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Exam 2 CAI > Wk 4- respiratory distress, ARDS, mechanical ventilation > Flashcards

Wk 4- respiratory distress, ARDS, mechanical ventilation Flashcards

(62 cards)

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1
Q

What is acute respiratory failure?

A

Inability of the body to sustain respiratory drive, resulting in decreased capacity to exchange O2 and CO2.

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2
Q

What are the two classifications of acute respiratory failure?

A
  • Hypoxemic
  • Hypercapnic
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3
Q

What does ventilation (V) refer to?

A

Airflow to alveoli, including inspiration and expiration affected by O2 levels and respiratory rate.

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4
Q

What does perfusion (Q) refer to?

A

Blood flow to alveoli, with O2 and CO2 dissolved in blood and transported to body tissues.

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5
Q

What is hypoxemic respiratory failure characterized by?

A

PaO2 <60 mmHg with normal or low PaCO2.

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6
Q

What is hypercapnic respiratory failure identified by?

A

PaCO2 >50 mmHg and acidotic pH <7.35.

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7
Q

What are common causes of hypoxemic respiratory failure?

A
  • Lung diseases
  • V/Q mismatch
  • Shunt
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8
Q

What is the primary issue in hypoxemic respiratory failure?

A

Low oxygen (Decreased PaO2).

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9
Q

What mechanisms contribute to hypoxemia?

A
  • V/Q mismatch
  • Shunt
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10
Q

What are common risk factors for lung failure?

A
  • Pulmonary emboli
  • Pulmonary edema
  • Heart failure
  • Atelectasis
  • Pneumonia
  • Emphysema
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11
Q

What are common risk factors for ventilatory failure?

A
  • Sedatives
  • COPD
  • Neuromuscular defects
  • CNS dysfunction
  • Chest trauma
  • Obesity
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12
Q

True or False: Hypoxemia occurs in clients with hypercapnic respiratory failure who are breathing room air.

A

True

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13
Q

What is asterixis?

A

Involuntary flapping of the hands/wrists, observed in severe hypercapnia.

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14
Q

What are clinical presentations of hypoxemia?

A
  • Dyspnea
  • Irritability/confusion
  • Somnolence
  • Tachycardia
  • Tachypnea
  • Arrhythmia
  • Cyanosis
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15
Q

What are clinical presentations of hypercapnia?

A
  • Headache
  • Change of behavior
  • Coma
  • Warm extremities
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16
Q

What is the nurse’s role in caring for clients with acute respiratory failure?

A

Assess and maintain ABCs, provide suctioning, assist with positioning, and maintain ventilator settings.

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17
Q

What is the primary focus when treating acute respiratory failure?

A

Increasing oxygen levels in the blood.

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18
Q

What is ARDS?

A

Acute Respiratory Distress Syndrome, a life-threatening condition that develops quickly.

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19
Q

What are the characteristics of ARDS?

A
  • Bilateral lung infiltrates
  • Stiffening of the lungs
  • Progressive hypoxemia
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20
Q

What are common causes of ARDS?

A
  • Sepsis
  • Pneumonia
  • Aspiration
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21
Q

What risk factors increase the likelihood of developing ARDS?

A
  • Female
  • Older than 60
  • Smoking
  • Excessive alcohol
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22
Q

What are common impacts of ARDS on overall health?

A
  • Muscle wasting
  • Weight loss
  • Functional impairment
  • Cognitive loss
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23
Q

What is the most common clinical presentation of ARDS?

A

Progressively worsening dyspnea within 6-72 hours of the inciting event.

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24
Q

What is the Berlin criteria for diagnosing ARDS?

