Exam 1: NUR254/ NUR 254 (Latest 2024/ 2023 Update)
Childbearing and Child Caring Families Review| 100%
Correct| Grade A- Galen
Type 1 Acute Respiratory Failure - ANSWER Hypoxemic
Type 2 Acute Respiratory Failure - ANSWER Hypercapnic
Hypoxemic respiratory failure (T1) is characterized by... - ANSWER PaO2 <60
mmHg despite increased inspired O2 with a normal or low PaCO2.
Hypercapnic respiratory failure (T2) is characterized by... - ANSWER respiratory
acidosis, PaCO2 > 50 mmHg, and pH <7.35... hypoxemia may or may not be
present
Risk Factors for acute resp. failure - ANSWER - Impaired Ventilation
(Hypoventilation)
- Ventilation Perfusion Mismatch
- Impaired Diffusion (Alveolar)
RF for acute resp. failure: Impaired ventilation (hypoventilation) causes - ANSWER -
Airway obstruction
-Resp muscle weakness/paralysis, sometimes caused by myasthenia gravis
- Chest-wall injury
-Anesthesia
- opioid administration
RF for acute resp. failure: Ventilation-Perfusion Mismatch causes - ANSWER -
COPD
- Restrictive lung disease (sarcoidosis, pulmonary fibrosis)
- Atelectasis
Pulmonary embolus
- Pneumothorax
RF for acute resp. failure: Impaired Diffusion (Alveolar) causes - ANSWER -
Pulmonary edema
- ARDS
Diagnostics done for Acute Resp. Failure - ANSWER - ABGs (hypoxemic - initially
alkolotic... hypercapnic - acidotic w/or w/out hypoxemia)
- H/H
-C X-ray
- Sputum Cx
Treatment for Acute Resp. Failure - ANSWER Not a disease... must treat CAUSE
, What is ARDS? - ANSWER A severe form of acute resp. failure
- non-cardiac pulmonary edema with refractory hypoxemia (despite hi flow O2)
ARDS is defined by the following characteristics: - ANSWER - Acute onset of <7
days
- Refractory hypoxemia
- Bilateral infiltrates R/O cardiac pulmonary edema as cause
Causes of ARDS (Direct & Indirect) ... most common? - ANSWER Common: Sepsis
Direct:
- Pneumonia
-Severe trauma
- aspiration
- Inhalation injury
- Pulmonary contusion
- PE
Indirect:
-Sepsis, shock
-Pancreatitis
- Burns
- massive transfusions (TRALI -> transfusion related acute lung injury)
- cardiopulmonary bypass
- drug/alc. overdose
Foundation of ARDS Pathophysiology - ANSWER Unregulated systemic
inflammatory response to either the acute injury or inflammation. Chemical
inflammatory mediators released.
What are the 3 stages to ARDS> - ANSWER - Exudative
-Proliferative
-Fibrotic
Exudative Phase
- When does this phase occur?
- This phase is the result of...
- Alveolar cells produce ___________, which maintains surface tension of alveoli to
prevent collapse... but with damage to alveoli there is decreased production causing
_______ - ANSWER - occurs 24-48 hours after injury
- Disruption in the alveolar-capillary membrane due to the release of inflammatory
mediators... causing fluid shift from capillaries into the interstitial space and alveoli
(SEVERE V/Q mismatch)
- SURFACTANT, ATELECTASIS
Clinical Manifestations of Exudative Phase: - ANSWER - hyperventilation
- Tachy <3
---> compensatory responses to hypoxemia
- ATELECTASIS
Childbearing and Child Caring Families Review| 100%
Correct| Grade A- Galen
Type 1 Acute Respiratory Failure - ANSWER Hypoxemic
Type 2 Acute Respiratory Failure - ANSWER Hypercapnic
Hypoxemic respiratory failure (T1) is characterized by... - ANSWER PaO2 <60
mmHg despite increased inspired O2 with a normal or low PaCO2.
Hypercapnic respiratory failure (T2) is characterized by... - ANSWER respiratory
acidosis, PaCO2 > 50 mmHg, and pH <7.35... hypoxemia may or may not be
present
Risk Factors for acute resp. failure - ANSWER - Impaired Ventilation
(Hypoventilation)
- Ventilation Perfusion Mismatch
- Impaired Diffusion (Alveolar)
RF for acute resp. failure: Impaired ventilation (hypoventilation) causes - ANSWER -
Airway obstruction
-Resp muscle weakness/paralysis, sometimes caused by myasthenia gravis
- Chest-wall injury
-Anesthesia
- opioid administration
RF for acute resp. failure: Ventilation-Perfusion Mismatch causes - ANSWER -
COPD
- Restrictive lung disease (sarcoidosis, pulmonary fibrosis)
- Atelectasis
Pulmonary embolus
- Pneumothorax
RF for acute resp. failure: Impaired Diffusion (Alveolar) causes - ANSWER -
Pulmonary edema
- ARDS
Diagnostics done for Acute Resp. Failure - ANSWER - ABGs (hypoxemic - initially
alkolotic... hypercapnic - acidotic w/or w/out hypoxemia)
- H/H
-C X-ray
- Sputum Cx
Treatment for Acute Resp. Failure - ANSWER Not a disease... must treat CAUSE
, What is ARDS? - ANSWER A severe form of acute resp. failure
- non-cardiac pulmonary edema with refractory hypoxemia (despite hi flow O2)
ARDS is defined by the following characteristics: - ANSWER - Acute onset of <7
days
- Refractory hypoxemia
- Bilateral infiltrates R/O cardiac pulmonary edema as cause
Causes of ARDS (Direct & Indirect) ... most common? - ANSWER Common: Sepsis
Direct:
- Pneumonia
-Severe trauma
- aspiration
- Inhalation injury
- Pulmonary contusion
- PE
Indirect:
-Sepsis, shock
-Pancreatitis
- Burns
- massive transfusions (TRALI -> transfusion related acute lung injury)
- cardiopulmonary bypass
- drug/alc. overdose
Foundation of ARDS Pathophysiology - ANSWER Unregulated systemic
inflammatory response to either the acute injury or inflammation. Chemical
inflammatory mediators released.
What are the 3 stages to ARDS> - ANSWER - Exudative
-Proliferative
-Fibrotic
Exudative Phase
- When does this phase occur?
- This phase is the result of...
- Alveolar cells produce ___________, which maintains surface tension of alveoli to
prevent collapse... but with damage to alveoli there is decreased production causing
_______ - ANSWER - occurs 24-48 hours after injury
- Disruption in the alveolar-capillary membrane due to the release of inflammatory
mediators... causing fluid shift from capillaries into the interstitial space and alveoli
(SEVERE V/Q mismatch)
- SURFACTANT, ATELECTASIS
Clinical Manifestations of Exudative Phase: - ANSWER - hyperventilation
- Tachy <3
---> compensatory responses to hypoxemia
- ATELECTASIS
