Acute Respiratory Failure (ARF) Overview
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Questions and Answers

What condition is indicated by a hypoxemic respiratory failure with a PF ratio less than 50?

  • Pleural effusion
  • Asthma exacerbation
  • Chronic obstructive pulmonary disease (COPD)
  • Acute respiratory distress syndrome (ARDS) (correct)
  • What does a pH less than 7.2 indicate in a patient with hypercapnic respiratory failure?

  • Compensated metabolic acidosis
  • Metabolic alkalosis
  • Uncompensated respiratory acidosis (correct)
  • Respiratory acidosis
  • What risk factor is critical to consider when preparing a patient for a thoracentesis?

  • History of hypertension
  • Previous lung surgery
  • Coagulation defects (correct)
  • Age above 60
  • What may indicate right mainstem intubation in an intubated patient?

    <p>Absent breath sounds on the left side (A)</p> Signup and view all the answers

    What does a low bicarbonate (HCO3) level indicate regarding kidney function in a patient with respiratory distress?

    <p>Impaired kidney function (C)</p> Signup and view all the answers

    Which nursing management strategy is essential for optimizing oxygenation and ventilation in ARD?

    <p>Positioning the patient (D)</p> Signup and view all the answers

    What is the primary nursing diagnosis for a patient with acute respiratory distress?

    <p>Impaired gas exchange (C)</p> Signup and view all the answers

    When is NIPPV not recommended for patients?

    <p>Patients with decreased level of consciousness (C)</p> Signup and view all the answers

    What is the distinct difference between BiPAP and CPAP?

    <p>BiPAP delivers varying pressures for inhalation and exhalation (D)</p> Signup and view all the answers

    Which statement about high flow nasal cannula is correct?

    <p>It provides heated and humidified oxygen (C)</p> Signup and view all the answers

    What is one of the risks associated with NIPPV during treatment?

    <p>Increased risk for aspiration (C)</p> Signup and view all the answers

    What is one of the goals of providing emotional support during ARD management?

    <p>To reduce anxiety and stress for the patient (D)</p> Signup and view all the answers

    Which medication class helps to decrease stomach acid related to GI bleeding management?

    <p>H2 blockers (C)</p> Signup and view all the answers

    What is a potential complication when using an endotracheal tube (ETT)?

    <p>Tracheal stenosis (D)</p> Signup and view all the answers

    Which medication must a patient be sedated with before administering neuromuscular blocking agents?

    <p>Etomidate (D)</p> Signup and view all the answers

    What is the purpose of using ECMO?

    <p>To oxygenate blood outside of the patient's body (A)</p> Signup and view all the answers

    Which nursing intervention is crucial for maintaining an endotracheal tube?

    <p>Ensuring ETT is secure (D)</p> Signup and view all the answers

    What can be a consequence of elevated PEEP during mechanical ventilation?

    <p>Decreased venous return to the heart (A)</p> Signup and view all the answers

    Which of the following is a sign of barotrauma due to mechanical ventilation?

    <p>Asymmetrical chest expansion (B)</p> Signup and view all the answers

    Which complication is associated with mechanical ventilation?

    <p>Self-extubation (D)</p> Signup and view all the answers

    What is the primary use of neuromuscular blocking agents in the context of intubation?

    <p>To facilitate muscle paralysis for easier intubation (B)</p> Signup and view all the answers

    What is a significant advantage of using a high-flow nasal cannula in patients with acute respiratory failure?

    <p>It matches a patient's inspiratory flow demands. (A)</p> Signup and view all the answers

    When should intubation be considered for a patient?

    <p>The patient requires suctioning. (B)</p> Signup and view all the answers

    What are essential items to have in a patient's room for airway management?

    <p>Suction equipment and oxygen supplies. (B)</p> Signup and view all the answers

    What might cause high pressure alarms on a ventilator?

    <p>Condensation is collecting in the tubing. (D)</p> Signup and view all the answers

    What is a vital step if a patient with a ventilator shows sudden drop in SpO2?

