respiratory failure - effectiveness.lahc.edu iv... · acute respiratory failure nursing and...
TRANSCRIPT
![Page 1: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/1.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
RespiratoryFailure
Revised1.5.17Chapter68
![Page 2: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/2.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
AcuteRespiratoryFailure• Resultsfrominadequategasexchange
• InsufficientO2transferredtotheblood• Hypoxemia
• InadequateCO2removal• Hypercapnia
![Page 3: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/3.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
GasExchangeUnit
![Page 4: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/4.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
AcuteRespiratoryFailure• NotadiseasebutacondiFon• oneormorediseasesinvolvingthelungsorotherbodysystems
![Page 5: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/5.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
Classi9icationofRespiratoryFailure
![Page 6: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/6.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
CaseStudy
• J.D.,a75-year-oldmalewithalong-standinghistoryofCOPD,developsarespiratoryinfecFonthatisunresponsivetotreatment.• HeisadmiMedtotheEDinmoderaterespiratorydistress.• RR32andshallow,andheisanxious.
• WhattypeofrespiratorydistressJ.D.isexperiencing.• Whatinforma7onandassessmentdatawillhelpindiagnosisandtreatment?
iStockphoto/Thinkstock
![Page 7: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/7.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
HypoxemicRespiratoryFailureEtiologyandPathophysiology• Causes• Ven7la7on-perfusion(V/Q)mismatch• COPD• Pneumonia• Asthma• Atelectasis• Resultofpain• Pulmonaryembolus
![Page 8: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/8.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
RegionalDifferencesinV/QMismatch
![Page 9: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/9.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
RangeofV/QRelationships
![Page 10: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/10.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
HypoxemicRespiratoryFailureEtiologyandPathophysiology
• Causes• Shunt• Anatomicshunt• Intrapulmonaryshunt
![Page 11: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/11.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
HypoxemicRespiratoryFailureEtiologyandPathophysiology
• Causes• Diffusionlimita7on• SevereCOPD• Recurrentpulmonaryemboli• Pulmonaryfibrosis• ARDS• IntersFFallungdisease• Hypoxemiapresentduringexercise
![Page 12: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/12.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
DiffusionLimitation
![Page 13: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/13.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
HypoxemicRespiratoryFailureEtiologyandPathophysiology• Causes• Alveolarhypoven7la7on• RestricFvelungdisease• CNSdisease• ChestwalldysfuncFon• Neuromusculardisease
![Page 14: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/14.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
HypoxemicRespiratoryFailureEtiologyandPathophysiology• Interrela7onshipofmechanisms• CombinaFonoftwoormorephysiologicmechanisms• V/Qmismatch• Shunt• DiffusionlimitaFon• AlveolarhypovenFlaFon
![Page 15: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/15.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
CaseStudy• J.D.’schestx-rayshowsbilateralinfiltrates.ABGresults:• pH7.18• PaO258mmHg• PaCO260mmHg• O2saturaFon85%
• Hiswifeisyellingatthehealthcareteamto“dosomethingorhewilldie.”
• WhatdohisABGresultsindicate?• Whatisthecauseofhisrespiratoryfailure?• Howwouldyouaddresshiswife’sconcern?• Howissheaffec7nghisresponsesandanxiety?
