Respiratory Acidosis Management Quiz
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Questions and Answers

What is the primary goal in the correction of hypercapnia respiratory acidosis?

  • Treat the underlying causes (correct)
  • Increase oxygen levels in the blood
  • Decrease patient mobility
  • Minimize fluid intake

    • Which respiratory support technique is recommended for patients with respiratory failure who require non-invasive assistance?

  • Mechanical ventilation through intubation
  • Chest tube insertion
  • Continuous Positive Airway Pressure (CPAP)
  • Non-invasive Positive Pressure Ventilation (NIPPV) (correct)

    • Under which condition is intubation indicated for a patient?

  • Persistent hypoxemia despite oxygen therapy (correct)
  • Mild respiratory distress
  • Stable oxygen saturation
  • Severe dehydration

    • What positioning technique is utilized to improve ventilation/perfusion (V/Q) matching in patients with acute respiratory distress syndrome?

    <p>Prone position</p> Signup and view all the answers

    What is the purpose of postural drainage and percussion in physiotherapy management?

    <p>Facilitating mucociliary clearance</p> Signup and view all the answers

    What is the primary function of manual hyperinflation in patients with lung complications?

    <p>Facilitate clearance of pulmonary secretions</p> Signup and view all the answers

    Which position serves to prevent the risk of gastroesophageal reflux and aspiration in patients?

    <p>Semi-recumbent position with a 45-degree head-up tilt</p> Signup and view all the answers

    Which technique involves using gravitational effects to aid in mucous clearance?

    <p>Postural drainage and percussion</p> Signup and view all the answers

    What arterial blood gas (ABG) value indicates hypoxemia?

    <p>PaO2 less than 60 mm Hg</p> Signup and view all the answers

    Which diagnostic tool is used to monitor end-tidal CO2 levels?

    <p>End-tidal CO2 monitor</p> Signup and view all the answers

    How should oxygen therapy be adjusted to prevent oxygen toxicity in hypoxemic patients?

    <p>Adjust to the lowest level sufficient for tissue oxygenation</p> Signup and view all the answers

    What is a potential consequence of uncontrolled oxygen supplementation?

    <p>Oxygen toxicity and CO2 narcosis</p> Signup and view all the answers

    Which therapeutic intervention is recommended for patients to improve ventilation and oxygenation?

    <p>Regular turning and mobilization</p> Signup and view all the answers

    What medical management strategy involves the use of a machine that delivers air at a constant pressure?

    <p>Continuous Positive Airway Pressure (CPAP)</p> Signup and view all the answers

    What should be monitored to guide the management of pulmonary vascular congestion?

    <p>Serum electrolytes</p> Signup and view all the answers

    Which condition is primarily addressed by bronchodilators in respiratory failure management?

    <p>Bronchospasm and inflammation</p> Signup and view all the answers

    Which of the following is NOT a common sign or symptom of Type 1 Respiratory Failure?

    <p>Warm extremities</p> Signup and view all the answers

    Which complication is least likely to occur following respiratory failure?

    <p>Cardiomyopathy</p> Signup and view all the answers

    What is a common gastrointestinal complication associated with acute respiratory failure?

    <p>Pneumoperitoneum</p> Signup and view all the answers

    Which of the following is a feature of Type 2 Respiratory Failure?

    <p>Change of behavior</p> Signup and view all the answers

    Which symptom is commonly associated with respiratory failure in patients experiencing hypoxemia?

    <p>Tachypnea</p> Signup and view all the answers

    Which of the following best describes a common infectious complication of respiratory failure?

    <p>Pneumonia</p> Signup and view all the answers

    What is a characteristic sign of worsening respiratory failure that may present?

    <p>Arrhythmias</p> Signup and view all the answers

    Which management approach is critical in the treatment of respiratory failure?

    <p>Ventilatory support</p> Signup and view all the answers

    Study Notes

    Correction of Hypercapnia Respiratory Acidosis

    • Treat the underlying cause of the respiratory acidosis.
    • Respiratory support for the patient with respiratory failure.

    Non-invasive Respiratory Support

    • Noninvasive Positive Pressure Ventilation (NIPPV) is used to reduce complications.
    • NIPPV avoids the need for Endotracheal intubation (ET intubation).

    Invasive Respiratory Support

    • Intubation is indicated when hypoxemia persists despite maximum oxygen therapy.
    • Intubation is also indicated when hypercapnia is present with impairment of conscious level.
    • Intubation is associated with the following complications:
      • Aspiration of gastric content.
      • Trauma to the teeth.
      • Barotraumas.
      • Trauma to the trachea.

    Positioning

    • Proper positioning is important to improve ventilation/perfusion (V/Q) matching.
    • Positioning also promotes mucociliary clearance, improves aeration, and reduces work of breathing.
    • Prone positioning helps:
      • Improve V/Q matching.
      • Redistribute edema.
      • Increase functional residual capacity (FRC) in patients with acute respiratory distress syndrome (ARDS).
    • Side-lying position with the affected lung uppermost helps:
      • Improve aeration through increased lung volumes in patients with unilateral lung disease.
    • Semi-recumbent position (45 degrees head-up) helps prevent:
      • Gastroesophageal reflux.
      • Aspiration.
    • Upright position helps:
      • Improve lung volumes.
      • Decrease work of breathing in patients being weaned from mechanical ventilation.