    <p>Disconnect the patient from the ventilator. (A)</p> Signup and view all the answers

    Which airway device is suitable for conscious patients?

    <p>Nasal trumpet. (D)</p> Signup and view all the answers

    Which condition necessitates the use of rapid sequence intubation?

    <p>The patient is tachypneic with resps in the 40s. (B)</p> Signup and view all the answers

    What can be a complication sign indicating issues with ventilation?

    <p>Asymmetrical chest expansion and drop in O2 stat. (A)</p> Signup and view all the answers

    What is the PaO2/FiO2 range that characterizes mild ARDS?

    <p>200-300 mm Hg (A)</p> Signup and view all the answers

    What is a common cause of indirect injuries leading to ARDS?

    <p>Sepsis (D)</p> Signup and view all the answers

    How is severe ARDS defined based on the PaO2/FiO2 ratio?

    <p>Less than or equal to 100 mm Hg (A)</p> Signup and view all the answers

    Which of the following is a characteristic feature of hypoxemia in ARDS?

    <p>Blood oxygen levels do not improve with supplemental oxygen (A)</p> Signup and view all the answers

    What is the normal range for HCO3 in blood gas measurement?

    <p>22-26 (C)</p> Signup and view all the answers

    Which option best describes the role of positive end-expiratory pressure (PEEP) in ARDS management?

    <p>Keeps alveoli open to improve oxygenation (B)</p> Signup and view all the answers

    What chest radiography finding would suggest a left pneumothorax?

    <p>Shifting of the mediastinum to the right (D)</p> Signup and view all the answers

    Which condition is considered a severe and life-threatening exacerbation of asthma requiring intubation?

    <p>Status asthmaticus (B)</p> Signup and view all the answers

    What is a primary cause of hypoxemia related to intrapulmonary shunting?

    <p>Blood passing through the lungs that doesn't partake in gas exchange (D)</p> Signup and view all the answers

    Which condition is commonly associated with a low V/Q ratio?

    <p>Pneumonia (D)</p> Signup and view all the answers

    What is a significant symptom of early acute respiratory distress syndrome (ARDS)?

    <p>Clear chest X-ray (B)</p> Signup and view all the answers

    What does refractory hypoxemia indicate about a patient's lung function?

    <p>Ineffective gas exchange due to lung damage (A)</p> Signup and view all the answers

    Which of the following is NOT a typical diagnostic method for acute respiratory failure (ARF)?

    <p>Electrocardiogram (ECG) (C)</p> Signup and view all the answers

    What characterizes respiratory acidosis?

    <p>High PaCO2 and low pH (A)</p> Signup and view all the answers

    What does positive end-expiratory pressure (PEEP) achieve in mechanical ventilation?

    <p>Maintains airway patency at the end of expiration (C)</p> Signup and view all the answers

    A chest X-ray showing 'whiteout' is indicative of what condition?

    <p>Severe pulmonary edema (C)</p> Signup and view all the answers

    What may cause absent or diminished breath sounds on the left side during an intubation?

    <p>Right mainstem intubation (C)</p> Signup and view all the answers

    Which acid-base component reflects renal function and is crucial during respiratory distress?

    <p>HCO3 (C)</p> Signup and view all the answers

    Which situation poses the highest risk when preparing a patient for thoracentesis?

    <p>Coagulation defects (A)</p> Signup and view all the answers

    What factor can indicate the inappropriate use of ECMO in a patient?

    <p>Failure to correct underlying pathology (D)</p> Signup and view all the answers

    What characteristic observation accompanies Kussmaul respiration in patients with DKA?

    <p>Deep and rapid breaths (C)</p> Signup and view all the answers

    What is the primary purpose of corticosteroids in the management of ARDS?

    <p>Reduction of airway inflammation (A)</p> Signup and view all the answers

    Which factor is critical in preventing Ventilator Associated Pneumonia (VAP)?

    <p>Maintaining a HOB position of 30-45 degrees (C)</p> Signup and view all the answers

    What diagnostic test is most effective in determining the sensitivity of the organism causing pneumonia?