iStockphoto/Thinkstock
![Page 16: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/16.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
HypercapnicRespiratoryFailureEtiologyandPathophysiology
• ImbalancebetweenvenFlatorysupplyandvenFlatorydemand
![Page 17: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/17.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
HypercapnicRespiratoryFailureEtiologyandPathophysiology• Airwaysandalveoliabnormali7es• Asthma• COPD• CysFcfibrosis
![Page 18: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/18.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
HypercapnicRespiratoryFailureEtiologyandPathophysiology• Centralnervoussystemabnormali7es• Drugoverdose• BrainsteminfarcFon• Spinalchordinjuries
![Page 19: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/19.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
HypercapnicRespiratoryFailureEtiologyandPathophysiology• Chestwallabnormali7es• Flailchest• Kyphoscoliosis• Severeobesity• Fractures• MechanicalrestricFon• Musclespasm
![Page 20: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/20.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
HypercapnicRespiratoryFailureEtiologyandPathophysiology• Neuromuscularcondi7ons• Musculardystrophy• Guillain-Barrésyndrome• MulFplesclerosis• Exposuretotoxins• MusclewasFng
![Page 21: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/21.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
RespiratoryFailureClinicalManifestations
• Suddenorgradualonset• AsuddendecreaseinPaO2orrapidincreaseinPaCO2indicatesaseriouscondiFon
![Page 22: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/22.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
CaseStudy• J.D.’swifereportsthathehashadincreaseddifficultysleeping.• HehasbeenconfusedatFmesoverthepastweek.• Heappearsrestlessnowandinsistsonleaningontheoverbedtable.
• Howdothesemanifesta/onsrelatetorespiratoryfailure?• Whatotherclinicalmanifesta/onswouldyouassessfor?
iStockphoto/Thinkstock
![Page 23: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/23.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
RespiratoryFailureClinicalManifestations
• SpecificclinicalmanifestaFons• Rapid,shallowbreathingpaMern• Orthopnea• TripodposiFon• Dyspnea• Pursed-lipbreathing• RetracFons• ChangeinI:EraFo
![Page 24: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/24.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
CaseStudy
• J.D.’swifestatesthathehasahistoryofMI,hypertension,andGERD.• Asputumcultureisorderedforhim.
• Whatotherdiagnos/cstudieswouldbeorderedforhim?
iStockphoto/Thinkstock
![Page 25: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/25.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
RespiratoryFailureDiagnosticStudies• Historyandphysicalassessment• ABGanalysis• Chestx-ray• CBC,sputum/bloodcultures,electrolytes• ECG• Urinalysis• V/Qlungscan• Pulmonaryarterycatheter(severecases)
![Page 26: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/26.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
CaseStudy• J.D.’swifesharesthatheisareFredteacher.• Hehasenjoyedwoodworkingbutstrugglestoworkonprojectsnow.• J.D.walksshortdistancesinhisneighborhoodwhenheiswell.• Hetoleratessmallfrequentmealsbest.
• Discussthesefindingsandotherques/onstheymightaskhimorhiswiferelatedtofunc/onalhealthpa>erns.• Discusshead-to-toeassessmentfocus.
iStockphoto/Thinkstock
![Page 27: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/27.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
CaseStudy• J.D.isplacedonoxygenviafacemask.
• Whatothercollaborativecareareappropriate?
iStockphoto/Thinkstock
![Page 28: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/28.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
![Page 29: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/29.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
AugmentedCough
![Page 30: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/30.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
AcuteRespiratoryFailureNursingandCollaborativeManagement
• Huffcoughing• Seriesofcoughsperformedwhilesaying“huff”• EffecFveinclearingcentralairways
• Stagedcough• Sitleaningforward• Takethreedeepbreathsthroughmouthandcough
![Page 31: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/31.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
AcuteRespiratoryFailureNursingandCollaborativeManagement
• HydraFonandhumidificaFon• Adequatefluidintake• IVhydraFon• HumidificaFondevices• O2viaaerosolmask
![Page 32: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/32.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
AcuteRespiratoryFailureNursingandCollaborativeManagement
• Chestphysicaltherapy• Posturaldrainage• Percussion• VibraFon
![Page 33: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/33.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
AcuteRespiratoryFailureNursingandCollaborativeManagement
• AirwaysucFoning• Nasopharyngeal• Oropharyngeal• Nasotracheal
![Page 34: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/34.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
AcuteRespiratoryFailureNursingandCollaborativeManagement
• Respiratorytherapy• PosiFvepressurevenFlaFon(PPV)• NoninvasivePPV• BiPAP• CPAP
![Page 35: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/35.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
NoninvasivePPV
![Page 36: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/36.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
CaseStudy
• Thesputumcultureisobtainedandsenttothelab.• Hissputumisthickandtanincolor.
