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21 Cards in this Set
- Front
- Back
RESPIRATORY FAILURE
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INSUFFICIENCY OF RESPIRATORY SYSTEM TO EXCHANGE 02 AND CO2 IN AMOUNTS TO MEET BODY'S NEED
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ACUTE RESPIRATORY FAILURE
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SUDDEN, LIFE-THREATENING
EXP: EMBOLISM,OBSTRUCTION |
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CHRONIC RESPIRATORY FAILURE
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SLOWER, GRADUAL DECLINE IN GAS EXCHANGE
-OFTEN DEVELOP TOLERANCE TO HYPOXEMIA OR HYPERCAPNIA EXP: COPD, NEUROMUSCULAR DISEASE |
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4 CAUSES OF RESPIRATORY FAILURE
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1.DECREASE IN RESP DRIVE
-CNS DEPRESSANTS (MORPHINE) 2.DYSFUNCTION OF RESP MUSCLE -SPINAL CORD INJURY,GUILLIAN BARRE SYN 3.DYSFUNCTION OF LUNG TISSUE -PNEUMONIA 4.POST OP -THE HIGHER THE INCISION ON ABDOMEN (GALLBLADDER,PANCREATIC CANCER) COUGH & DB 10 TIMES/HR |
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S/S OF RESP FAILURE
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DECREASED PO2 AND INCREASED PCO2
-RESPIRATORY ACIDOSIS |
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ASSESSMENT FOR RESP FAILURE
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CHECK LOC
CHECK DYSPNEA INCREASED PULSE INCREASED BP LOW BOWEL SOUNDS ABG AND EKG-PVC'S MAY BE PRESENT DUE TO HYPOXEMIA-->VENTRICULAR FIBRILLATION=DEATH |
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IF MORPHINE IS CAUSING DECREASE IN RESPIRATIONS...WHAT SHOULD BE GIVEN?
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NARCAN
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HOW DOES ONE CORRECT UNDERLYING CAUSE OF RESP FAILURE
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C & DB
LOC ABG POX VS PT MAY NEED INTUBATION/VENTILATOR |
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ACUTE RESPIRATORY DISTRESS SYNDROME
(ARDS) |
COMPLEX FORM OF RESPIRATORY FAILURE
-SUDDEN PROGRESSIVE PULMONARY EDEMA (NOT ASSOCIATED W/ HEART) -BILATERAL INFILTRATED ON CXR ***HYPOXEMIA UNRESPONSIVE TO INCREASE IN OXYGENATION** -DECREASED COMPLIANCE OF LUNGS(STIFF) |
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CAUSES OF ARDS
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-ASPIRATION (NEAR DROWNING,FLUID)
-HEMATOLOGIC D/O (DIC,BYPASS) -INFECTION -METABOLIC D/O(PANCREATITIS,DRUG OVERDOSE) -SHOCK,TRAUMA,CANCER,BURNS |
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TRIGGER OF ARDS LEADS TO
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DECREASED BLD FLOW TO LUNG
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ASSESSMENT OF ARDS
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S/S 12-24 HR AFTER TRIGGER
-DSYPNEA,HIGH RR,HIGH HEART RATE -COUGH(FROM FLUID IN LUNGS -USE OF ACCESSORY MUSCLES -DECREASED LOC AVEOLI STIFF/COLLAPSED CXR-INFILTRATES **RESP DISTRESS CONTINUES DESPITE AMT OF O2 GIVEN |
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IMPLEMENTATION
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MECHANICAL VENTILATION
PEEP-POSITIVE END EXPIRATORY PRESSURE (LOW TIDAL VOLUME) WEAN TO O2 MAINTAIN GAS EXCHANGE ALLOW LUNGS TIME TO HEAL |
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NSG DIAGNOSIS FOR ARDS
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-IMPAIRED GAS EXCHANGE
-ANXIETY |
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GOALS FOR ARDS
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-INCREASE TISSUE OXYGENATION
-MINIMIZE O2 CONSUMPTION -PREVENT/TREAT COMPLICATIONS -ABC'S (AIRWAY,BREATHING,CIRCULATION) |
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WHATS DONE TO IMPROVE AIRWAY
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-MECHANICAL VENTILATION
-A/W PATENCY,SUCTION,SIGHING -NEUROMUSCULAR BLOCKING AGENTS(PARALYZE PT. TO PREVENT PT FROM FIGHTING VENTILATOR) |
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WHAT SHOULD BE GIVEN TO PT WHILE ON NEUROMUSCULAR BLOCKING AGENT
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EYE CARE-DROPS
HUMIDITY CPT/PT |
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WHAT IS THE POSITION OF CHOICE FOR SOMEONE W/ ARDS
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PRONE POSITION
-IMPROVES OXYGENATION AND PROTECTS LUNGS "SWIMMING POSITION" |
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WHAT SHOULD BE DONE FOR SOMEONE WITH ARDS
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FLUIDS-DO NOT OVERLOAD
NUTRITION-ENTERAL/TPN (NEEDS 2500-3000 CAL/DAY) ANTIBIOTICS-MAYBE STEROIDS-MAYBE |
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COMPLICATIONS OF ARDS
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MECHANICAL VENTILATION/ENDOTRACHEAL TUBE
GI=DECREASED MOTILITY->STRESS ULCER RENAL=DECREASED PERFUSION/MEDS CV DIC=DYSRYTHMIAS (PVC'S) INFECTION |
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EVALUATION FOR ARDS
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PREVENTION=PREVENT ASPIRATION
SURFACTANT=IF PT SURVIVES,NORMAL LUNG FCN W/IN 1 YR NITRIC ACID ECMO (EXRA CORPOREAL MEMBRAN OXYGENATION)=BYPASS FOR LUNGS,ALLOWS LUNGS TIME TO HEAL |