ARDS
Alveolar capillary membrane becomes damaged and more permeable to intravascular fluid causing the alveoli to fill with fluid.
What is Acute Respiratory Distress Syndrome (ARDS).
What type of respiratory failure would you classify this as?
PaO2 less than or equal to 60 mm Hg
What is Hypoxemic respiratory failure.
Guidelines for preventing ventilator-associated pneumonia (VAP) ?
What is Elevate HOB, daily oral care, daily SBTs, Minimize sedation.
Signs of a tension pneumonthorax?
What is Dyspena, marked tachycardia, tracheal deviation, decreased or absent breath sounds, neck vein distention, cyanosis, profuse diaphoresis.
Normal fluctuation of water withing the water-seal chamber.
What is Tiadaling.
Continuous side-to-side rotation to help stimulate postural drainage and mobilize secretions.
What is continuous lateral rotation therapy.
What are some causes of Hypoxemic respiratory failure?
What is ARDS, Pneumonia, Toxic inhalation.
Reference slide 3 of ARF PPT
Your client pulls out their ETT. What should you do next?
What is manually ventilate the client with a bag valve mast and 100% o2 if needed.
Clinical manifestations of pleural effusion?
What is dyspnea, cough, sharp chest pain often worse on inhalation, decreased breath sounds of affected side.
You clients tracheostomy becomes dislodged. After you call for help, what is your next step?
What is attempt to insert a spare tracheostomy tube.
Common causes of ARDS?
Indirect: sepsis, trauma, head injury, shock
What type of respiratory failure would you classify this as?
PaCO2 greater than 50 mm Hg
What is Hypercapnic respiratory failure.
The low-pressure alarm sounds on the ventilator. The O2 sat dropped to 87%. What should the nurse do?
What is tighten ventilator tubing and connections and checking for a possible leak.
The non-fractures side of the chest will expand on inspiration while the injured side will sink inward on inspiration.
What is Flail Chest.
A nurse is caring for a client who has a chest tube. The nurse notes that the chest tube has become disconnected from the chest drainage system. What should the nurse do?
Immerse the end of the chest tube in a bottle of sterile water.
This allows air to escape and not enter the pleural space.
Late clinical manifestations of ARDS.
What is refractory hypoxemia, hypercapina, hypoventilation, whiteout on CXR.
Interventions to mobilize secretions?
What is positioning, coughing, chest CPT, suctioning, hydration, humidified oxygen, ambulation.
A family member asks you what Assist control ventilation is. What do you tell them?
What is this mode will ensure that a set number of breaths are taken. This mode sets the ventilator to give a preset TV and RR. The ventilator will work even if the client is not breathing on their own.
Clinical manifestations of pulmonary embolism.
What is dyspnea, mild to moderate hypoxemia, tachypnea, cough, chest pain, hemoptysis, crackles, wheezing, fever, tachycardia, syncope, decreased LOC, hypotension, impending doom.
Methods for verifying correct placement of a tracheostomy?
End-tidal CO2 capnography, auscultating breath sounds bilaterally for air entry, chest x-ray, inspection of bilateral chest wall movement.
PaO2/FiO2 Ratio of <100
What is Severe ARDS.
Mild ARDS is less than 300, Moderate ARDS is less than 200, Severe ARDS is less than 100.
What are some causes of Hypercapnic respiratory failure?
What is Asthma, COPD, Cystic fibrosis, Overdose, MG, etc.
Reference Slide 4 of ARF PPT
What does a client on pressure support ventilation (PSV) need to be able to do on their own?
What is be awake and alert to initiate a breath.
Treatment for Tension Pneumothorax?
What is urgent needle decompression followed by chest tube insertion.
A client comes to the ED in severe respiratory distress following left-sided blunt chest trauma. The nurse notes absent breath sounds on the client’s left side and a tracheal shift to the right. Which procedure should the nurse prepare the client?
What is chest tube insertion.
The client’s manifestations indicate pneumothorax due to blunt chest trauma. The nurse should prepare the provider to insert a chest tube and connect it to a water-seal drainage system.