NURSING 4551 Critical Care Nursing: N4551 Completed Module 1 Review

N4551 Critical Care Nursing: Module #1 Review 1. The nurse is evaluating the respiratory status of pt diagnosed with respiratory distress. Please match which assessment data would help the nurse evaluate each diagnosis (one diagnosis per assessment finding). Ability to verbalize __1___ 1. Altered Airway Clearance Skin color __3___ 2. Impaired Breathing Pattern Respiratory depth __2___ 3. Impaired Gas Exchange Level of consciousness __3___ Respiratory rate __2___ Breath sounds __2___ Secretions __1___ Accessory muscle use __2___ Tongue obstruction __1___ 2. Define the two types of respiratory failure and the potential causes for each? Respiratory Type I Definition: PaO2 60 mmHg; Supplemental O2 60%; cannot be on nasal cannula because those only go up to 44%; low O2 below 60 , but CO2 is normal (normal level 35-45) Hypoxemic Causes: VQ mismatch & shunting Normocapnic • VQ mismatching (ventilation-perfusion mismatch; supposed to be 1:1 ratio; normal circulation of blood out of heart is 4-5 L; so if there is not enough blood, or not enough O2 in blood, results in mismatch) • Caused by: increase secretions, alveolar collapse, bronchio-constriction, pulmonary embolism, atelectesis (water in alveoli) • Shunting: blood going from one side to the other without being oxygenated • Anatomic shunt caused by:  Ventricular septal defect (blood goes through without any O2 due to the hole between the ventricles) TX: surgical  Patent Ductus Arteriosus (lack of connection between the pulmonary artery n the pulmonary vein with no O2) * becomes a ligament TX: surgical  Tetrology of Fallot: (1) ventricular septal defect, aorta shifted causing an obstruction of blood from R ventricle to the lungs causing (2)pulmonary stenosis,(3)R ventricle develops hypertrophy which narrows the pulmonary vein; O2 poor blood goes to body  Transposition of the Great Vessels: completely unoxygenated blood is going to the body, pulmonary artery comes off the L ventricle, cannot survive without being fixed • Intrapulmonary shunt caused by: *the body closes gate to keep from circulating blood to certain part of lung that you’re not going to oxygenate.