Respiratory Failure

Question 1

Ventilation involves:

Answer 1

1. muscles of the respiratory system
2. CNS control system
3. spinal cord nerves

Question 2

Ventilation is affected by:

Answer 2

1. respiratory pressure
2. surface tension
3. lung compliance

Question 3

How does O2 affect ventilation?

Answer 3

decreased O2 leads to hypoxia, which causes ventilation to increase (tachypnea)

Question 4

How does CO2 affect ventilation?

Answer 4

increased CO2 causes acidosis, which increases ventilation (hyperventilation)

Question 5

PaO2 range of 50-80 is what level of hypoxemia?

Answer 5

mild hypoxemia

Question 6

PaO2 range of mild hypoxemia

Answer 6

60-80

Question 7

PaO2 range of 50-60 is what level of hypoxemia?

Answer 7

moderate hypoxemia

Question 8

PaO2 range of moderate hypoxemia?

Answer 8

50-60

Question 9

PaO2 range of <50 is what level of hypoxemia

Answer 9

severe hypoxemia

Question 10

PaO2 range of severe hypoxemia?

Answer 10

<50

Question 11

PF ratio 100-200?

Answer 11

moderate ARDS

Question 12

What does the PF ratio tell us?

Answer 12

severity of ARDS

Question 13

Severe ARDS PF ratio?

Answer 13

<100

Question 14

Mild ARDS PF ratio?

Answer 14

200-300

Question 15

normal PF ratio?

Answer 15

350

Question 16

name 4 causes of V/Q mismatch - shunting

Answer 16

1. pneumonia
2. pulmonary edema
3. trauma
4. ARDS
5. TRALI
6. post-op atelectasis or immobility

Question 17

name 4 causes of narrowed airways

Answer 17

1. asthma
2. anaphylaxis
3. mucus plug
4. bronchospasms

Question 18

name 4 causes of alveolar hypoventilation

Answer 18

1. narcotics
2. AMS
3. alcohol
4. liver disease - toxin accumulation
5. alkalosis
6. COPD

Question 19

name 4 causes of impaired diffusion

Answer 19

1. pulmonary fibrosis
2. ARDS
3. pulmonary edema
4. PNA
5. atelectasis

Question 20

name 4 causes of impaired ventilation

Answer 20

1. trauma
2. thoracic surgery
3. emphysema
4. chronic bronchitis
5. pulmonary effusion
6. pulmonary embolism
7. pneumothorax

Question 21

types of VQ mismatch

Answer 21

1. shunting
2. constricted airway
3. impaired blood flow
4. dead space

Question 22

causes of dead space ventilation

Answer 22

1. ARDS
2. atelectasis

Question 23

causes of impaired blood flow

Answer 23

1. hemorrhage
2. pulmonary embolism
3. pulmonary HTN

Question 24

mechanisms of impaired ventilation

Answer 24

1. VQ mismatch
2. intrapulmonary shunting
3. alveolar hypoventilation
4. impaired diffusion
5. impaired ventilation / extrapulmonary problems
6. low PiO2/FiO2

Question 25

pathophysiology of respiratory failure

Answer 25

hypoxia -> pulmonary vasoconstriction -> pulmonary HTN -> RT sided heart failure

Question 26

pathophysiology of smoke inhalation lung injury

Answer 26

smoke toxins -> inflammatory response -> swelling and increased alveolar permeability -> increased fluids in alveoli -> shunting -> decreased O2 diffusion + alveolar collapse and obstruction

Question 27

respiratory failure treatment

Answer 27

1. assessment
   
   • LOC
   • respirations
   • pupillary response
   • vital signs
2. interventions
   
   • call CODE if respiratory distress + CPR/suction
   • increase O2
   • suction
   • check glucose
   • check ABGs

Question 28

treatment for smoke inhalation injury

Answer 28

1. maximize O2
2. abx prophylaxis
3. anti-inflammatory - steroids
4. frequent ABGs
5. fluid balance