    Physiotherapy Management

    • Postural drainage and percussion utilize gravity to facilitate mucociliary clearance.
    • Suction is used to clear secretions when the patient cannot do so independently.
    • Manual hyperinflation is used to:
      • Re-inflate atelectatic areas of the lungs.
      • Facilitate clearance of pulmonary secretions.
    • Active cycle of breathing technique and manual techniques such as shaking and vibration are used to facilitate mucus clearance.
    • Limb exercises, including passive, active-assisted, and active exercises, help:
      • Optimize oxygen transport.
      • Reduce the effects of immobility.

    Diagnostic Evaluations

    • Arterial Blood Gas (ABG) analysis shows changes in:
      • PaO2.
      • PaCO2.
      • pH.
      • HCO3 from the patient's normal levels.
    • PaO2 less than 60 mmHg, PaCO2 greater than 50 mmHg, or pH less than 7.35 indicate respiratory failure.
    • Pulse oximetry shows decreasing SpO2 (less than 90%).
    • End-tidal CO2 monitoring shows an elevated value (greater than 40 mmHg or greater than 5 mmHg above PaCO2).
    • Complete blood count, serum electrolytes, chest x-ray, urinalysis, electrocardiogram (ECG), and blood and sputum culture are used to:
      • Determine the underlying cause of respiratory failure.
      • Assess the patient's condition.

    Medical Management of Respiratory Failure

    • Hypoxemia is the major acute concern impacting organ function.
    • Once ventilation and hemodynamics are stabilized, identification and correction of the underlying causes is essential to direct treatment.
    • Oxygen therapy is used to correct hypoxemia.
    • Regular turning and mobilization, when clinically stable, improve ventilation and oxygenation. Early ambulation is encouraged when appropriate.
    • Diuretics are used to treat pulmonary vascular congestion or pulmonary edema.
    • Bronchodilators and possibly corticosteroids are used to reduce bronchospasm and inflammation.
    • Ventilatory support, using mechanical ventilation or noninvasive positive pressure ventilation (NIPPV) using a facemask, is employed to assist breathing.

    Continuous Positive Airway Pressure (CPAP)

    • A machine specifically designed to deliver a constant flow of air at a constant pressure.
    • CPAP machines pressurize room temperature air and deliver it through a hose connected to a mask or nasopharyngeal tube worn by the patient.

    Nursing Management of Respiratory Failure

    • Correction of Hypoxemia:
      • Controlled oxygen therapy/supplementation.
      • Uncontrolled oxygen supplementation can lead to oxygen toxicity and CO2 narcosis.
      • Inspired oxygen should be adjusted to the lowest level sufficient for tissue oxygenation.
    • Abnormalities of the alveoli that result in type 1 (hypoxemic) respiratory failure, like in cases of pulmonary edema and severe pneumonia.

    Common Symptoms of Respiratory Failure

    • Dyspnea
    • Tachycardia
    • Tachypnea
    • Restlessness
    • Confusion
    • Anxiety
    • Cyanosis (central)
    • Pulmonary hypertension
    • Loss of consciousness

    Symptoms of Type 1 Respiratory Failure

    • Dyspnea
    • Irritability
    • Confusion
    • Seizures
    • Somnolence
    • Tachycardia
    • Arrhythmia
    • Tachypnea
    • Cyanosis

    Symptoms of Type 2 Respiratory Failure

    • Change in behavior
    • Headache
    • Coma
    • Warm extremities
    • Asterixis (sudden relaxation of muscles or loss of muscle tension)
    • Papilledema (swelling of the optic disc due to elevated intracranial pressure)

    Complications of Respiratory Failure

    • Pulmonary Complications:
      • Pulmonary embolism
      • Pulmonary fibrosis
      • Complications secondary to the use of mechanical ventilation
    • Cardiovascular Complications:
      • Hypotension
      • Reduced cardiac output
      • Cor pulmonale
      • Arrhythmias
      • Pericarditis
      • Acute myocardial infarction
    • Gastrointestinal Complications:
      • Hemorrhage
      • Gastric distention
      • Ileus
      • Diarrhea
      • Pneumoperitoneum
      • Duodenal ulceration (caused by stress is common in patients with acute respiratory failure)
    • Infectious Complications:
      • Nosocomial (hospital-acquired) pneumonia
      • Urinary tract infection
      • Catheter-related sepsis (usually occurs with the use of mechanical devices)
    • Renal Complications:
      • Acute renal failure
      • Abnormalities of electrolytes and acid-base balance
    • Nutritional Complications:
      • Malnutrition
      • Complications relating to parenteral or enteral nutrition
      • Complications associated with nasogastric (NG) tube (abdominal distention and diarrhea)

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    Respiratory Failure PDF

    Description

    Test your knowledge on the management of respiratory acidosis, covering both non-invasive and invasive respiratory support methods. This quiz explores the importance of treating underlying causes, appropriate ventilation techniques, and considerations for positioning patients effectively.

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