Acute Respiratory Failure Quiz

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Questions and Answers

What characterizes Type I respiratory failure?

Inadequate ventilation due to muscular dysfunction

Inability to remove CO2 from the blood effectively

Disruption of O2 transport from the alveolus to arterial flow (correct)

Stimulation of respiration is impaired

Which condition is associated with Type II respiratory failure?

Pneumonia

Chronic obstructive pulmonary disease (COPD) (correct)

Acute respiratory distress syndrome (ARDS)

Aspiration pneumonia

What defines the process of ventilation in the respiratory system?

Transport of gases between the alveoli and capillaries

Mechanical act of moving air into and out of the respiratory tree (correct)

Chemical exchange of carbon dioxide and oxygen

Diffusion of oxygen into the bloodstream

What is a major consequence of impaired respiration in Type I respiratory failure?

Severe hypoxia from inadequate oxygen transport (A) Signup and view all the answers

Which of the following is an advantage of nasal oxygen delivery?

Minimally invasive and promotes patient comfort (B) Signup and view all the answers

What is a significant disadvantage of low-flow oxygen devices?

They mix room air with the inspired gas at variable rates. (D) Signup and view all the answers

Which outcome is NOT typically a desired result of mechanical ventilation?

Decrease in heart rate (C) Signup and view all the answers

What complication is most strongly associated with mechanical ventilation?

Ventilator-associated pneumonia (VAP) (B) Signup and view all the answers

What does high-flow oxygen therapy aim to achieve?

Provide oxygen at a higher flow rate than the patient’s inspiratory flow rate. (A) Signup and view all the answers

Which device is used for non-invasive mechanical ventilation?

Nasal cannula (A) Signup and view all the answers

What is a primary role of nutritional support in mechanically ventilated patients?

To reduce the risk of nutritional shortages. (D) Signup and view all the answers

During intubation, what critical parameter must be monitored by the nurse?

Oxygenation status and arterial oxygen saturation (SaO2) (D) Signup and view all the answers

What type of ventilation does not guarantee improved gas exchange?

Invasive mechanical ventilation (A) Signup and view all the answers

What defines hypoxemia?

Inadequate levels of oxygen in the blood. (C) Signup and view all the answers

Which condition can result from high pressure during mechanical ventilation?

Volutrauma (C) Signup and view all the answers

Study Notes

Acute Respiratory Failure (ARF)

ARF is a critical care disorder where the lungs fail to adequately exchange oxygen and remove carbon dioxide.
ALI (acute lung injury) and ARDS (acute respiratory distress syndrome) are severe forms of ARF, characterized by diffuse alveolar damage and profound hypoxia.
Nurses must differentiate between ventilation (mechanical air movement) and respiration (gas exchange).

Types of Respiratory Failure

Type I (hypoxemic): Impaired O2 transport from alveoli to blood. Causes include pneumonia, cardiogenic edema, ARDS, aspiration, and atelectasis. Associated with Impaired Gas Exchange.
Type II (hypoxemic hypercapneic): Insufficient ventilation, often due to lung disease (COPD), neurological issues (narcotic overdose, head injury), muscular weakness, or skeletal abnormalities. CO2 builds up (hypercapnea) alongside low oxygen (hypoxemia).

Oxygen Therapy Devices

Nasal cannula: Simple, low-flow device. Delivers O2 up to 6 LPM, but FiO2 (fractional inspired oxygen) is unpredictable.
Simple face mask: Delivers higher FiO2 (8-12 LPM), but FiO2 is still affected by patient breathing.
High-flow devices: Deliver oxygen at a rate exceeding the patient's inspiratory flow. Room air is mixed in less. Can create an oxygen reservoir. Includes wide nasal cannulas, nasal pillows, and face masks.

Mechanical Ventilation

Mechanical ventilation assists individuals unable to breathe independently.
Noninvasive (NIV) and invasive methods exist.
NIV shows gas exchange improvement within 15 minutes.
Invasive mechanical ventilation uses positive pressure via tubes (nasotracheal, endotracheal, tracheostomy).

Intubation Procedure

Nasotracheal/Endotracheal tubes establish a patent airway.
Monitoring O2 saturation (SaO2) during intubation is key. SaO2 below 90% halts the procedure, requiring manual ventilation.
Post-intubation, auscultation ensures proper tube placement (air should be heard bilaterally).

Tracheostomy

A tracheostomy is for patients requiring long-term ventilation (>21 days) or airway protection.

Complications of Mechanical Ventilation

Ventilator-Associated Pneumonia (VAP): A significant complication, preventable by nursing interventions.
Ventilator-Induced Lung Injury (VILI): Caused by excessive pressure (barotrauma) or excessive volume (volutrauma).

Nutrition in Critical Care

Early enteral nutrition is preferred over parenteral nutrition.
Special nutritional formulas may be necessary to address compromised organ systems (protein supplements and probiotics).

Oxygen Therapy: General Information

Oxygen is essential for cell metabolism and tissue oxygenation.
Oxygen is used to maintain cellular oxygenation and treat acute/chronic respiratory conditions.
Oxygen delivery methods vary based on the patient's needs.

Hypoxemia is inadequate blood oxygen levels. Causes include hypovolemia, hypoventilation, and issues with arterial flow.
Cyanosis (bluish skin/mucous membranes) is caused by low blood oxygen.
Breathlessness can be caused by various diseases (asthma, pulmonary embolism, cardiac insufficiency), high altitudes, anemia, lung diseases (pulmonary edema, pneumonia), and other conditions.

Signs and Symptoms of Respiratory Distress & Hypoxemia

Early signs: Tachypnea, restlessness, pallor, anxiety.
Late signs: Confusion, cyanosis, bradycardia, hypotension, cardiac dysrhythmias.

Nursing Interventions for Oxygen Therapy

Assess and monitor for hypoxemia signs and symptoms.
Apply oxygen delivery devices per order.
Monitor O2 saturation (SaO2).
Position patient for optimal breathing.
Maintain good oral hygiene.
Document the patient's response.
Monitor skin integrity and provide appropriate care.
Educate patient and family.

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Description

Test your knowledge on Acute Respiratory Failure (ARF) including its types, causes, and the devices used for oxygen therapy. Understand the differences between hypoxemic and hypercapnic respiratory failure, and the role of healthcare professionals in managing these conditions.