Respiratory Failure

• Mismatch causes:

  • Pulmonary embolus reduces blood flow – less blood gets to alveoli to receive O2
  • Gas exchange is dependent upon:

  1. Ventilation = movement of gas
  2. Perfusion = blood flow
• Nursing Care Plan – COPD

  • Improve gas exchange
  • Improve airway clearance
  • Improve breathing pattern
  • Self-care needs met
  • Get adequate sleep
  • Increase activity
  • Assist with pt & family coping
  • Minimize complications
• Pulmonary edema: Mad Dog Mnemonic

  • M – Morphine
  • A – Airway
  • D – Digitalis

   

  • D – Diuretics (Lasix)
  • O – Oxygen
  • G – Blood gas (“ABG’s)
• Respiratory failure Interventions:

  • Oxygen – NC, venturi mask, NRM, CPAP, ventilator
  • Mobilize secretions – CPT, TCBD, suction
  • Positioning

  1. HOB >45
  2. Good lung down – maximize VQ matching

  • Hydration
  • Meds – bronchodilators, steroids, diuretics, abx, anxiety meds
  • Support patient and family
• Emergency Assessment of respiratory failure:

  • Establish airway first!!
  • Hypoxemia Assessment
  • Vitals

  1. >30, HTN, Tachycardia

  • ABG’s
  • Increased effort, accessory muscle use
  • Agitation, confusion