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19 Cards in this Set
- Front
- Back
Describe ARDS |
The exchange of O2 for CO2 in the lungs is not adequate for O2 consumption and CO2 production within the body's cells.
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Hypoxemia in ARDS
Hypercapnia in ARDS |
O2 below 50 mmHg
CO2 above 45 mmHg |
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HESI HINT ARDS
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Unexpected, catastrophic pulmonary complication occurring in a person with no previous pulmonary problems. The mortality rate is high! 50%
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During acute failure the arterial pH falls below 7.30 this indicates...
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Acidosis
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HESI HINT: Clients with ARDs commonly have a lowered PO2, however...
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these clients are not very responsive to high concentrations of O2.
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HESI HINT: PEEP
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Think about the physiology of lungs by remembering PEEP. Positive end expiratory pressure is the instillation and maintenance of small amounts of air into the alveolar sacs to prevent them from collapsing each time the client exhales. The amount of pressure can be set is around 5-10 cm of water.
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Name 11 common causes of respiratory failure! 1...2...3...GO!
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1. COPD
2. Pneumonia 3. TB 4. Contusion 5. Aspiration 6. Inhaled toxins. 7. Emboli 8. Drug overdose 9. Fluid overload 10. DIC 11. Shock |
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S/S of ARDS
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Dyspnea, tachypnea
Intercostal retractions Cyanosis Hypoxemia: PO2 < 50 mmHg with FiO2 > 60% Diffuse pulmonary infiltrations on CXR "white-out" look Verbalize anxiety and restlessness |
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HESI HINT: Suction
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Suction only when secretions are present.
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Nursing Interventions: ARDS
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Ventilator settings, Care with oral airway or a tracheostomy
Monitor breath sounds for pneumothorax especially when PEEP is used Monitor the client hemodynamically with VS and ECG Monitor ABGs routinely Monitor vital organ status: CNS, LOC, Renal outuput, myocardium (apical pulse, BP) Monitor F&E electrolyte balance |
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Normal Values for Arterial Blood Gases
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pH 7.35 - 7.45
PO2 80 - 100 PCO2 35 - 45 HCO3 22 - 26 Anion 10 - 18 |
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Normal Values for Venous Blood Gases
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pH 7.31 - 7.42
PO2 35 - 45 PCO2 39 - 52 HCO3 22 - 26 Anion 8 - 16 |
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How do you check for a collateral circulation?
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Perform Allen Test
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How do you know if it the Allen Test is positive?
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Put pressure on your ulnar and radial pulse points and hold it, then let go of the ulnar point and see if it flushes back to normal. If it does, this is a positive pressure point.
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What do you do if the Allen Test is negative?
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Go to a different arm or site.
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What are the 8 common causes of respiratory failure in children?
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1. Congenital Heart Disease
2. Respiratory distress syndrome 3. Infection, sepsis 4. Neuromuscular diseases 5. Trauma and burns 6. Aspiration 7. Fluid overload or dehydration 8. Anesthesia and narcotic overdose |
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S/S respiratory failure in children
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"Bad" looking child
Very slow or rapid RR, apnea, gasping Tachycardia Cyanosis, pallor, or mottled color Irritability, lethargy Retractions, nasal flaring, poor air movement Hypoxemia, hypercapnia, respiratory acidosis |
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What percentage of O2 do you want to have a child on when you see that they are in severe respiratory distress?
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100%
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In a child, what are the values for severe respiratory failure?
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PCO2 > 45
PO2 < 60 on 50% |