    <p>Sputum culture (D)</p> Signup and view all the answers

    Which medication class is used to manage severe anxiety in ARDS patients?

    <p>Benzodiazepines (D)</p> Signup and view all the answers

    What could be a complication of ARDS related to altered mental status?

    <p>Encephalopathy (D)</p> Signup and view all the answers

    Which intervention aids in reducing pulmonary congestion in ARDS patients?

    <p>Implementing diuretics (B)</p> Signup and view all the answers

    What is the role of enteral nutrition in ARDS management?

    <p>To support energy needs and promote healing (A)</p> Signup and view all the answers

    What does poor hand hygiene increase the risk of in a hospital setting?

    <p>Ventilator Associated Pneumonia (VAP) (A)</p> Signup and view all the answers

    Which of the following complications can arise from the use of an endotracheal tube (ETT)?

    <p>Tracheal stenosis (A)</p> Signup and view all the answers

    Which medication must be administered to a patient before neuromuscular blocking agents?

    <p>Etomidate (B)</p> Signup and view all the answers

    What is one major use of ECMO in clinical practice?

    <p>To support patients with severe respiratory failure (C)</p> Signup and view all the answers

    Which of the following should be monitored closely to prevent complications during intubation?

    <p>Blood pressure every minute (C)</p> Signup and view all the answers

    What significant complication can occur with mechanical ventilation related to intrathoracic pressure?

    <p>Decreased venous return to the heart (D)</p> Signup and view all the answers

    What procedure is recommended to verify the correct placement of an endotracheal tube?

    <p>Auscultation and color change of CO2 detector (D)</p> Signup and view all the answers

    What condition can result from the elevated settings of PEEP and tidal volume during mechanical ventilation?

    <p>Barotrauma (pneumothorax) (A)</p> Signup and view all the answers

    What is a primary advantage of using high-flow nasal cannula (HFNC) for patients in acute respiratory failure?

    <p>It delivers high flow rates to match peak inspiratory flow demands. (C)</p> Signup and view all the answers

    Which of the following medications is classified as a neuromuscular blocking agent?

    <p>Pancuronium bromide (B)</p> Signup and view all the answers

    Which item is essential to have in a patient's room for airway management?

    <p>Suction equipment (D)</p> Signup and view all the answers

    What is a primary benefit of using PEEP in patients with acute respiratory failure?

    <p>Improves oxygenation (B)</p> Signup and view all the answers

    What complication may be indicated by asymmetrical chest expansion and a drop in O2 saturation?

    <p>Ventilator malfunction (A)</p> Signup and view all the answers

    Which of the following is a negative effect of PEEP during ventilation?

    <p>Barotrauma causing subcutaneous emphysema (C)</p> Signup and view all the answers

    What nursing intervention can help manage low cardiac output caused by PEEP?

    <p>Administer fluids and positive inotropes (C)</p> Signup and view all the answers

    When is rapid sequence intubation indicated for a patient?

    <p>The patient shows signs of severe respiratory distress. (C)</p> Signup and view all the answers

    Which statement is true regarding the use of oral airways before intubation?

    <p>They help maintain airway patency by preventing tongue obstruction. (D)</p> Signup and view all the answers

    How does extracellular gas exchange work in managing severe acute respiratory failure?

    <p>It removes blood from the body, oxygenates it, and returns it. (B)</p> Signup and view all the answers

    What should be done if a ventilated patient exhibits a sudden drop in SpO2 and shows signs of distress?

    <p>Disconnect the patient from the ventilator and use an ambu bag. (C)</p> Signup and view all the answers

    What positioning technique is beneficial for optimizing ventilation in patients with ARF?

    <p>Prone positioning (D)</p> Signup and view all the answers

    Which symptom indicates potential oxygen toxicity in patients being treated for respiratory failure?

    <p>Substernal chest pain increasing with deep breathing (D)</p> Signup and view all the answers

    What is a likely cause of high-pressure alarms on a ventilator?

