47. Respiratory Failure & ARDS
1
Respiratory Failure & ARDS Pathophysiology Course When the capillaries (little blood vessels in the alveoli) cannot adequately exchange CO2 for Oxygen. • Infection causes these alveoli to become swollen, inflamed, & filled with mucus or fluid which blocks gas exchange! • Clients can present with a common FLU which can progress into pneumonia & eventually into DEADLY A.R.D.S. - Acute Respiratory Distress Syndrome 0₂ 0₂ 0₂ 0₂ 0₂ 0₂ 0₂ Respiratory Failure Causes A.R.F. - ACUTE RESPIRATORY FAILURE HypOXemic failure LOW O2 (PaO2 60 or LESS) HyperCapnic failure HIGH CO2 (PaCO2 Over 50 ) 2 types: • Sepsis - bloodborne infection that inflames the entire body • Respiratory inflammation - pneumonia, inhaled toxin, or even aspiration. • Acute pancreatitis = HIGH risk for developing ARDS accidental release of active pancreatic enzymes & cytokines into the bloodstream - which get sucked into the lungs causing inflammation. 0₂ PaO2 <60 Causes 0₂ PEEP (posive end-expiratory pressure) Mechanical Venlaon H O L Y High Fowler's posion (HOB up) Oral suconing & Oxygen Listen to lung sounds Yell for help! Nofy HCP “provider” Nursing Interventions for ARDS Common Exam Queson Which arterial blood gas (ABG) values support suspected acute respiratory failure (ARF)? 1. PaO2 55 mm Hg, PaCO2 47 mm Hg 2. PaO2 62 mm Hg, PaCO2 32 mm Hg 3. PaO2 47 mm Hg, PaCO2 63 mm Hg 4. PaO2 82 mm Hg, PaCO2 22 mm Hg ? ? ? ? ? ? pH PaCO₂ PaO₂ 80 100 47 35 45 63 7.35 7.45 A B B A #1 Sign = Altered Mental status Refractory Hypoxemia Low PaO2 = Despite Oxygen delivery Agitaon Restlessness Confusion 1. 2. 3. Hypoxemia LOW O2 ARDS NCLEX TIP Lab Values ABG Arterial Blood Gas Low PaO2 High CO2 CO2 C O O PaO2 0₂ REsistant to Oxygen REfractory Hypoxemia MEMORY TRICK 0₂ 0₂ 0 ₂ 0₂ 0₂ Signs & Symptoms • Impaired gas exchange The alveoli become hard due to the capillaries around the Alveoli becoming inflamed & fluid-filled, creating a leaky barrier, which eventually fills up the little alveoli sac like a sinking ship! THIS makes it impossible to get oxygen in & to get CO2 OUT! Eventually clients DIE from hypoxia IF they are not on a ventilator early. • ARDS = HARD Alveoli O2 in CO2 out ARDS Pathophysiology MEMORY TRICK PRIORITY DIAGNOSIS NCLEX TIP
Transcript of 47. Respiratory Failure & ARDS
Respiratory Failure & ARDSPathophysiology Course
When the capillaries (little blood vessels in the alveoli) cannot adequately exchange CO2 for Oxygen.
• Infection causes these alveoli to become swollen, inflamed, & filled with mucus or fluid which blocks gas exchange! • Clients can present with a common FLU which can progress into pneumonia & eventually into DEADLY A.R.D.S. - Acute Respiratory Distress Syndrome
0₂0₂
0₂
0₂0₂
0₂
0₂
Respiratory Failure
Causes
A.R.F. - ACUTE RESPIRATORY FAILURE
HypOXemic failure LOW O2 (PaO2 60 or LESS)
HyperCapnic failure HIGH CO2 (PaCO2 Over 50 )
2 types:
• Sepsis - bloodborne infection that inflames the entire body • Respiratory inflammation - pneumonia, inhaled toxin, or even aspiration. • Acute pancreatitis = HIGH risk for developing ARDS accidental release of active pancreatic enzymes & cytokines into the bloodstream - which get sucked into the lungs causing inflammation.
0₂
PaO2 <60
Causes
0₂ PEEP (positive end-expiratory pressure)
Mechanical Ventilation
HOLY
High Fowler's position (HOB up)
Oral suctioning & Oxygen
Listen to lung sounds
Yell for help! Notify HCP “provider”
Nursing Interventions for ARDS
Common Exam QuestionWhich arterial blood gas (ABG) values support suspected acute respiratory failure (ARF)?
1. PaO2 55 mm Hg, PaCO2 47 mm Hg2. PaO2 62 mm Hg, PaCO2 32 mm Hg 3. PaO2 47 mm Hg, PaCO2 63 mm Hg 4. PaO2 82 mm Hg, PaCO2 22 mm Hg
??? ???
pH
PaCO₂
PaO₂80 10047
35 45 63
7.35 7.45
A
B
B
A
#1 Sign = Altered Mental status
Refractory Hypoxemia
Low PaO2 = Despite Oxygen delivery
Agitation
Restlessness
Confusion
1.
2.
3.
Hypoxemia LOW O2
ARDS
NCLEX TIP
Lab Values ABG Arterial Blood Gas Low PaO2 High CO2
CO2
CO O
PaO2
0₂
REsistant to OxygenREfractory Hypoxemia
MEMORY TRICK
0₂
0₂0₂
0₂0₂
Signs & Symptoms
• Impaired gas exchange
The alveoli become hard due to the capillaries around the Alveoli becoming inflamed & fluid-filled, creating a leaky barrier, which eventually fills up the little alveoli sac like a sinking ship! THIS makes it impossible to get oxygen in & to get CO2 OUT! Eventually clients DIE from hypoxia IF they are not on a ventilator early. • ARDS = HARD Alveoli
O2in
CO2out
ARDS Pathophysiology
MEMORY TRICK PRIORITY DIAGNOSIS
NCLEX TIP
