Final Exam: Respiratory Failure
What is chronic respiratory failure? - Answer COPD, Bronchitis, Emphysema (causes)
A slow progressive decline in respiratory function characterized by problems with
oxygenation and ventilation
What is COPD? - Answer chronic obstructive pulmonary disease
-An irreversible, progressive tissue degeneration and airway obstruction characterized
by increased CO2 (CO2 retention) and decreased O2 levels in the blood
-over time, the CO2 drive is knocked out d/t retention, so the O2 takes over.
What blood gas normally controls the rate and depth of respiration? - Answer carbon
dioxide
What is chronic hypercapnia? - Answer A build up of carbon dioxide in the blood which
shifts the respiratory drive from the need to blow off excess CO2 to the need to increase
oxygen levels.
How does the carbonic acid equation shift with chronic CO2 retention? - Answer Shifts
from carbonic acid converting into CO2 and H2O to the left instead which involves
converting into bicarb and H+
What is bicarbonate mostly combined with? - Answer H+
True or false: Bicarbonate is 20x more powerful than carbonic acid at changing the pH
of the blood - Answer False, for every 1 carbonic acid, there must be 20 bicarbonate
ions to balance the pH
For every carbonic acid produced in the blood, _____ HCO3 ions must be formed to
maintain a 20:1 ratio and normal pH - Answer 20
pH is inversely r/t the _______ ion concentration - Answer H+
So the more H+, the lower the pH
What system compensates for chronic hypercapnia? - Answer Kidneys by retaining
HCO3
If the pH is normal, is it an acute or chronic problem? - Answer Chronic
How can we know if a patient in the hospital was retaining CO2 prior to coming into the
hospital? - Answer Look at admission labs. The BMP will indicate the CO2 and HCO3
levels
Also, clubbing!
, What is acute respiratory failure? - Answer An acute issue that causes a problem with
ventilation or oxygenation
What are the signs of an acute inability to ventilate? - Answer Hypercarbic Respiratory
Failure
-Unable to clear CO2
-CO2 retention (hypercarbia/hypercapnia)
Respiratory Acidosis
-kidneys won't kick in
What are the signs of an acute inability to oxygenate? - Answer Hypoxic Respiratory
Failure
-Unable to get oxygen across the alveoli into the capillaries = hypoxia
What is it called when a patient has an inability to oxygenate/ventilate? - Answer
Hypoxic Hypercarbic Respiratory Failure
What does capnos mean? - Answer smoke
What doe capnia mean? - Answer CO2
Causes of Acute Hypercarbic Respiratory Failure - Answer Anything that decreases a
person's ability to ventilate
-overdose
-spinal cord injury
-profound weakness
-status epilepticus or asthmaticus
-head injury
CM of Hypercapnia - Answer Mild
-H/A
-tachycardia
-dysrhythmias
-lethargy
-confusion
-shallow, slow RR
Severe
-paranoia, depression, confusion
-coma
-dilation of skin vessels
-fainting
-hyperventilation (pursed lip breathing)
-panic attack
What is chronic respiratory failure? - Answer COPD, Bronchitis, Emphysema (causes)
A slow progressive decline in respiratory function characterized by problems with
oxygenation and ventilation
What is COPD? - Answer chronic obstructive pulmonary disease
-An irreversible, progressive tissue degeneration and airway obstruction characterized
by increased CO2 (CO2 retention) and decreased O2 levels in the blood
-over time, the CO2 drive is knocked out d/t retention, so the O2 takes over.
What blood gas normally controls the rate and depth of respiration? - Answer carbon
dioxide
What is chronic hypercapnia? - Answer A build up of carbon dioxide in the blood which
shifts the respiratory drive from the need to blow off excess CO2 to the need to increase
oxygen levels.
How does the carbonic acid equation shift with chronic CO2 retention? - Answer Shifts
from carbonic acid converting into CO2 and H2O to the left instead which involves
converting into bicarb and H+
What is bicarbonate mostly combined with? - Answer H+
True or false: Bicarbonate is 20x more powerful than carbonic acid at changing the pH
of the blood - Answer False, for every 1 carbonic acid, there must be 20 bicarbonate
ions to balance the pH
For every carbonic acid produced in the blood, _____ HCO3 ions must be formed to
maintain a 20:1 ratio and normal pH - Answer 20
pH is inversely r/t the _______ ion concentration - Answer H+
So the more H+, the lower the pH
What system compensates for chronic hypercapnia? - Answer Kidneys by retaining
HCO3
If the pH is normal, is it an acute or chronic problem? - Answer Chronic
How can we know if a patient in the hospital was retaining CO2 prior to coming into the
hospital? - Answer Look at admission labs. The BMP will indicate the CO2 and HCO3
levels
Also, clubbing!
, What is acute respiratory failure? - Answer An acute issue that causes a problem with
ventilation or oxygenation
What are the signs of an acute inability to ventilate? - Answer Hypercarbic Respiratory
Failure
-Unable to clear CO2
-CO2 retention (hypercarbia/hypercapnia)
Respiratory Acidosis
-kidneys won't kick in
What are the signs of an acute inability to oxygenate? - Answer Hypoxic Respiratory
Failure
-Unable to get oxygen across the alveoli into the capillaries = hypoxia
What is it called when a patient has an inability to oxygenate/ventilate? - Answer
Hypoxic Hypercarbic Respiratory Failure
What does capnos mean? - Answer smoke
What doe capnia mean? - Answer CO2
Causes of Acute Hypercarbic Respiratory Failure - Answer Anything that decreases a
person's ability to ventilate
-overdose
-spinal cord injury
-profound weakness
-status epilepticus or asthmaticus
-head injury
CM of Hypercapnia - Answer Mild
-H/A
-tachycardia
-dysrhythmias
-lethargy
-confusion
-shallow, slow RR
Severe
-paranoia, depression, confusion
-coma
-dilation of skin vessels
-fainting
-hyperventilation (pursed lip breathing)
-panic attack
