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22 Cards in this Set

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respiratory failure:
-state of disturbed gas exchange resulting in abnormal blood gases
In RF, what are the abnormal values of pH, PaO2 and PaCO2?
pH < 7.30 breathing room air
PaO2 < 60 mmHg
PaCO2 > 50 mmHg
3 categories of pts with respiratory failure:
1. Failure of respiration and oxygenation leading to hypoxemia and normal or low CO2.
2. Failure of ventilation leading to hypercapnia
3. A combination of respiratory and ventilatory failure.
4 causes of acute respiratory failure:
1. hypoxemia (poor ventilation/perfusion)
2. hypercapnea
3. chronic process
4. acute process
hypercapnea:
-reduced alveolar ventilation in relation to production of CO2
-causes metabolic and respiratory acidosis, cerebral depression, hypotension and heart failure
chronic respiratory failure:
-renal compensation by retaining HCO3 and excreting H+
acute respiratory failure:
-acidosis due to lack of time for renal compensation
What effect does respiratory failure have on the body?
-causes RSB with increased respiratory muscle movement
-hypoxia and hypercapnea leading to headaches, confusion, dizziness, initial HTN, later hypotension and tachycardia
-late findings of cyanosis and intercostal retraction
3 buffer systems in the body:
1. chemical (slowest, most efficient)
2. respiratory
3. renal (fastest, least efficient)
Dx of respiratory failure:
ABGs
electrolytes
CBC
Tx of respiratory failure:
-depends on cause
-assisted ventilation with positive pressure (PEEP)
-low CHO diet so as to not increase CO2 production
-tx of infection, bronchospasm, heart conditions may be necessary
Adult Respiratory Distress Syndrome (ARDS):
"shock lung"
-damage to alveolar-capillary membrane
-mortality rate of 43-63%
Causes of ARDS:
severe trauma
sepsis
aspiration of gastric acid
fat emboli
shock
What effect does ARDS have on the body?
1. severe hypoxemia
2. decrease in lung capacity
3. decrease in functional residual capacity
4. low blood volume
5. shallow respirations progressing to tachycardia, tachypnea, hypotension
Dx of ARDS:
1. hypoxemia that does not respond to increased levels of O2
2. hypotension (decreasing UO, acidosis, cardiac arrest)
3. ABGs
4. xray shows diffuse, fluffy, infiltrates
5. absence of cardiogenic pulmonary edema
6. high conc of O2 given causing less inspired N
purpose of nitrogen in the lungs:
-remains in the alveoli and keeps alveoli open
Tx of ARDS:
1. ventilators
2. fluid and electrolyte balance
3. Tx of underlying process
ventilator support:
-PEEP
-to keep alveoli open
-increase air volume in alveoli causing a decrease in fluid volume
-forces edema fluid from alveoli
(Infant) Respiratory Distress Syndrome (IRDS):
-aka Hyaline membrane disease
-usually found in premature babies
-lack of surfactant
-leakage of protein fluid into alveoli causing hyaline membrane
-sometimes L to R shunt (PFO or PDA) or inadequate capillary blood supply
surfactant:
-increases alveolar surface tension and decreases lung compliance
-composed of lipoprotein that is secreted by the alveolar cells of the lung and serves to maintain the stability of pulmonary tissue by reducing the surface tension of fluids that coat the lung
Clinical manifestations and diagnosis of IRDS is similar to what disorder?
ARDS
Tx of IRDS:
-mechanical ventilation
-surfactant administration