Sherpath - Respiratory Failure & ARDS Flashcards
Which term describes the condition in which the PaO2 has fallen sufficiently to cause signs and symptoms of inadequate oxygenation?
a. Hypoxia
b. Hypoxia
c. Hypercapnia
d. Hypoventilation
Hypoxia
What phase of acute respiratory distress syndrome (ARDS) occurs approximately 2 to 3 weeks after the initial direct lung injury or host insult?
a. Fibrotic phase
b. Exudative phase
c. Reparative phase
d. Proliferative phase
a. Fibrotic phase
- Exudative Phase (Days 1–7) — “The Chaos Begins”
• Capillary leak party. Fluid floods into alveoli.
• Surfactant goes on vacation. Alveoli collapse.
• Gas exchange? Ha. Not happening.
• Classic signs: crackles, hypoxemia, bilateral infiltrates on CXR.
Think: lungs are drowning in their own mess, and it’s your job to fix it with high-flow oxygen and prayers.
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- Proliferative Phase (Days 7–21) — “We’re Trying, OK?”
• The body’s like “let’s clean this up.”
• Macrophages and fibroblasts try to rebuild the damaged lung epithelium.
• There’s still inflammation, but less fluid. Maybe you can wean from the vent if things go right.
Think: the lungs are cautiously rebuilding after the apocalypse, but it’s still a construction zone.
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- Fibrotic Phase (After ~3 weeks) — “Scarred for Life”
• Collagen moves in, elastin checks out.
• Fibrosis thickens alveolar walls = reduced lung compliance and chronic gas exchange problems.
• Some patients never fully recover. Others become frequent flyers in the pulmonary rehab department.
The nurse is caring for a patient on mechanical ventilation. Which nursing intervention prevents the development of volutrauma in a patient on a ventilator?
a. Sterile techniques
b. Strict hand washing
c. Smaller tidal volumes
d. Oral hygiene care
c. Smaller tidal volumes
Because volutrauma happens when the ventilator pushes in too much air (too large of a tidal volume), stretching the alveoli to the point of injury. Think of it as alveolar yoga gone horribly wrong.
Using smaller tidal volumes (usually around 6 mL/kg of ideal body weight) is a key strategy in lung-protective ventilation, especially for patients with ARDS or other fragile lung situations. The goal is to ventilate them just enough to exchange gases without popping lung tissue like bubble wrap.
Which is the underlying cause of severe acute respiratory syndrome (SARS)?
a. Coronavirus
b. Nosocomial pneumonia
c. Legionella pneumophila
d. Streptococcus pneumonia
a. Coronavirus
Which position is preferred for patients with acute respiratory distress syndrome?
a. Prone
b. Supine
c. Fowlers
d. Trendelenburg
a. Prone
In acute respiratory distress syndrome (ARDS), the lungs are basically staging a protest: alveoli fill with fluid, oxygen exchange goes on strike, and everyone is miserable. Prone positioning helps because:
1. Better ventilation-perfusion matching: Gravity is rude and pulls blood to the posterior lungs when you lie on your back. But that area gets squashed in supine, so flipping the patient prone helps open up those dorsal alveoli and improves oxygenation.
2. Alveolar recruitment: More alveoli are recruited to participate in gas exchange like it’s a lung team-building exercise.
3. Less lung compression: The heart and other heavy stuff compress the lungs less when you’re face-down, believe it or not.
The nurse is monitoring a patient through pulse oximetry. Which parameter is monitored through pulse oximetry?
a. Inspired oxygen concentration
b. Expired oxygen concentration
c. Arterial oxygen saturation (SpO2)
d. Venous oxygen saturation
c. Arterial oxygen saturation (SpO2)
Which phase of acute respiratory distress syndrome (ARDS) occurs approximately 1 to 7 days after the initial direct lung and injury or host insult?
a. Fibrotic phase
b. Exudative phase
c. Reparative phase
d. Proliferative phase
b. Exudative phase
In ARDS, the exudative phase is the opening act of the lung drama, kicking in within 1 to 7 days after lung injury or insult.
Here’s what’s going on during that time:
• Fluid leaks from the capillaries into the alveoli (because the membrane’s integrity is trashed).
• Surfactant production drops, making the alveoli collapse faster than your motivation after one practice question.
• Gas exchange tanks, leading to hypoxemia.
• Basically: lungs fill with junk instead of air. Not ideal.
The other phases come later:
• Proliferative: the “let’s start fixing this” phase.
• Fibrotic: the “too much fixing, now it’s stiff” phase
Which term describes the presence of excessive amounts of CO2 in the blood?
a. Hypoxia
b. Hypoxemia
c. Hypercapnia
d. Hypoventilation
c. Hypercapnia
Correct answer: c. Hypercapnia – It literally means too much CO₂ in the blood, which is what happens when your ventilation is slacking and your body’s like, “Hey, I ordered oxygen, not recycled fart gas.”
Let’s break down the impostors, because they tried:
• a. Hypoxia – Low oxygen in tissues. Like your brain turning into mashed potatoes from lack of O₂.
• b. Hypoxemia – Low oxygen in blood. Same sad story, different zip code.
