30 terms

A&C II resp

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causes of COPD
smoking, air pollution, dust, chemicals
diagnostics used for COPD
Pulmonary function tests, Chest X-ray, CT, ABG, CBC, BNP
COPD collaborative care goals
- Improve health status
-Decrease symptoms
-Reduce frequency and severity of exacerbations
how to decrease symptoms in COPD patients
oxygen, bronchodilators, oral corticoidsteriods and antibiotics (for exacerbations) , surgical therapy (get rid of diseased portion of lung), breathing retraining and airway clearance
nursing care for ineffective air way clearance
-teach huff coughing
-regulate fluid intake
- administer bronchodilators
nursing care for impaired gas exchange
-administer O2
-teach pt and family about oxygen at home
- observe for complications of oxygen use
- tach patient about pursed lip breathing
collaborative care on reducing frequency and severity of exacerbations
-minimize infection risk
- short-acting bronchodilators
-oral systemic corticosteriods
-antibiotic therapy
right-sided heart failure- the enlargement of the right ventricle due to high blood pressure in the lungs usually cause by chronic lung disease is termed
cor pulmonale
COPD complications
-cor pulmonale
- ARDS/ respiratory failure
-depression / anxiety
Type of pulmonary edema that is unrelated to heart failure , Injured pulmonary capillaries cause increased tissue permeability- this draws fluid into the alveolus, causing impaired gas exchanged is termed
acute respiratory distress syndrome
how to decide the degree of ARDS
measure how much fluid is in the alveolus sac
t/f: anything that can cause damage to the alveoli can cause ARDS
true
s/s of respiratory distress or hallmark features of ARDS
-Bilateral patchy infiltrates on the chest x-ray
-No signs or symptoms of heart failure/cardiac involvement
-No improvement of Pa02, despite increased oxygen delivery
-Profound respiratory distress
what do you do with patients that show No improvement of Pa02, despite increased oxygen delivery?
put on mechanical ventilation --> PRV and high PEEP.
goal of ARDS therapy
correct initial cause of pulmonary injury, if possible, and maintain adequate oxygenation
collaborative and nursing care for ARDS
-correct cause of ARDS
-supportive care til lungs heal
-intubation and respiratory support (PEEP and ET suctioning and pt positioning to mobilize secretions RoTo bed)
-diligent nursing assessment to avoid complications
complications of ARDS
Pneumonia, Barotrauma, Volutrauma, etc
if PaO2/FiO2 is 200 or less
its an ARDS diagnosis
is respiratory failure a condition or disease
condition
causes of respiratory failure
COPD exacerbation, aspirational pneumonia, obesity, anesthesia, pneumothorax, CNS diseases, head trauma, drug overdose
Insufficient oxygen transfer from alveoli to capillaries is termed
hypoxemic respiratory failure
causes of hypoxemic respiratory failure
V/Q mismatch
shunting
diffusion limitation
alveolar hypoventilation
what is shunting
blood comes to alveoli and can't exchange Co2 or O2
what is diffusion limitation
not enough gas can get to alveoli
Increased CO2 buildup due to inadequate removal from capillaries is termed as
Hypercapnic Respiratory Failure
diagnostics for respiratory failure
-VS, H&P, ABGs, SpO2
-Chest X-ray, ECG
-CBC, UA, CMP, cultures
-CT scan, V/Q lung scan
-Hemodynamic parameters
consequences of respiratory failure
-anaerobic metabolism
-Organ dysfunction
-brain damage
goal of respiratory failure
restore adequate gas exchange
collaborative and nursing care in regards to respiratory care
ET intubation & Mechanical ventilation
Ventilation support w/ positive pressure
Oxygen therapy
drug therapy for respiratory failure
Antibiotics- treat infections
Bronchodilators- treat bronchospasm - open airway
Corticosteriods- reduce inflammation
Diuretics- decrease pulmonary congestion