• Whatdrugtherapywouldbeusedforhim?
iStockphoto/Thinkstock
![Page 37: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/37.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
AcuteRespiratoryFailureNursingandCollaborativeManagement
• Drugtherapy• Reliefofbronchospasm• Bronchodilators
• ReducFonofairwayinflammaFon• CorFcosteroids
• ReducFonofpulmonarycongesFon• DiureFcs,nitratesifheartfailurepresent
![Page 38: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/38.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
AcuteRespiratoryFailureNursingandCollaborativeManagement
• Drugtherapy• TreatmentofpulmonaryinfecFons• IVanFbioFcs
• ReducFonofsevereanxiety,pain,andagitaFon• Benzodiazepines• Opioids
![Page 39: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/39.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
AcuteRespiratoryFailureNursingandCollaborativeManagement
• MedicalsupporFvetherapy• Treattheunderlyingcause• MaintainadequatecardiacoutputandhemoglobinconcentraFon
![Page 40: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/40.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
AcuteRespiratoryFailureNursingandCollaborativeManagement
• NutriFonaltherapy• Maintainproteinandenergystores• EnteralorparenteralnutriFon• NutriFonalsupplements
![Page 41: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/41.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
Evaluation• Expectedoutcomes• MaintainapatentairwaywitheffecFveremovalofsecreFons• NormalorbaselineRR,breathsounds,oxygenaFon• Normalhemodynamicstatus
![Page 42: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/42.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
CaseStudy
• J.D.wasadmiMedtoamedicalunitandisslowlyrecoveringfromhisrespiratoryinfecFon.• Heandhiswifeaskabouthowthismightbepreventedinthefuture.
• Whatwillbeyourteachingplanfordischarge?
iStockphoto/Thinkstock
![Page 43: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/43.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
ApaFent’sABGresultsincludepH7.31,PaCO250mmHg,PaO251mmHg,andHCO324mEq/L.Oxygenisadministeredat2L/min,andthepaFentisplacedinhigh-Fowler’sposiFon.Anhourlater,theABGsarerepeatedwithresultsofpH7.36,PaCO240mmHg,PaO260mmHg,andHCO324mEq/L.Whatismostimportantforthenursetodo?a. Increasetheoxygenflowrateto4L/min.b. DocumentthefindingsinthepaFent’srecord.c. ReposiFonthepaFentinasemi-Fowler’sposiFon.d. PreparethepaFentforendotrachealintubaFonandmechanical
venFlaFon.
AudienceResponseQuestion
![Page 44: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/44.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
ApaFentwithseverechroniclungdiseaseishospitalizedwithrespiratorydistress.WhichfindingwouldsuggesttothenursethatthepaFenthasdevelopedrapiddecompensaFon?a. AnSpO2of86%b. AbloodpHof7.33c. AgitaFonorconfusiond. PaCO2increasesfrom48to55mmHg
AudienceResponseQuestion
![Page 45: Respiratory Failure - effectiveness.lahc.edu IV... · Acute Respiratory Failure Nursing and Collaborative Management • Huff coughing • Series of coughs performed while saying](https://reader031.vdocument.in/reader031/viewer/2022022807/5ce0b9df88c99349468dc7e6/html5/thumbnails/45.jpg)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
WhichpaFentisathighestriskforhypoxemicrespiratoryfailure?a. ApaFentwhohasrespiratorymuscleparalysisb. ApaFentwhohasfracturedribsandaflailchestc. ApaFentwhohasamassivepulmonaryembolismd. ApaFentwhohasslowbreathingfromadrug
overdose
AudienceResponseQuestion