Week 3

Question 1

What is the difference between acute and chronic respiratory failure?

Answer 1

Acute respiratory failure

• occurs when resp. system is unable to exchange sufficient oxygen and carbon dioxide to maintain blood flow
• life threatening condition

Chronic respiratory failure

• respiratory function deteriorates slowly
• gas exchange is permanently impaired

Question 2

What is the difference between Type I and Type II acute resp. failure?

Answer 2

Type I: Hypoxaemic

• resp. failure caused by a failure of oxygenation
• insufficient oxygen diffuses from the alveoli to the pumonary capillary bed

Type II: Hypercapnic

• resp. failure caused by inability to ventilate and excrete carbon dioxide
• insufficient carbon dioxide diffuses from the pulmonary capillary bed to the alveoli

Question 3

Is it possible to have a mixture of both Type I and II acute resp. failure?

Answer 3

Yes.

Question 4

Define pneumothorax, haemothorax and pleural effusion.

Answer 4

Pneumothorax

• air between the visceral and parietal space

Haemothorax

• collection o fblood in the interpleural space

Pleural effusion

• a build up of infective tissue
• exudate in the pleural space

Question 5

What is the difference between open and tension pneumothorax?

Answer 5

Open pneumothorax:

• caused either by penetrating trauma or surgery

Tension pneumothorax:

• life threatening condition that results from a progressive deterioration and worsening of a simple pneumothorax
• associate with the formation of a one-way valve at the point of a rupture in the lung

Question 6

Name FIVE nursing assessment and managements for UWSD.

Answer 6

• monitor water in seal chamber
• keep bottles lower than the height of the pt chest
• DO NOT clamp ICC for >60 secs unless full expansion of lung
• observe insertion site for air leak and surgical emphysema
• auscultate pt’s chest for breath sounds at start of shift and PRN
• ensure adequate pain relief
• encourage deep breathing and coughing
• maintain clean dry dressing

Question 7

What are the factors that increase a pt’s risk of pulmonary embolism?

In your own time, look up the detailed explanation in your lecture notes.

Answer 7

• venous stasis
• hypercoagulability
• injury to endothelial cells

Question 8

Name FOUR indications for NIPPV.

Answer 8

• elevated resp. rate
• dyspnoea (difficulty breathing)
• increase WOB & increase use of accessory muscles
• decrease SpO2 usually less than 90% on high flow O2
• PaCO2 greater than 45mmHg
• acidosis (pH <7.35)
• TO PREVENT INTUBATION

Question 9

Name FIVE common complications associated with NIPPV.

Answer 9

• barotrauma
• hypotension
• aspiration risk
• gastric distension
• increase ICP
• facial and nasal pressure sores
• epistaxis