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19 Cards in this Set

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Describe ARDS

The exchange of O2 for CO2 in the lungs is not adequate for O2 consumption and CO2 production within the body's cells.
Hypoxemia in ARDS

Hypercapnia in ARDS
O2 below 50 mmHg

CO2 above 45 mmHg


Unexpected, catastrophic pulmonary complication occurring in a person with no previous pulmonary problems. The mortality rate is high! 50%
During acute failure the arterial pH falls below 7.30 this indicates...
HESI HINT: Clients with ARDs commonly have a lowered PO2, however...
these clients are not very responsive to high concentrations of O2.
Think about the physiology of lungs by remembering PEEP. Positive end expiratory pressure is the instillation and maintenance of small amounts of air into the alveolar sacs to prevent them from collapsing each time the client exhales. The amount of pressure can be set is around 5-10 cm of water.
Name 11 common causes of respiratory failure! 1...2...3...GO!
2. Pneumonia
3. TB
4. Contusion
5. Aspiration
6. Inhaled toxins.
7. Emboli
8. Drug overdose
9. Fluid overload
10. DIC
11. Shock
Dyspnea, tachypnea

Intercostal retractions


Hypoxemia: PO2 < 50 mmHg with FiO2 > 60%

Diffuse pulmonary infiltrations on CXR "white-out" look

Verbalize anxiety and restlessness
HESI HINT: Suction
Suction only when secretions are present.
Nursing Interventions: ARDS
Ventilator settings, Care with oral airway or a tracheostomy

Monitor breath sounds for pneumothorax especially when PEEP is used

Monitor the client hemodynamically with VS and ECG

Monitor ABGs routinely

Monitor vital organ status: CNS, LOC, Renal outuput, myocardium (apical pulse, BP)

Monitor F&E electrolyte balance
Normal Values for Arterial Blood Gases
pH 7.35 - 7.45
PO2 80 - 100
PCO2 35 - 45
HCO3 22 - 26
Anion 10 - 18
Normal Values for Venous Blood Gases
pH 7.31 - 7.42
PO2 35 - 45
PCO2 39 - 52
HCO3 22 - 26
Anion 8 - 16
How do you check for a collateral circulation?
Perform Allen Test
How do you know if it the Allen Test is positive?
Put pressure on your ulnar and radial pulse points and hold it, then let go of the ulnar point and see if it flushes back to normal. If it does, this is a positive pressure point.
What do you do if the Allen Test is negative?
Go to a different arm or site.
What are the 8 common causes of respiratory failure in children?
1. Congenital Heart Disease
2. Respiratory distress syndrome
3. Infection, sepsis
4. Neuromuscular diseases
5. Trauma and burns
6. Aspiration
7. Fluid overload or dehydration
8. Anesthesia and narcotic overdose
S/S respiratory failure in children
"Bad" looking child

Very slow or rapid RR, apnea, gasping


Cyanosis, pallor, or mottled color

Irritability, lethargy

Retractions, nasal flaring, poor air movement

Hypoxemia, hypercapnia, respiratory acidosis
What percentage of O2 do you want to have a child on when you see that they are in severe respiratory distress?
In a child, what are the values for severe respiratory failure?
PCO2 > 45
PO2 < 60 on 50%