Patho - Exam 4 Ventilation And Respiratory Failure

Front 1

respiratory failure:

Back 1

-state of disturbed gas exchange resulting in abnormal blood gases

Front 2

In RF, what are the abnormal values of pH, PaO2 and PaCO2?

Back 2

pH < 7.30 breathing room air
PaO2 < 60 mmHg
PaCO2 > 50 mmHg

Front 3

3 categories of pts with respiratory failure:

Back 3

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.

Front 4

4 causes of acute respiratory failure:

Back 4

1. hypoxemia (poor ventilation/perfusion)
2. hypercapnea
3. chronic process
4. acute process

Front 5

hypercapnea:

Back 5

-reduced alveolar ventilation in relation to production of CO2
-causes metabolic and respiratory acidosis, cerebral depression, hypotension and heart failure

Front 6

chronic respiratory failure:

Back 6

-renal compensation by retaining HCO3 and excreting H+

Front 7

acute respiratory failure:

Back 7

-acidosis due to lack of time for renal compensation

Front 8

What effect does respiratory failure have on the body?

Back 8

-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

Front 9

3 buffer systems in the body:

Back 9

1. chemical (slowest, most efficient)
2. respiratory
3. renal (fastest, least efficient)

Front 10

Dx of respiratory failure:

Back 10

ABGs
electrolytes
CBC

Front 11

Tx of respiratory failure:

Back 11

-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

Front 12

Adult Respiratory Distress Syndrome (ARDS):

Back 12

"shock lung"
-damage to alveolar-capillary membrane
-mortality rate of 43-63%

Front 13

Causes of ARDS:

Back 13

severe trauma
sepsis
aspiration of gastric acid
fat emboli
shock

Front 14

What effect does ARDS have on the body?

Back 14

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

Front 15

Dx of ARDS:

Back 15

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

Front 16

purpose of nitrogen in the lungs:

Back 16

-remains in the alveoli and keeps alveoli open

Front 17

Tx of ARDS:

Back 17

1. ventilators
2. fluid and electrolyte balance
3. Tx of underlying process

Front 18

ventilator support:

Back 18

-PEEP
-to keep alveoli open
-increase air volume in alveoli causing a decrease in fluid volume
-forces edema fluid from alveoli

Front 19

(Infant) Respiratory Distress Syndrome (IRDS):

Back 19

-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

Front 20

surfactant:

Back 20

-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

Front 21

Clinical manifestations and diagnosis of IRDS is similar to what disorder?

Back 21

ARDS

Front 22

Tx of IRDS:

Back 22

-mechanical ventilation
-surfactant administration