Term
If a person cannot maintain ventilation and cardiopulmonary arrest is imminent, what is essential? |
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Definition
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Term
What three observations should occur during the initial evaluation of the patient? |
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Definition
| Level of consciousness, appearance and texture of the pts skin, vital signs (rr, hr, bp, temp, spo2) |
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Term
What is the definition of acute respiratory failure? |
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Definition
| The inability to maintain arterial PO2, PCO2, and pH at acceptable levels. These levels are generally considered to be (1)a PaO2 below the predicted norm range for the pts age under ambient air conditions, (2)a PaCO2 over 50 mmHg and rising, and (3)a falling pH of 7.25 and lower |
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Term
What causes hypoxic lung failure? |
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Definition
| Severe ventilation/perfusion (V/Q) mismatching, diffusion defects, right-to-left shunting, alveolar hypoventilation, aging, and inadequate inspired o2 |
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Term
What is the definition of acute hypoxic respiratory failure? |
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Definition
| Acute-life threatening or vital organ threatening tissue hypoxia |
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Term
How do we treat hypoxic respiratory failure? |
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Definition
| O2 or in combination with positive end expiratory pressure or continuous positive airway pressure (PEEP/CPAP) |
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Term
What is the definition of hypercapneic respiratory failure? |
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Definition
| The inability of the body to maintain a normal PaCO2 |
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Term
What 3 disorders can lead to pump failure? |
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Definition
| CNS disorders, neuromuscular disorders, and disorders that increase the WOB |
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Term
What are 2 early indicators of hypoxia? |
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Definition
| Tachycardia and tachypnea |
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Term
What happens to PaCO2 levels during respiratory failure? |
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Definition
| Elevated with accompanying hypoxia unless the pt his receiving o2 therapy |
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Term
What are the 3 elements of a successful outcome? |
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Definition
| (1)use of supplemental o2 therapy, (2)maintenance of a patent airway, and (3)continuous monitoring of oxygenation and ventilatory status with pulse oximetry and ABG analysis |
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Term
Disorders of the CNS can lead to significant reductions in what two values? |
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Definition
| Minute and alveolar ventilation |
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Term
For long-range outcomes: is controlled hyperventilation recommended for patients with a closed head injury? |
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Definition
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Term
What are some examples of neuromuscular disorders that can lead to respiratory failure? |
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Definition
| Motor nerve damage, problems with transmission of nerve impulses at the neuromuscular junction, muscle dysfunction, nervous system disorders, drugs that affect neuromuscular function |
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Term
What 2 spirometry values are used as indicators of respiratory muscle function in patients with neuromuscular disorders? |
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Definition
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Term
What are the threshold values for VC and MIP? |
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Definition
| A VClower than 10-15 mL/kg and a MIP of -20 to -30 cm H2O or lower (i.e-0 to -20 cm H2O) |
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Term
An increase in the WOB can lead to what? |
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Definition
| Respiratory failure secondary to respiratory muscle fatigue |
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Term
What factors limit a patient’s tolerance to increased work? |
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Definition
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Term
What signs indicate an increased WOB? |
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Definition
| Rapid, shallow breathing and paradoxical breathing |
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Term
What is paradoxical breathing? |
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Definition
| When the abdomen moves out on exhalation and in on inhalation, whereas the chest wall moves out on inhalation and in on exhalation |
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Term
What spirometry value is used most often to assess patients w/asthma? |
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Definition
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Term
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Definition
| Lowest pressure generated during a forceful inspiratory effort against an occluded airway |
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Term
What is the normal value for MIP? |
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Definition
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Term
What is the name of the device that measures MIP? |
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Definition
| Bourdon gauge pressure manometer |
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Term
What is the normal value for VC? |
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Definition
| 65-75 mL/kg of ideal body wt (IBW) |
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Term
What is the name of the device that measures VC? |
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Definition
| Pneumotachometer and respirometer |
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Term
What is the normal value for PEFR? |
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Definition
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Term
What are 2 other parameters measured to assess respiratory function? |
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Definition
| RR and minute ventilation |
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Term
What is the normal value for RR? |
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Definition
| 12-20 breaths/min in adults (RR exceeding 35 for extended periods of time are a signal of inadequate alveolar ventilation or hypoxemia (or both) |
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Term
What is the normal value for minute ventilation? |
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Definition
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Term
How is minute ventilation calculated? |
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Definition
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Term
What is the best single indicator of adequate ventilation? |
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Definition
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Term
____ and ____ are the key indicators of the presence and severity of acute respiratory failure |
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Definition
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Term
What is the normal value for (P[A-a]O2) |
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Definition
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Term
What is the normal value for (PaO2/PAO2)? |
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Definition
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Term
How do we treat hypoxemia? |
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Definition
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Term
| With conditions such as _____, _____, _____, and ____ protecting the airway is top priority |
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Definition
| stroke, drug overdose, cerebral damage, and copious secretions (particularly if viscous), |
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Term
Standard criteria for instituting mechanical ventilation: |
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Definition
| Apnea or absence of breathing, acute respiratory failure, impending respiratory failure, refracrory hypoxic respiratory failure with increased WOB or an ineffective breathing pattern |
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Term
Approx. what percent of pts fail on NPPV and end up requiring intubation? |
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Definition
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