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JM Resp. Fail
Respiratory failure/hesi
Question | Answer |
---|---|
Respiratory Failure/Hesi pgs 27-28 | |
What is the basic definition of what is happening with acute respiratory distress syndrome? | ARDS-the oxygen exchange for Co2 in the lungs is inadequate for O2 consumption and CO2 production in the body’s cells. |
What is ARDS characterized by? | Hypoxemia(even w/ 100% O2);decreased pulmonary compliance;dyspnea;non-cardiac-assoc bilateral pulmonary edema;dense pulmonary infiltrates on xray. |
Discuss ARDS. | An unexpected, CATASTROPHIC pulmonary complication OCCURRING IN A PERSON WITH NO PREVIOUS PULMONARY PROBLEMS. Mortality rate 50%. |
Discuss lung sounds associated with ARDS. | NO abnormal lung sounds are present on auscultation because the edema of ARDS occurs first in the interstitial spaces NOT IN THE AIRWAYS. |
What is a common lab finding with ARDS. | Lowered PO2. |
What tx is often needed with ARDS? | Often require intubation & mechanical ventilation w/ PEEP. THESE PTS ARE NOT VERY RESPONSIVE TO HIGH CONCENTRATIONS OF O2. |
What is PEEP? | Positive end-expiratory pressure-the instillation/maintenance of small amts of air into alveoloar sacs toprevent collapsing when pt exhales. |
What is PEEP usually set at? | 5-10 cm H2O. |
What are some common causes of respiratory failure? | COPD;pneumonia;TB;contusion;aspiration;inhaled toxins;emboli;drug O/D;fluid overload;DIC;shock. |
Discuss nursing assessment with ARDS. | Dyspnea;hyperpnea;intercostals retraction;cyanosis, pallor;hypoxemia: PO2<50mmHg w/FIO@>60%; VERBALIZED ANXIETY, RESTLESS; diffuse pulmonary infiltrates on xray seen as “white-out”. |
Discuss nursing diagnoses related to ARDS. | Impaired gas exchange r/t; Risk for deficient fluid volume r/t; Ineffective breathing pattern r/t;risk for injury r/t; risk for infection r/t; |
Discuss nursing plans/interventions for pt with ARDS. | Position/maxlung expansion;monitor signs of hypoxemia &O2 toxicity; breath sounds/ pneumothorax ESP W/PEEP; v/s&cardiac monitor;ABGs;vital organ status;cns;loc,output;apical pulse,BP; f/e bal;routine labs. |
Norm PH? | 7.35-7.45 |
Normal PCO2? | 35-45mm Hg |
Norm HCO3? | 21-28 mEQ/L |
Norm Po2? | 80-100 mm Hg |
Normal O2 sat? | 95-100% |