    <p>Condensation in the breathing circuit. (D)</p> Signup and view all the answers

    What is the purpose of performing secretion clearance in the management of ARF?

    <p>To prevent desaturation (A)</p> Signup and view all the answers

    Which airway device is appropriate for a conscious patient who requires airway support?

    <p>Nasal trumpet (C)</p> Signup and view all the answers

    What is one of the least common methods for gas exchange within the body?

    <p>Intracorneal gas exchange (D)</p> Signup and view all the answers

    What condition is characterized by blood passing through the lungs without participating in gas exchange?

    <p>Intrapulmonary shunting (B)</p> Signup and view all the answers

    Which of the following is a significant early symptom of acute respiratory distress syndrome (ARDS)?

    <p>Non-productive cough (C)</p> Signup and view all the answers

    What does a 'whiteout' on a chest film typically indicate?

    <p>Severe pulmonary edema (C)</p> Signup and view all the answers

    What is the expected arterial blood gas (ABG) result in respiratory acidosis?

    <p>Low pH, high PaCO2 (C)</p> Signup and view all the answers

    Which factor contributes to refractory hypoxemia in ARF?

    <p>Ineffective gas exchange in damaged lungs (C)</p> Signup and view all the answers

    What is a key characteristic of ARF shown in a chest X-ray?

    <p>Bilateral infiltration (D)</p> Signup and view all the answers

    How does positive end-expiratory pressure (PEEP) benefit patients in mechanical ventilation?

    <p>Prevents airway collapse at end of expiration (B)</p> Signup and view all the answers

    Which of the following findings would most likely indicate significant changes in acute respiratory failure?

    <p>Use of accessory muscles (C)</p> Signup and view all the answers

    Flashcards

    Cardiac dysrhythmias

    Abnormal heart rhythms.

    Venous thromboembolism (VTE) treatment

    Medications like heparin, lovenox, and some STDs help stimulate protein C (an antiplatelet).

    GI bleeding treatment

    Treatments include PPIs, H2 blockers, and reducing stressors to lower stomach acid.

    ARD Nursing Management

    Optimize oxygenation, provide comfort/support, monitor for complications, and educate patients/families during Acute Respiratory Distress.

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    Primary nursing diagnoses (ARD)

    Impaired gas exchange, ineffective airway clearance, ineffective breathing pattern, and dysfunctional ventilator weaning response are potential diagnoses in Acute Respiratory Distress.

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    NIPPV (Non-Invasive Positive Pressure Ventilation)

    A method of respiratory support that uses a mask to deliver positive pressure to the lungs, without intubation.

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    High-flow nasal cannula

    Delivers heated, humidified oxygen, improving oxygenation and potentially reducing airway inflammation.

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    NIPPV contraindications

    Conditions like hemodynamic instability, decreased level of consciousness, or excessive secretions may prohibit NIPPV, requiring intubation instead.

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    ARDS Severity Levels

    ARDS is categorized into mild, moderate, and severe based on blood oxygen levels.

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    PaO2/FiO2 Ratio

    Measure of how well the lungs are transferring oxygen from inhaled air to the blood.

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    Mild ARDS (PaO2/FiO2)

    PaO2/FiO2 ratio between 200-300 mmHg with PEEP/CPAP ≥ 5 cm H2O.

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    Moderate ARDS (PaO2/FiO2)

    PaO2/FiO2 ratio between 100-200 mmHg with PEEP ≥ 5 cm H2O.

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    Severe ARDS (PaO2/FiO2)

    PaO2/FiO2 ratio ≤ 100 mmHg with PEEP ≥ 5 cm H2O.

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    Aspiration

    Foreign material in the lungs such as food or liquids.

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    Sepsis

    Body's potentially life-threatening response to an infection.

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    Hypoxemia

    Low oxygen levels in the blood.

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    High-flow nasal cannula (HFNC)

    Delivers high flow rates of oxygen to meet a patient's increased inspiratory demands.

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    Indicators for intubation

    Intubation is needed when a patient has airway obstruction, lacks protective reflexes, requires suctioning, or needs ventilation assistance.

