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ARF
acute respiratory failure
| Question | Answer |
|---|---|
| acute respiratory failure | inability of body to maintain respiratory drive |
| hypoxemic respiratory failure | paO2 < 60 mmHg when patient is recieving inspired O2 concentration of 60% or more |
| patients who experience hypoxemic respiratory failure | COPD, atelectasis, asthma, and pneumonia |
| hypercapninc respiratory failure | ventilatory failure, paCO2 > 45 and pH is less than 7.35, insufficient CO2 removal |
| failure of oxygenation | hypoventilation, intrapulmonary shunting, ventilation-perfusion mismatch, diffusion limitation, low cardiac output, low hemoglobin, tissue hypoxia |
| intrapulmonary shunting | blood is shunted from right to left side of the heart without oxygenation |
| causes of intrapulmonary shunting | ARDs, pneumonia, atrial or septal defect, atelectasis, PE, vaping |
| why should you not increase oxygen for patients with intrapulmonary shunting | does not help because the body does nothing with oxygen because fluid is in the space where gas exchange occurs |
| V/Q ratio | 1:1 |
| when does mismatch occur | if each portion of lung does not receive 1 mL of air for every 1 mL of blood flow |
| diffusion limitation | occurs when gas exchange across the alveolar-capillary membrane is compromised by a process that thickens, damages or destroys the alveolar membrane or affects blood flow through the pulmonary capillaries |
| classic sign of diffusion limitation | hypoxemia that is present during exercise and not at rest |
| failure of ventilation is related to | respiratory system inflammation, CNS (head injury or spinal cord injury), chest wall (pain, obesity, chest trauma), neuromuscular system (ALS, MD, MS) |
| signs of respiratory failure | extent of change in paO2 or paCO2, speed of the change, patient's ability to compensate |
| signs and symptoms of inadequate O2 | restlessness, agitation, dyspnea, tachypnea, confusion, combativeness, nasal flaring, intercostal retraction, cyanosis |
| signs and symptoms of inadequate CO2 removal | morning headache, decreased RR, decreased LOC, dyspnea, pursed lip breathing, shallow respirations, and decreased tidal volume |
| interventions for respiratory failure | maintain patent airway, good lung down, reposition, adequate hydration, treat cause, prevent DVTs, use BiPAP or CPAP, medications |
| medical management of ARF | oxygen bronchodilators ( metaproterenol and albuterol) corticosteroids (IV solu-medrol) sedation (propofol and ativan) nutritional support therapeutic paralysis (Nimbex) hemodynamic monitoring |
Created by:
ebrewer12
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