• d. Hypoventilation – A cause of hypercapnia, not the result. It’s like blaming a nap for being tired, when the nap was just your coping mechanism.
Which term describes a state of low oxygen tension in the blood and a decrease in arterial oxygen saturation?
a. Hypoxia
b. Hypoxemia
c. Hypercapnia
d. Hypoventilation
b. Hypoxemia
• a. Hypoxia – Low oxygen in tissues. Like your brain turning into mashed potatoes from lack of O₂. • b. Hypoxemia – Low oxygen in blood. Same sad story, different zip code. • d. Hypoventilation – A cause of hypercapnia, not the result. It’s like blaming a nap for being tired, when the nap was just your coping mechanism.
Which phase of acute respiratory distress syndrome (ARDS) occurs approximately 1 to 2 weeks after the initial direct lung injury or host insult?
a. Late phase
b. Fibrotic phase
c. Exudative phase
d. Proliferative phase
d. Proliferative phase
Which cue places a patient at risk for hypercapnic respiratory failure resulting from the affected central nervous system?
a. asthma
b. obesity
c. opioid overdose
d. multiple sclerosis
c. opioid overdose
Which abbreviation reflects the oxygen saturation in the blood measured by pulse oximetry?
a. PaO2
b. SaO2
c. SpO2
d. PaCO2
c. SpO2
Which physiological system can contribute to hypoxemic respiratory failure?
a. Renal
b. Cardiac
c. Central nervous
d. Neuromuscular
b. Cardiac
Which condition is the mechanism for respiratory failure in asthma?
a. Bronchospasms
b. Destruction of the alveoli
c. Abnormal viscous secretion
d. Gas exchange impaired by fluid.
a. Bronchospasms
Which clinical findings is associated with hypoxemia?
a. Seizures
b. Confusion
c. Bradycardia
d. Bounding pulse
b. Confusion
Which treatment will the nurse anticipate implementing when caring for a patient with acute respiratory distress syndrome?
a. Supine positioning
b. Placement of a chest tube
c. High frequency oscillation
d. Continued positive airway pressure.
c. High frequency oscillation
The patient with respiratory failure has hypexmia due to ventilation-perfusion (V/Q) mismatch. Which primary intervention would the nurse implement in this case?
a. Administer antibiotics as ordered.
b. Give oxygen therapy as ordered.
c. Administer bronchodilators as ordered.
d. Give antisecretory agents as ordered.
b. Give oxygen therapy as ordered.
The nurse is providing care for an older adult patient who has worsening left-sided pneumonia. Which intervention would the nurse use to help the patient mobilize secretions?
a. Augmented coughing or huff coughing
b. Positioning the patient side-lying on the left side.
c. Frequent and aggressive nasopharyngeal suctioning.
d. Application of noninvasive positive pressure ventilation (NIPPV).
a. Augmented coughing or huff coughing
The nurse in the cardiac care unit is caring for a patient who has developed acute respiratory failure. The nurse knows that which medication is being used to decrease this patient’s pulmonary congestion and agitation?
a. Morphine
b. Salbutamol
c. Vancomycin
d. Methylprednisolone
a. Morphine
Before administering prescribed oxygen therapy via face mask, the nurse would assess if the patient has a hx of which condition?
a. Hyperglycemia
b. Claustrophobia
c. Mucosal damage
d. Addison’s disease
b. Claustrophobia
Upon reviewing the reports of a patient, the nurse determines that the patient is at risk for hypoxia. Which finding supports the nurses conclusion?
a. The patient’s ventilation/perfusion ratio is 1:1.
b. The patient’s inspiratory to expiratory ratio is 1:2.
c. The patients partial pressure of oxygen in arterial blood is 40 mm Hg.
d. The patients partial pressure of carbon dioxide in arterial blood is 35 mm Hg.
c. The patients partial pressure of oxygen in arterial blood is 40 mm Hg.
The nurse is caring for a patient with pneumothorax at risk of developing respiratory failure. Which assessment finding is the earliest indication of respiratory failure?
a. Cyanosis
b. Difficulty in walking
c. Change in mental status
d. Early morning headache
c. Change in mental status
The nurse is aware of the value of using a mini-tracheostomy to facilitate suctioning when patients are unable to independently mobilize their secretions. For which patient is the use of mini tracheostomy indicated?
a. A patient whose recent ischemic stroke has resulted in the loss of the gag reflect
b. A patient who requires long-term mechanical ventilation as the result of a spinal cord injury
c. A patient whose increased secretions are the result of a community acquired pneumonia
d. A patient with head injury who has developed aspiration pneumonia after the patient’s family insisted on spoon-feeding the patient.
c. A patient whose increased secretions are the result of a community acquired pneumonia
A patient with respiratory distress becomes agitated and confused. Which action is the best nursing intervention for the patient?
a. Administer an intravenous anti-anxiety medication, and then report to the health care provider.
b. Provide chest physiotherapy and airway suctioning.
c. Administer 3 L/minute oxygen via nasal cannula.
d. Assess the patient and report findings to the health care provider.
d. Assess the patient and report findings to the health care provider.
