respiratory failure.pptx

7/25/2019 RESPIRATORY FAILURE.pptx

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DefnitionTypes

Causes

Clinical eaturesPathophysiology

Diagnosis

Nursing management


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PHYSIOLOGY


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RESPIRATORY AI!"RE

inability of the lung to meet the metabolicdemands of the body. This can be from failu

tissue oxygenation and/or failure of CO 2homeostasis.

Clinically:Respiratory failure is defined a

aO2!"# mm$g %hile breathing air& or a

'(# mm$g


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TYPES OF RESPIRATORY

FAILURE

#Type$%&ypo'emic R(

Type )%&yp

Pao)*+,mmhg

Paco)-mhg

#Type$%&ypo'emic R(

#Type$%&ypo'emic R(

#Type$%&ypo'emic R(

Pao)*+,mmhg


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TYPE $ RESPIRATORY AI!"RE%&YPO/E0IC(

The failure of the lung and heart to pro)ide ade*uatmeet metabolic needs.

+no%n as lung failure& oxygenation failure& respira

insufficiency.

aO2 !"#mm$g %ith normal or lo% aCO2.

,ost common form of respiratory failure.


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Causes o hypo'emic respiratoailure

Acute asthma

ARDS

Pulmonary f1rosis

Pulmonary e2ema

Pneumonia COPD %most common cause(

Pulmonary em1olism

Decrease2 car2iac output


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PATHOPHYSIOLOGY

3entilation4 perusion mismatch%345(Shunting

Di6usion limitation

Al7eolar hypo7entilation


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$ypercapnic Respiratory -ailureType 0

t is 1no%n as pump failure

The failure of lung to eliminate ade*uate CO2

aCO2 '(# mm$g

$ypoxemia is al%ays present


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Causes of Hypercapnic Respiratory failur

"pper air8ay o1structions9 tumor: oreign 1o2ylaryngeal e2ema;

Air8ay 2isor2er9 se7ere asthma: COPDCNS9 2rug o7er2ose: 1rainstem in ?arsyn2rome: multiple sclerosis;


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Pathophysiology o &ypercapnicrespiratory ailure


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Clinical and aboratory ,anifestation

Rstlesness& fatigue& headache $304yspneaTachypnea$ypoxemic0

5radypnea $ypercapnic0

Orthopnea / Tripod position,ild hypertension

aradoxical breathing

ater: Confusion& somnolence& cyanosis and comaCon)ulsions

M i f li i l f


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Mnemonics for clinical feature


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DIAGNOSIS


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DIAGNOSIS&istory an2 physical e'amination

A?=

Chest '@ray %pneumonia: atelectasis(

C?C

C0P %comprehensi7e meta1olic panel(

Sputum culture?loo2 culture

Serum electrolytes

E=


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,anagement of Respiratory -ailurerinciples

$ypoxemia may cause death in R-rimary ob6ecti)e is to re)erse and pre)ent

hypoxemia

7econdary ob6ecti)e is to control aCO2 and

respiratory acidosis

Treatment of underlying disease

atient8s C97 and C7 must be monitored an

treated

l i i


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Plan an inter!entions

Plan4 goal9

@ To maintain a2eBuate o'ygenation an2 7entilation

A2minister o'ygen9 @ 2eli7ery metho2 %nasal: mas: mechanical 7entilat

0o1ilie pulmonary secretions9

@ e6ecti7e coughing

@ a2eBuate hy2ration an2 humi2ifcation

@ chest physical therapy

@ Proper positioning %high o8lers(

@ Tracheal suctioning

Cont2


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Cont2

0e2ication "se9

@ ?roncho2ilators

@ Corticosteroi2s to 2ecrease inFammation; @ Diuretics: nitroglycerine: opioi2s to 2ecreasecongestion

@ Anti1iotics

@ Se2ations an2 analgesic to 2ecrease an'ietyan2 pain;

@ So2ium 1icar1onate or meta1olic aci2osis

" t


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"ont#

I measure ails to impro7e o'ygenation an2

7entillation9Positi7e pressure 7entilation is necessary

En2otracheal intu1ation

E al ation Desire o tco


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E!aluation$ Desire outco

Clients has a2eBuate o'ygenation an2 7entilaDecrease in 8or o 1reathingA?= 8ithin normal

?reath soun2s clear %a1sence o cracle or rhon

O'ygen saturation -G)H

Speech in ull sentence


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respiratory failure.pptx

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