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    Airway patency maintenance

    Maintaining an open airway. Methods include oxygen, suctioning, airway devices (nasopharyngeal, oropharyngeal), endotracheal tubes (ETT), and bronchodilators.

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    Ventilator room essentials

    Essential equipment includes suction equipment, oxygen, airways, monitoring devices, emergency medications, and an Ambu bag.

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    Rapid sequence intubation

    A method used when a patient is in respiratory distress or anticipates apnea.

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    Ventilator complications

    Signs include asymmetrical chest expansion, decreased oxygen saturation, and mental status changes.

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    High pressure alarm

    Indicates obstruction or interference with the ventilator and the patient's breathing, such as coughing, secretions or condensation.

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    Low pressure alarm

    Indicates a disconnection in the ventilator circuit.

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    Intrapulmonary shunting

    Blood passing through the lungs without participating in gas exchange, like a traffic jam in the lungs.

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    Low V/Q ratio

    Imbalance between ventilation (air flow) and blood flow in the lungs, hindering gas exchange.

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    Respiratory acidosis

    A condition with a low blood pH and high carbon dioxide (PaCO2) levels.

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    Refractory hypoxemia

    Low blood oxygen levels that do not improve with supplemental oxygen. A sign of severe lung damage.

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    ARDS early symptoms

    Dyspnea, non-productive cough, restlessness, clear chest X-ray, and respiratory alkalosis.

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    ARDS later symptoms (changes)

    Chest x-ray shows infiltration, respiratory acidosis, retractions, accessory muscle use, and pallor/cyanosis.

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    ARF Diagnosis—ABG

    Arterial blood gas (ABG) analysis is used in diagnosing acute respiratory failure.

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    Positive End-Expiratory Pressure (PEEP)

    A mechanical ventilation method to keep airways open at the end of exhalation, ensuring alveoli fill with air and improving oxygenation.

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    Hypoxemic Respiratory Failure

    A type of respiratory failure where the lungs are not able to transfer enough oxygen into the blood. This is defined by a PaO2/FiO2 ratio of less than 50.

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    Hypercapnic Respiratory Failure

    A type of respiratory failure where the lungs are not able to effectively remove carbon dioxide from the blood. This is often accompanied by a low pH (acidosis).

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    End-Tidal CO2

    A measurement of the carbon dioxide concentration in exhaled breath. It can be used to assess how well the lungs are ventilating.

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    Thoracentesis

    A procedure where a needle is inserted into the chest cavity to remove fluid from the space between the lungs and the ribcage.

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    HCO3 (Bicarbonate)

    A component of the blood that reflects kidney function. Bicarbonate helps to regulate blood pH by removing excess acid.

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    What is an ETT?

    Endotracheal tube, a plastic tube inserted through the mouth or nose into the trachea, used to assist breathing.

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    What is a cricoid abscess?

    A collection of pus in the tissue surrounding the cricoid cartilage, a ring-shaped cartilage in the larynx (voice box).

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    Why is sedation important before giving neuromuscular blocking agents?

    Sedatives relax the patient and prevent discomfort and anxiety during intubation, making the procedure safer.

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    Neuromuscular blocking agents

    Medications that block the nerve signals that control muscle movement. They paralyze muscles, including the diaphragm, making artificial ventilation possible.

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    What are common complications of intubation?

    Problems that can occur during or after intubation, including: tracheoesophageal fistula (connection between trachea and esophagus), cricoid abscess (pus in the cricoid cartilage), tracheal stenosis (narrowing of the trachea), and tube obstruction.

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    What is barotrauma?

    Lung injury caused by too much pressure in the lungs during mechanical ventilation.

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    What is ECMO?

    Extracorporeal membrane oxygenation, a life-support system that takes over the function of the lungs outside the body.

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    What is a major reason for using ECMO?

    Severe respiratory or cardiac failure, where the body's natural systems are unable to provide enough oxygen to organs.

