NSG 5140
NSG 5140- Respiratory disorders assessment
Study Guide 2026
Acute Respiratory Failure
-gas exchange is inadequate (insufficient amount of O2 for transfer and/or insufficient
removal of CO2).
- condition not disease
- can be due to pneumonia or COPD
- hypoxemic or hypercapnic
Hypoxemia
- low levels of oxygen within the blood (O2 under 90%)
- PaCO2 over 60 mmHg
- often due to pneumonia. pulmonary emboli, smoke inhalation, or heart failure
hypercapnia
- an excessive amount of CO2 in the blood
- measured by pulse oximeter and arterial blood gasses
- PaCO2 under 45 mmHg
- lead to an acid-base imbalance
- causes: trauma (rib fracture), CNS depressant meds, neuromuscular diseases
Causes of Hypoxemia
1. Ventilation: not enough air entering the lungs. Insufficient blood supply. (Asthma,
COPD)
2. Shunting: Blood did not go to the lungs for gas exchange. This can be due to atrial or
ventricular septal defects.
3. Diffusion limitation: decrease om gas exchange due to capillary membrane being
thickened or destroyed.
4. Alveolar hypoventilation: decrease in ventilation causing an increase in CO2 levels due
to restrictive lung disease, chest wall dysfunction, or neuromuscular disease.
Respiratory failure: airways and alveoli
- fluid enters the lungs and interferes with gas exchange.
- bronchospasms reduce airflow
- alveoli destroyed
- viscous secretions blocking gas exhange
NSG 5140
, NSG 5140
Respiratory failure: CNS
- opioids or CNS depressant meds
- brainstem injury
Respiratory failure: chest wall
- soft tissue injury
- kyphoscoliosis
- obesity
Respiratory failure: neuromuscular conditions
- spinal cord injuries
- phrenic nerve injury
- muscle weakness/paralysis
- muscular dystrophy
Early sign of respiratory failure
- change in pt. mental status
S/S respiratory failure
-Early: SOB, change in mental status, tachycardia, hypertension, cool clammy skin,
tachypnea, SpO2 under 90%
- Late: decreased LOC, acidosis, hypotension, bradycardia, weak pulses, hypoxia
Hypoxia
- PaO2 has significantly decreased causing inadequate oxygenation
- can cause anaerobic metabolism -> can give bicarbonate
Hypoxia- RAT BED
R- restlessness
A- anxiety
T- tachycardia/tachypnea
B- bradycardia
E- extreme restlessness
D- dyspnea
diagnosis
- history/physical
- chest x-ray
- arterial blood gas: PaO2 under 80 and CO2 over 45
- pH levels
NSG 5140
NSG 5140- Respiratory disorders assessment
Study Guide 2026
Acute Respiratory Failure
-gas exchange is inadequate (insufficient amount of O2 for transfer and/or insufficient
removal of CO2).
- condition not disease
- can be due to pneumonia or COPD
- hypoxemic or hypercapnic
Hypoxemia
- low levels of oxygen within the blood (O2 under 90%)
- PaCO2 over 60 mmHg
- often due to pneumonia. pulmonary emboli, smoke inhalation, or heart failure
hypercapnia
- an excessive amount of CO2 in the blood
- measured by pulse oximeter and arterial blood gasses
- PaCO2 under 45 mmHg
- lead to an acid-base imbalance
- causes: trauma (rib fracture), CNS depressant meds, neuromuscular diseases
Causes of Hypoxemia
1. Ventilation: not enough air entering the lungs. Insufficient blood supply. (Asthma,
COPD)
2. Shunting: Blood did not go to the lungs for gas exchange. This can be due to atrial or
ventricular septal defects.
3. Diffusion limitation: decrease om gas exchange due to capillary membrane being
thickened or destroyed.
4. Alveolar hypoventilation: decrease in ventilation causing an increase in CO2 levels due
to restrictive lung disease, chest wall dysfunction, or neuromuscular disease.
Respiratory failure: airways and alveoli
- fluid enters the lungs and interferes with gas exchange.
- bronchospasms reduce airflow
- alveoli destroyed
- viscous secretions blocking gas exhange
NSG 5140
, NSG 5140
Respiratory failure: CNS
- opioids or CNS depressant meds
- brainstem injury
Respiratory failure: chest wall
- soft tissue injury
- kyphoscoliosis
- obesity
Respiratory failure: neuromuscular conditions
- spinal cord injuries
- phrenic nerve injury
- muscle weakness/paralysis
- muscular dystrophy
Early sign of respiratory failure
- change in pt. mental status
S/S respiratory failure
-Early: SOB, change in mental status, tachycardia, hypertension, cool clammy skin,
tachypnea, SpO2 under 90%
- Late: decreased LOC, acidosis, hypotension, bradycardia, weak pulses, hypoxia
Hypoxia
- PaO2 has significantly decreased causing inadequate oxygenation
- can cause anaerobic metabolism -> can give bicarbonate
Hypoxia- RAT BED
R- restlessness
A- anxiety
T- tachycardia/tachypnea
B- bradycardia
E- extreme restlessness
D- dyspnea
diagnosis
- history/physical
- chest x-ray
- arterial blood gas: PaO2 under 80 and CO2 over 45
- pH levels
NSG 5140
