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21 Cards in this Set

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  • Back
RESPIRATORY FAILURE
INSUFFICIENCY OF RESPIRATORY SYSTEM TO EXCHANGE 02 AND CO2 IN AMOUNTS TO MEET BODY'S NEED
ACUTE RESPIRATORY FAILURE
SUDDEN, LIFE-THREATENING
EXP: EMBOLISM,OBSTRUCTION
CHRONIC RESPIRATORY FAILURE
SLOWER, GRADUAL DECLINE IN GAS EXCHANGE
-OFTEN DEVELOP TOLERANCE TO HYPOXEMIA OR HYPERCAPNIA
EXP: COPD, NEUROMUSCULAR DISEASE
4 CAUSES OF RESPIRATORY FAILURE
1.DECREASE IN RESP DRIVE
-CNS DEPRESSANTS (MORPHINE)
2.DYSFUNCTION OF RESP MUSCLE
-SPINAL CORD INJURY,GUILLIAN BARRE SYN
3.DYSFUNCTION OF LUNG TISSUE
-PNEUMONIA
4.POST OP
-THE HIGHER THE INCISION ON ABDOMEN
(GALLBLADDER,PANCREATIC CANCER)
COUGH & DB 10 TIMES/HR
S/S OF RESP FAILURE
DECREASED PO2 AND INCREASED PCO2
-RESPIRATORY ACIDOSIS
ASSESSMENT FOR RESP FAILURE
CHECK LOC
CHECK DYSPNEA
INCREASED PULSE
INCREASED BP
LOW BOWEL SOUNDS
ABG AND EKG-PVC'S MAY BE PRESENT DUE TO HYPOXEMIA-->VENTRICULAR FIBRILLATION=DEATH
IF MORPHINE IS CAUSING DECREASE IN RESPIRATIONS...WHAT SHOULD BE GIVEN?
NARCAN
HOW DOES ONE CORRECT UNDERLYING CAUSE OF RESP FAILURE
C & DB
LOC
ABG
POX
VS
PT MAY NEED INTUBATION/VENTILATOR
ACUTE RESPIRATORY DISTRESS SYNDROME
(ARDS)
COMPLEX FORM OF RESPIRATORY FAILURE
-SUDDEN PROGRESSIVE PULMONARY EDEMA
(NOT ASSOCIATED W/ HEART)
-BILATERAL INFILTRATED ON CXR
***HYPOXEMIA UNRESPONSIVE TO INCREASE IN OXYGENATION**
-DECREASED COMPLIANCE OF LUNGS(STIFF)
CAUSES OF ARDS
-ASPIRATION (NEAR DROWNING,FLUID)
-HEMATOLOGIC D/O (DIC,BYPASS)
-INFECTION
-METABOLIC D/O(PANCREATITIS,DRUG OVERDOSE)
-SHOCK,TRAUMA,CANCER,BURNS
TRIGGER OF ARDS LEADS TO
DECREASED BLD FLOW TO LUNG
ASSESSMENT OF ARDS
S/S 12-24 HR AFTER TRIGGER
-DSYPNEA,HIGH RR,HIGH HEART RATE
-COUGH(FROM FLUID IN LUNGS
-USE OF ACCESSORY MUSCLES
-DECREASED LOC
AVEOLI STIFF/COLLAPSED
CXR-INFILTRATES
**RESP DISTRESS CONTINUES DESPITE AMT OF O2 GIVEN
IMPLEMENTATION
MECHANICAL VENTILATION
PEEP-POSITIVE END EXPIRATORY PRESSURE
(LOW TIDAL VOLUME)
WEAN TO O2
MAINTAIN GAS EXCHANGE
ALLOW LUNGS TIME TO HEAL
NSG DIAGNOSIS FOR ARDS
-IMPAIRED GAS EXCHANGE
-ANXIETY
GOALS FOR ARDS
-INCREASE TISSUE OXYGENATION
-MINIMIZE O2 CONSUMPTION
-PREVENT/TREAT COMPLICATIONS
-ABC'S (AIRWAY,BREATHING,CIRCULATION)
WHATS DONE TO IMPROVE AIRWAY
-MECHANICAL VENTILATION
-A/W PATENCY,SUCTION,SIGHING
-NEUROMUSCULAR BLOCKING AGENTS(PARALYZE PT. TO PREVENT PT FROM FIGHTING VENTILATOR)
WHAT SHOULD BE GIVEN TO PT WHILE ON NEUROMUSCULAR BLOCKING AGENT
EYE CARE-DROPS
HUMIDITY
CPT/PT
WHAT IS THE POSITION OF CHOICE FOR SOMEONE W/ ARDS
PRONE POSITION
-IMPROVES OXYGENATION AND PROTECTS LUNGS
"SWIMMING POSITION"
WHAT SHOULD BE DONE FOR SOMEONE WITH ARDS
FLUIDS-DO NOT OVERLOAD
NUTRITION-ENTERAL/TPN (NEEDS 2500-3000 CAL/DAY)
ANTIBIOTICS-MAYBE
STEROIDS-MAYBE
COMPLICATIONS OF ARDS
MECHANICAL VENTILATION/ENDOTRACHEAL TUBE
GI=DECREASED MOTILITY->STRESS ULCER
RENAL=DECREASED PERFUSION/MEDS
CV
DIC=DYSRYTHMIAS (PVC'S)
INFECTION
EVALUATION FOR ARDS
PREVENTION=PREVENT ASPIRATION
SURFACTANT=IF PT SURVIVES,NORMAL LUNG FCN W/IN 1 YR
NITRIC ACID
ECMO (EXRA CORPOREAL MEMBRAN OXYGENATION)=BYPASS FOR LUNGS,ALLOWS LUNGS TIME TO HEAL