A
  • Onset within 7 days
  • Noncardiac origin
  • Bilateral lung infiltrates
  • Abnormal oxygenation measurements
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25
What are the complications of mechanical ventilation?
* Cardiovascular complications * Pulmonary complications
26
What is the purpose of noninvasive ventilation?
Assist with breathing without artificial airways.
27
What is Continuous Positive Airway Pressure (CPAP)?
Delivers pressure continuously during spontaneous breathing to prevent airway collapse.
28
What is Bilevel Positive Airway Pressure (BiPAP)?
Delivers positive pressure at two levels for inhalation and exhalation.
29
Fill in the blank: The primary goal of mechanical ventilation is to increase _______ and lower _______.
[PaO2], [PaCO2]
30
What is a common assessment after intubation?
Confirm placement with end tidal CO2 detector and auscultate breath sounds.
31
What is the expected ABG result in respiratory acidosis?
Low pH.
32
What is the priority for clients with ARDS?
Provide ventilatory assistance and supportive care.
33
What are the expected nursing interventions for clients on mechanical ventilation?
* Elevate HOB * Perform ROM exercises * Provide oral care * Assess and clean skin frequently
34
What is the length marking where the ETT is even with the teeth?
22 cm
35
What cardiovascular complication can arise from mechanical ventilation?
Increased intrathoracic pressure leading to decreased cardiac output and venous return
36
What is barotrauma?
Rupture of the lungs due to added pressure from mechanical ventilation
37
What is volutrauma?
Lung rupture due to high volume of air delivered by the ventilator
38
How can ventilator-associated pneumonia be prevented?
By removing the ventilator
39
What is oxygen toxicity and what are its symptoms?
Toxicity due to high FiO2 (over 50%) for more than 24-48 hours; symptoms include fatigue, restlessness, N/V, coughing, dyspnea, hypoxia, and cyanosis
40
What is ECMO?
Extracorporeal membrane oxygenation, a modality of cardiopulmonary support delivered in the ICU
41
What is the process of ECMO?
Blood is removed, oxygenated, and reinfused into the client’s circulatory system
42
What are the nursing responsibilities regarding heparin in ECMO?
Administer heparin as ordered and monitor coagulation lab values
43
What platelet count should be maintained during ECMO?
Above 150,000
44
What activated clot times should be monitored during ECMO?
Between 180-240 seconds
45
What are the risks associated with ECMO?
* Thrombus formation * Heparin-induced thrombocytopenia * Neurological changes * Renal failure and oliguria * Sepsis
46
What should be monitored regularly in a client receiving ECMO?
Neurological function, urine output, electrolytes, metabolic panel, WBC count, and vital signs
47
What should be done if a ventilator alarm sounds?
Immediately check on the client and the equipment; if the problem can't be determined, disconnect and provide manual breaths with an ambu-bag
48
What causes high pressure alarms in mechanical ventilation?
* Coughing * Breathing asynchronously * Condensation buildup * Kinked tubing * Decreased lung compliance
49
What causes low pressure alarms in mechanical ventilation?
Decreased pressure due to disconnection of the ventilator or accidental extubation
50
What triggers the apnea alarm in mechanical ventilation?
No breathing detected or oversedation suppressing respirations
51
What conditions can cause high Vt or RR alarms?
* Pain * Anxiety * Infection * Fever * Hypoxia * Hypercapnia
52
What does a low Vt alarm indicate?
A leak in the circuit or a cuff leak in the ETT or tracheostomy tube
53
What is Assist Control (A/C) in mechanical ventilation?
Full support mode that assists with each breath by providing volume or pressure
54
What is Synchronized Intermittent Mandatory Ventilation (SIMV)?
Partial support mode that administers ventilation with the client's own inspiratory efforts
55
What is Pressure Support Ventilation (PSV)?
Spontaneous mode where RR, tidal volume, and inspiratory times are determined by the patient
56
What does FiO2 represent in ventilator settings?
The fraction of inspired oxygen provided to the client
57
What is PEEP?
Positive end-expiratory pressure, the amount of pressure remaining in the lungs upon expiration
58
What is the role of the nurse in tracheostomy care?
Meticulous care to avoid complications like infection and skin breakdown
59
What should be monitored regarding cuff pressure in tracheostomy care?
Keep pressure between 20-30 cm of water or as prescribed
60
What is the recommended practice before tracheal suctioning?
Preoxygenation prior to suctioning
61
What is a key step after inserting a tracheostomy?
Inflate the cuff and auscultate breath sounds
62
What must be ensured after securing a tracheostomy tube?
Obtain a chest X-ray

Exam 2 CAI (2 decks)

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