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    ARDS Drug: Bronchospasm Relief

    Medications like albuterol (and similar 'ol' ending drugs) relax the airway muscles, opening up breathing passages.

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    ARDS Drug: Airway Inflammation

    Corticosteroids reduce swelling and inflammation in the lungs, helping to improve breathing.

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    ARDS Drug: Pulmonary Congestion

    Diuretics remove excess fluid from the body, while mucolytics (like Mucinex) loosen thick mucus, improving oxygen levels.

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    ARDS Type: Community Acquired Pneumonia (CAP)

    Pneumonia acquired outside of a hospital setting, often caused by viruses or bacteria.

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    ARDS Type: Hospital Acquired Pneumonia (HAP)

    Pneumonia that develops in hospitalized patients, often due to exposure to bacteria in the hospital environment.

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    ARDS Type: Ventilator Associated Pneumonia (VAP)

    Pneumonia that develops in patients on mechanical ventilation, often due to poor infection control.

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    ARDS Medical Management: Oxygenation

    Using pulse oximetry and ABGs, doctors monitor and adjust oxygen therapy levels to ensure adequate blood oxygenation.

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    ARDS Complication: Encephalopathy

    Brain dysfunction caused by low oxygen levels, leading to confusion, disorientation, and altered mental state.

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    HFNC Advantages

    HFNC can provide high oxygen flow rates, improve oxygenation, reduce airway inflammation, and is often more comfortable than other non-invasive ventilation methods.

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    When is intubation needed?

    Intubation is necessary when a patient has an airway obstruction, lacks protective reflexes, requires suctioning, or needs ventilation assistance.

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    PEEP

    Positive End-Expiratory Pressure. A mechanical ventilation technique that keeps airways open at the end of exhalation to improve oxygenation and reduce lung collapse.

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    PEEP Benefits

    PEEP improves oxygenation by reducing atelectasis (lung collapse) and decreasing the effort needed for breathing by keeping airways open.

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    PEEP Risks

    PEEP can cause complications like reduced cardiac output (heart pumping blood), barotrauma (lung injury from pressure), and increased intrathoracic pressure.

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    Prone Positioning

    Lying on the stomach/front, helps expand the lungs, improving oxygenation in ARF.

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    Extracorporeal Membrane Oxygenation (ECMO)

    A life-support system that filters and oxygenates blood outside the body, used when conventional ventilation fails to meet oxygen demands in severe lung or heart failure.

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    Nursing Management for ARF

    Optimizing oxygenation, ventilation, positioning, preventing desaturation, clearing secretions, monitoring, providing comfort and emotional support.

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    O2 Toxicity Symptoms

    Substernal chest pain (behind the breastbone) worse with deep breaths, rising CO2 levels, sore throat, and eye/ear discomfort.

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    Low Cardiac Output (CO) due to PEEP

    PEEP can lower CO by reducing venous return to the heart. Treatment involves giving fluids and medication to strengthen the heart, and potentially reducing the PEEP level.

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    ARDS Later Symptoms

    Chest X-ray shows infiltrations (white spots), respiratory acidosis, retractions (chest pulling in), accessory muscle use (using extra muscles to breathe), and pallor/cyanosis (pale/blue skin).

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    ARDS Diagnosis

    Diagnosed through arterial blood gas (ABG) analysis, complete blood count (CBC) to rule out infection, a chest X-ray, and assessment of refractory hypoxemia.

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    ETT Placement Verification

    Confirming the endotracheal tube (ETT) is correctly placed in the trachea (windpipe), not the esophagus (food pipe).

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    ETT Complications

    Potential problems that can arise from an endotracheal tube, such as a connection between the trachea and esophagus, a pus buildup near the voice box, a narrowed airway, or a blocked tube.

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    Why Sedate Before NMBAs?

    Sedatives calm the patient and prevent discomfort and anxiety during intubation, making the procedure safer.

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    Mechanical Ventilation Complications

    Potential problems associated with using a mechanical ventilator, such as irregular heart rhythms, low blood pressure, malfunctioning equipment, accidental tube removal, anxiety, hospital-acquired pneumonia, lung injury, and reduced heart output.

