How can pneumonia further compromise gas exchange within lungs that are already altered by COPD?
Pnemonia is an infection of the lung tissue.
Edema and a build-up of exudates can infiltrate the alveoli.
Sputum builds up in airways already narrowed by the chronic mucus production of chronic bronchitis.
In the alveoli, inflammation and edema interfere with gas diffusion, causing hypoxemia. In the bronchioles and bronchi, sputum interferes with ventilation, causing hypercapnia
Hypercapnic (Ventilatory) Respiratory Failure
Hypercapnic (ventilatory) respiratory failure occurs when PaCO2 is above normal in combination with acidosis. Ventilatory demand exceeeds ventilatory supply, resulting in greater than normal PaCO2 levels. The pH is low normal due to compensation, however, a decline in the patient's ability to compensate will lead to more severe acidosis.
Hypoxemic (Oxygenation) Respiratory Failure
Hypoxemic (oxygenation) respiratory failure occurs when the PaO2 is 60 mm Hg or less when the patient is on 60% or greater oxygen concentration. While this patient's PO2 is lower than normal, the primary type of respiratory failure remains hypercapnic. However, as the pneumonia wrosens and exudate fills more alveoli with fluid, the hypoxemic component of respiratory failure will worsen.
Other than respiratory diseases or infections, what other patient situations could precipitate the development of respiratory failure?
- Narcotic OD
- Spinal cord injury
- Neurological diseases
How would the RN anticipate treating respiratory failure under these circumstances?
Maintain the airway and treat underlying causes
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