1 / 31

Respiratory

Respiratory. Respiratory Failure and ARDS. Normal Respirations. Respiratory Failure. Not a disease process, sign of severe dysfunction Lungs unable to oxygenate blood & remove CO2 Alveolar ventilation is inadequate to meet the body’s need Commonly defined in terms of ABG’s

daniel_millan
Download Presentation

Respiratory

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Respiratory Respiratory Failure and ARDS

  2. Normal Respirations

  3. Respiratory Failure • Not a disease process, sign of severe dysfunction • Lungs unable to oxygenate blood & remove CO2 • Alveolar ventilation is inadequate to meet the body’s need • Commonly defined in terms of ABG’s • PO2 of less than 50 mmHg • PCO2 greater than 50 mmHg • Arterial pH of less than 7.35

  4. Respiratory failure & affect on acid-base balance • 1. Hypoxemia resp failure is failure of oxygenation. • PO2 significantly reduced and PCO2 is at or below normal • Metabolic acidosis results from tissue hypoxia • 2. Hypercapnia resp failure results from hypoventilation. • PCO2 rises rapidly and resp acidosis develops • PO2 drops more slowly

  5. Causes of respiratory failure (p.1157) • Impaired ventilation • Impaired diffusion • Ventilation-perfusion mismatch (VQ) • COPD most common cause of resp failure

  6. Common manifestations/complications of respiratory failure • Hypoxemia • Hypercapnia • Underlying disease process symptoms (p. 1157)

  7. Cyanosis

  8. Therapeutic interventions for Resp Failure • Diagnostic tests- ABG’s; ETCO2; chest X-ray • Main treatment- correct underlying cause & restore adequate gas exchange in lung • Elevate HOB • Medications • Oxygen therapy (O2 sat 90%; PaO2 60 mmHg) • Airway management

  9. Tracheotomy

  10. Endotracheal tube

  11. Endotracheal tube

  12. Make sure airway attached to lungs

  13. Therapeutic interventions cont. • Mechanical ventilation • Adeq gas exchange & tissue perfusion • Criteria to put on • RR > 35-45 • pCO2 >45 • pO2 <50

  14. Mechanical ventilation cont • Types • Modes • PEEP; CPAP • Ventilator settings- including alarms • Complications • Ventilate one lung • Nosocomial pneumonia • Barotraumas • Cardiovascular • Gastrointestinal

  15. Nursing assessment specific to respiratory failure • Health history • Physical exam

  16. Pertinent nursing problems and interventions specific to respiratory failure • Impaired spontaneous ventilation • Ineffective airway clearance • Anxiety • Home care

  17. Acute respiratory distress syndrome- ARDS • Syndrome, sudden & progressive acute resp failure- not primary • Alveolar capillary membranes damaged more permeable> noncardiac pulmonary edema & progressive refractory hypoxemia

  18. Pathophysiology of ARDS- Stages • Refer to BB course documents Module 2 for video • Page 1170-1 illustrations of stages • Initiation of ARDS; onset pulmonary edema; alveolar collapse; end-stage ARDS

  19. surfactant keeping alveoli open

  20. Common manifestations/complications of ARDS • Symptoms develop 24-48 hrs after initial insult • Early symptoms • Later symptoms • Hallmark sign- progressive refractory hypoxemia • Noncardiac pulmonary edema

  21. Therapeutic interventions for ARDS • Diagnostic tests • ABG’s- hypoxemia • Chest X-ray- snow storm effect • Pulmonary function tests • Hemodynamic monitoring

  22. Therapeutic intervention for ARDS cont. • Medications • Mainstay of treatment---Mechanical ventilation with intubation • Correct underlying condition • Fluid replacement keep vascular volume • Nutrition positive protein balance • Heparin prevent thrombothebitis • ‘Proning’

  23. Independent Lung Ventilation

  24. Prone Device

  25. Benefits to Proning >

  26. Nursing assessment specific to ARDS • Health history • Physical exam

  27. Pertinent Nursing problems and interventions for ARDS • Decreased cardiac output • Ineffective airway clearance; impaired tissue perfusion; imbalance nutrition: less than body requirements; risk for infection • Dysfunctional ventilatory weaning response • Home care

More Related