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    ECMO: What is it?

    Extracorporeal membrane oxygenation, a life support system that acts like the lungs outside the body, oxygenating blood with a machine and returning it to the patient's body.

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    Why Use ECMO?

    ECMO is used for severe respiratory or cardiac failure when the body can't deliver enough oxygen to its organs on its own.

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    Study Notes

    Acute Respiratory Failure (ARF)

    • V/Q ratio: Should be 1:1. Imbalance is a common cause of hypoxemia.
      • V (ventilation): Amount of air entering and leaving alveoli.
      • Q (perfusion): Amount of blood flowing to alveolar capillaries.
    • V/Q imbalance: Ventilation and perfusion don't match.
      • Shunt: Normal perfusion, lack of ventilation (atelectasis, COPD, asthma, pneumonia, pneumothorax).
      • High V/Q: High ventilation, low perfusion (pulmonary embolism, sickle cell anemia, blood loss).
    • Acid-base balance: Hydrochloric acid combines with sodium bicarbonate to produce salt, water, and bicarbonate.
    • Acute Respiratory Failure (ARF) types:
      • Type 1 (hypoxemic normocapnic): Low oxygen (hypoxemia), normal carbon dioxide (normocapnic).
        • Causes: pneumonia, pulmonary edema, ARDS, high altitude, aspiration (foreign material in lungs), aspiration (vomitus).
        • Symptoms: cyanosis, shortness of breath (SOB), increased respiratory rate.
      • Type 2 (hypoxemic hypercapnic): Low oxygen (hypoxemia), high carbon dioxide (hypercapnia).
        • Causes: COPD, asthma, anything impairing ventilation, such as trauma, multiple blood transfusions, drug overdose.
        • Symptoms: headache, confusion, drowsiness, build up of CO2 affecting the brain, decreased level of consciousness (LOC), altered mental status, decreased respiratory rate.

    Acid-Base Balance

    • Hydrochloric acid combines with sodium bicarbonate to produce salt, water, and bicarbonate.
    • Three elements produced are salt, water, HCO3

    ARF Assessment

    • Hypoxemia: Intrapulmonary shunting (blood passing through lungs doesn't participate in gas exchange), low V/Q ratio.
    • Hypercapnia: High levels of carbon dioxide in the blood.
    • Acidosis: Respiratory acidosis (low pH, high PaCO2)- indicates an acid buildup from poor ventilation.
    • Early symptoms: Dyspnea, non-productive cough, restlessness, change in level of consciousness.
    • Later symptoms: Changes in CXR (chest X-ray), changes in respiratory rate, respiratory alkalosis (decrease in blood carbon dioxide),retractions, accessory muscles use, pallor, cyanosis, and abnormal breath sounds.

    Diagnostics and Medical Management

    • ABG analysis: Arterial blood gas analysis
    • CBC (complete blood count)
    • Chest X-ray
    • Pulse oximetry
    • Diagnostic tests (like sputum culture, V/Q scan, blood tests, etc.)
    • Oxygen therapy
    • Mechanical ventilation: (including positive end-expiratory pressure [PEEP])
    • Non-invasive ventilation (CPAP or BiPAP)
    • Drugs (e.g., antibiotics, bronchodilators, corticosteroids, synthetic surfactant, analgesics, antibiotics, antacids).
    • Nutrition support (enteral or parenteral)
    • Managing complications (e.g., encephalopathy, cardiac dysrhythmias, DVTs, ARDS, aspiration pneumonia, aspiration).
    • Treatment (e.g., intubation, ECMO if indicated, mechanical ventilation, and monitoring for complications).

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    Description

    This quiz covers the fundamentals of Acute Respiratory Failure (ARF), focusing on the V/Q ratio and its importance in hypoxemia. Different types of ARF, such as hypoxemic and hypercapnic conditions, are explored along with their causes and symptoms. Test your understanding of ventilation, perfusion, and acid-base balance related to ARF.

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