Respiratory Flashcards

1
Q

Acute Respiratory Failure

A

failure of the lungs to provide adequate V/Q, PAO2 <60 mm, PACO2 >50 mm, Ph <7.35

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2
Q

Causes of oxygenation failure

A

pneumonia, ARDS, HF, COPD, PE

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3
Q

Causes of Ventilation failure

A

CNS depression (drug overdose, head trauma, sleep apnea); Neuromuscular dysfunction (SCI, ALS, myasthenia gravis); Musculoskeletal dysfunction (Chest trauma)

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4
Q

Range of V/Q Relationships

A

A, Absolute shunt, no ventilation
due to fluid filling the alveoli.
B, V/Q mismatch, ventilation partially compromised by secretions in
the airway.
C, Normal lung unit.
D, V/Q mismatch, perfusion partially compromised by emboli
obstructing blood flow.
E, Dead space, no perfusion due to obstruction of the pulmonary capillary.

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5
Q

Early signs of ARF

A

restlessness, fatigue, headache, increased BP (non descript)

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6
Q

Late Signs

A

confusion, tachypnea, tachycardia, cyanosis, diaphoresis, use of accessory muscles

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7
Q

Medical and Nursing Management of ARF

A

Correct underlying cause, restore adequate gas exchange with intubation and mechanical ventilation

Lung assessment, ABGs, continuous pulse ox and VS, turning, mouth care, skin care, ROM, Communication, VAP bundles

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8
Q

Acute Respiratory Distress Syndrome

A

severe form of acute lung injury characterized by sudden, progressive pulmonary edema, increasing bilateral lung infiltrates visible on CXR, decreased lung compliance, occurs within 72 hrs of a precipitating event

Manifestations include rapid onset of severe dyspnea, and hypoxemia that does not respond to supplemental oxygen

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9
Q

Risk Factors for ARDs

A

Aspiration, drug ingestion and OD, Hematologic disorders, prolonged inhalation of high concentrations of oxygen, smoke or corrosive substances, localized infection, metabolic disorders, shock, trauma, major surgery, fat/ air embolism, sepsis

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10
Q

Med management for ARDs

A

intubation, mechanical ventilation with PEEP to keep alveoli open, identify and treat underlying condition, circulatory support, possibly ECMO

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11
Q

PEEP with ARDs

A

lower tidal volume, lower airway pressure, permissive hypercapnia, high PEEP, ensure gas exchange while limiting injury to vili

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12
Q

ARDs Nursing Management

A

Nutritional support (enteral perferred), prone positioning best (monitored by practitioners, extra care to face and ETT obstruction)
Management and monitoring of sedation and neuromuscular blocking agents
alarms, eye care, VTE prophylaxis, skin care, preventing foot drop, H2 blockers, TOF

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13
Q

Train of Four Monitor

A

peripheral nerve stimulator, assesses depth of neuromuscular blockade

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14
Q

ECMO

A

Extracorporeal membrane oxygenation- if it helps, think of it as dialysis for the lungs

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15
Q

Normals for pH

A

7.35-7.45

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16
Q

Normals for PCO2 and PO2

A

35-45, 80-100

17
Q

Bicarb normals

A

22-26

18
Q

Respiratory acidosis

A

low pH, high pCO2

19
Q

Respiratory Alkalosis

A

High pH, low pCO2,

20
Q

Metabolic alkalosis

A

high bicarb, high pH,

21
Q

Metabolic Acidosis

A

low pH, low bicarb