lOMoAR cPSD| 22896205
Exam 1 405B
ACUTE RESPIRATORY FAILURE
EXAM 1 MED SURG
PENNSYLVANIA STATE UNIVERSITY
Acute Respiratory Failure & Acute Respiratory Distress
Syndrome (ARDS)
Respiratory Failure
• A general statement regarding the sudden and life-threatening deterioration in pulmonary gas
exchange, resulting in inadequate oxygenation and carbon dioxide retention.
• May be Acute or Chronic
Chronic Respiratory Failure
• Develops over time
• Deterioration of gas exchange in the lungs
• COPD and neuromuscular disease (GB, MS)
• Can have acute exacerbation episodes
Acute Respiratory Failure
• Defined as PaCO2 >50 or PaO2 <60, pH <7.35 o What acid/base imbalance would this be?
• Ventilation or perfusion is impaired
• Functional problem not disease process
• Hypercapnia
• Hypoxemia
Causes
• Ventilatory o
Impaired CNS
function (drug OD,
head trauma,
infection,
hemorrhage, sleep
apnea)
o Impaired neuromuscular function (MG, GB, ALS, spinal cord trauma) o Impaired
musculoskeletal function (chest trauma, kyphosis, malnutrition)
o Impaired pulmonary function o Airway Obstruction
• Oxygenation o
Pneumonia
o Acute Respiratory Distress Syndrome (ARDS) o Heart Failure
o COPD
o PE
pg. 1
, lOMoAR cPSD| 22896205
Exam 1 405B
o Restrictive lung disease
Manifestations
1. Hypoxemia
a. Change in mental status/LOC: Restlessness, anxiety, confusion
b. Tachypnea
c. Orthopnea
d. Cyanosis
e. Cardiac Dysrhythmias (atrial)
2. Hypercapnia
a. Dyspnea
b. Headache
c. Decreased LOC3. Tachycardia
Diagnostic Tests: Chest xray
• Ct scan
• Arterial blood gases
• H&H
• WBC
Nursing management & Treatment
Nursing Care
• Position pt for optimal breathing
• Chest PT, postural drainage
• Assess resp status q2h
• Monitor VS, I&O, daily weight
• Nutritional Support
• Skin care
• Provide patient education
Complications:
• Severe respiratory acidosis
• Metabolic acidosis
• Infection
• Failure to wean from the ventilator
Acute Respiratory Distress Syndrome (ARDS)
• Acute hypoxemic respiratory failure following a systemic or pulmonary insult without evidence
of heart failure
• Hypoxemia does not respond to oxygen administration
• Also known as noncardiogenic pulmonary edema & shock lung
• Not a disease but a syndrome
ARDS-Patho:
pg. 2
Exam 1 405B
ACUTE RESPIRATORY FAILURE
EXAM 1 MED SURG
PENNSYLVANIA STATE UNIVERSITY
Acute Respiratory Failure & Acute Respiratory Distress
Syndrome (ARDS)
Respiratory Failure
• A general statement regarding the sudden and life-threatening deterioration in pulmonary gas
exchange, resulting in inadequate oxygenation and carbon dioxide retention.
• May be Acute or Chronic
Chronic Respiratory Failure
• Develops over time
• Deterioration of gas exchange in the lungs
• COPD and neuromuscular disease (GB, MS)
• Can have acute exacerbation episodes
Acute Respiratory Failure
• Defined as PaCO2 >50 or PaO2 <60, pH <7.35 o What acid/base imbalance would this be?
• Ventilation or perfusion is impaired
• Functional problem not disease process
• Hypercapnia
• Hypoxemia
Causes
• Ventilatory o
Impaired CNS
function (drug OD,
head trauma,
infection,
hemorrhage, sleep
apnea)
o Impaired neuromuscular function (MG, GB, ALS, spinal cord trauma) o Impaired
musculoskeletal function (chest trauma, kyphosis, malnutrition)
o Impaired pulmonary function o Airway Obstruction
• Oxygenation o
Pneumonia
o Acute Respiratory Distress Syndrome (ARDS) o Heart Failure
o COPD
o PE
pg. 1
, lOMoAR cPSD| 22896205
Exam 1 405B
o Restrictive lung disease
Manifestations
1. Hypoxemia
a. Change in mental status/LOC: Restlessness, anxiety, confusion
b. Tachypnea
c. Orthopnea
d. Cyanosis
e. Cardiac Dysrhythmias (atrial)
2. Hypercapnia
a. Dyspnea
b. Headache
c. Decreased LOC3. Tachycardia
Diagnostic Tests: Chest xray
• Ct scan
• Arterial blood gases
• H&H
• WBC
Nursing management & Treatment
Nursing Care
• Position pt for optimal breathing
• Chest PT, postural drainage
• Assess resp status q2h
• Monitor VS, I&O, daily weight
• Nutritional Support
• Skin care
• Provide patient education
Complications:
• Severe respiratory acidosis
• Metabolic acidosis
• Infection
• Failure to wean from the ventilator
Acute Respiratory Distress Syndrome (ARDS)
• Acute hypoxemic respiratory failure following a systemic or pulmonary insult without evidence
of heart failure
• Hypoxemia does not respond to oxygen administration
• Also known as noncardiogenic pulmonary edema & shock lung
• Not a disease but a syndrome
ARDS-Patho:
pg. 2
