collapsed alveoli
Hypercapnic Respiratory Failure Etiology
- Too slow respirations
- Too shallow respirations
- Diminished lung function
Hypercapnia s/s
- Dyspnea
- Headache
- Peripheral and conjunctival vasodilation
- Tachycardia
- Hypertension
- Dysrhythmia
- Disorientation
- Confusion
- Decreased LOC
- Respiratory acidosis
Hypercapnia Progression
- Respiratory center depression
- Decreased rr
- Progressive somnolence/coma
- Tremors
- Seizures
- Bradycardia
- Hypotension
- Cardiac dysrhythmia
Pulmonary edema
Fluid accumulation in the alveoli and interstitial spaces of lungs
Most common cause of pulmonary edema
Left sided heart failure
S/S of pulmonary edema
- SOB
- Tachypnea
- Hypoxemia
- Frothy secretions
- Rales/crackles during auscultation
Pleural effusion
Collection of fluid around the lungs/pleural space, limits expansion of lungs
S/S of pleural effusion
- Dyspnea
- Worsening cough
- Chest pain/pain on inspiration
- Diminished/absent breath sounds on affected area depending on size
Atelectasis
Complete or partial collapse of the lung, alveoli within the lung become deflated
Common cause of atelectasis
- Airway obstruction from retained exudates/secretions
Rapid s/s of atelectasis
- Pain on affected side
- Sudden dyspnea
- Cyanosis
Gradual s/s of atelectasis
- Asymptomatic
- Mild SOB
- Coughing
CPAP
1 pressure setting that delivers a steady continuous pressurized air into the airway throughout spontaneous inspiration and exhalation
What is needed for CPAP to work?
Intact respiratory drive and adequate tidal volume
What does CPAP help with?
- Increases O2
- Decreases work of breathing
- Increases intrathoracic pressure
- Decreases preload/work of heart
BiPAP
2 pressure settings that delivers a different pressure for inspiratory and expiratory phases of breathing
What does BiPAP correct?
- Hypercapnia
- Hypercarbia
ARDS Pathology
Acute lung injury from unregulated systemic inflammatory response to acute injury or inflammation
ARDS s/s
- Tachypnea with use of accessory muscles at rest
- Nasal flaring
- Tachycardia at rest
- Hypotension
- Fever possibly
- Bilateral crackles, coarse rhonchi
- Cold, mottled dusky extremities
- Prolonged CRT
Worsening s/s of ARDs
- Dyspnea/tachypnea
- Cough
- Chest discomfort
- Anxiety/restlessness
ARDS progression
- A: assault to the pulmonary system
- R: respiratory distress
- D: decreased lung compliance
- S: severe respiratory failure
