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6200 Adult /Older Adult II > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Hypoxemic Respiratory Failure Causes

A
  • Ventilation/Perfusion (Q) mismatch:
    • ↓ Ventilation
    • ↓ Perfusion
  • Shunt:
    • Anatomic
    • Intrapulmonary
  • Diffusion limitation
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2
Q

V/Q stands for

A

Ventilation/Perfusion

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3
Q

Hypercapnic Respiratory Failure Causes

A
  • Airways and alveoli
  • Central nervous system (decreased drive to breath: OD/stroke)
  • Chest wall (decreased chest wall expansion: flail chest)
  • Neuromuscular conditions that cause muscle weakness, impairing resp muscle use
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4
Q

Acute Respiratory Failure Clinical Manifestations - Hypercapnic Failure?

A
  • Neuro changes
  • Dyspnea and HA
  • ↑ ↓ RR
  • ↑ HR
  • ↑BP
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5
Q

Acute Respiratory Failure Clinical Manifestations - Hypoxemic Failure?

A
  • Neuro changes
  • Dyspnea
  • ↑ RR
  • ↑ HR
  • ↑BP
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6
Q

How what diffentiates hypoxemic failure from hypercapnic failure?

A

retention of CO2 in hypercapnic failure causes a HEADACHE

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7
Q

What diagnostic tests are run in a pt in Acute Respiratory Failure?

A
  • Arterial Blood Gas (ABG) analysis
  • Chest x-ray (CXR)
  • CBC,
  • Complete Metabolic Panel (e-lytes)
  • Urinalysis
  • Sputum/blood cultures (infection)
  • V/Q lung scan/CT chest (PE)
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8
Q

What is the difference between BiPAP and CPAP?

A
  • BiPAP: different pressure for inspiration and experation

- CPAP: constant pressure for both

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9
Q

Acute Respiratory Failure Nursing/Collaborative Management

A
  • Prevention-early recognition

- Respiratory therapy

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10
Q

Types of respiratory therapy for patient with acute respiratory failure?

A
  • Oxygen therapy
  • Mobilization of secretions (pat back with cupped hands)
  • Positive pressure ventilation (PPV)
    • Mask (BiPAP, CPAP)
    • Intubation
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11
Q

Drug Therapy for acute respiratory failure?

A
  • Bronchodilators (albuterol)
  • Corticosteroids (methylprednisolone)
  • Diuretics
  • Nitrates
  • IV antibiotics (vancomycin/ceftriazone)
  • Sedatives, Benzodiazepines, Narcotics (ativan/versed)
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12
Q

Physiologic aging results in what respiratory changes?

A
  • ↓ Ventilatory capacity
  • Alveolar dilation
  • Larger air spaces
  • Loss of surface area
  • Diminished elastic recoil
  • Decreased respiratory muscle strength
  • ↓ Chest wall compliance
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13
Q

Acute Respiratory Failure Gerontologic Considerations

A
  • Physiologic aging
  • Lifelong smoking
  • Poor nutritional status
  • Less available physiologic reserve
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14
Q

Sudden progressive form of acute respiratory failure?

A

Acute Respiratory Distress Syndrome (ARDS)

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15
Q

Acute Respiratory Distress Syndrome (ARDS)

A
  • Sudden progressive form of acute respiratory failure
  • Alveolar capillary membrane damaged -↑ permeability to intravascular fluid
  • 50% mortality rate
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16
Q

Acute Respiratory Distress Syndrome (ARDS) starts with?

A

Alveolar capillary membrane damaged, which ↑ permeability to intravascular fluid

17
Q

Direct causes of ARDS?

A

aspiration, pneumonia, inhalation

18
Q

Indirect causes of ARDS?

A

secondary result of a massive systemic insult

19
Q

Pathophysiology of ARDS?

A

thought to be due to stimulation of the inflammatory and immune systems

20
Q

ARDS causes?

A
  • Severe dyspnea
  • Hypoxia
  • Decreased lung compliance
  • Diffuse pulmonary infiltrates (white out lung)
21
Q

3 phases of ARDS?

A

1) Injury or Exudative
2) Reparative or Proliferative
3) Fibrotic

22
Q

Injury or Exudative phase of ARDS occurs?

A

1 - 7 days after initial injury

23
Q

Summary of processes of the Injury or Exudative phase of ARDS?

A
  • Pulmonary edema and atelectasis
  • V/Q mismatch-severe
  • Shunting of pulmonary capillary blood
  • Refractory hypoxemia
24
Q

Occurs when oxygenation continues to decrease regardless of the amount of O2 given?

A

refractory hypoxemia

25
Q

Reparative or Proliferative phase of ARDS occurs?

A

1 to 2 weeks after initial injury

26
Q

Summary of processes of the Reparative or Proliferative phase of ARDS?

A
  • Influx or neutrophils, monocytes, and lymphocytes
  • Lung becomes dense and fibrous – ↓ compliance
  • ↑ Pulmonary vascular resistance, pulmonary HTN
27
Q

Fibrotic or chronic/late phase of ARDS occurs?

A

2 to 3 weeks after initial injury

28
Q

Summary of processes of the Fibrotic or chronic/late phase of ARDS?

A
  • Lung completely remodeled
  • ↓ Lung compliance
  • ↓ surface area for gas exchange
  • Pulmonary hypertension
29
Q

Early symptoms of ARDS?

A
  • May not exhibit respiratory symptoms
    or
  • Dyspnea, tachypnea, cough, restlessness
  • Normal or scattered crackles
30
Q

Interpretation of Arterial Blood Gas results/values of pt in the early stage of ARDS will show?

A

Mild hypoxemia and respiratory alkalosis

31
Q

Early chest xrays of ARDS patient?

A

May be normal or have minimal scattered interstitial infiltrates

32
Q

ARDS clinical manifestations: Progressive

A
  • Symptoms worsen
    • evident discomfort, ↑ WOB
    • ↑ fluid accumulation,
    • ↓ lung compliance
  • Pulmonary Function Tests (PFTs) show ↓ compliance and lung volume
33
Q

ARDS clinical manifestations: Late

A
  • Suprasternal retractions
  • Tachycardia, diaphoresis
  • ↓ mentation
  • Cyanosis, pallor
  • Hypoxemia despite ↑ FIO2
  • Hypercapnia causing muscle fatigue, hypoventilation
34
Q

ARDS Complications

A
  • MO Dysfunction
  • Sepsis
  • Ventilator
  • Ventilator Associated
    • Pneumonia (VAP)
    • Ventilator complications
  • Stress ulcers
  • Renal failure
35
Q

Major causes of death in ARDS patient?

A
  • MODS

- Sepsis

6200 Adult /Older Adult II (17 decks)

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