Respiratory Failure & ARDS

Pathophysiology Course

Respiratory Failure
0₂ 0₂
0₂ 0₂
0₂

When the capillaries (little blood vessels in the alveoli) cannot adequately exchange CO2 for Oxygen. 0₂
0₂

Causes
• Infection causes these alveoli to become swollen, inflamed, & filled with mucus
or fluid which blocks gas exchange!
• Clients can present with a common FLU which can progress into pneumonia &
eventually into DEADLY A.R.D.S. - Acute Respiratory Distress Syndrome

Signs & Symptoms MEMORY TRICK Common Exam Question

REsistant to Oxygen Which arterial blood gas (ABG) values
Hypoxemia LOW O2 REfractory Hypoxemia support suspected acute respiratory
failure (ARF)?
#1 Sign = Altered Mental status NCLEX TIP
0₂
0₂
1. PaO2 55 mm Hg, PaCO2 47 mm Hg
0₂
0₂
0₂
2. PaO2 62 mm Hg, PaCO2 32 mm Hg
1. Agitation 3. PaO2 47 mm Hg, PaCO2 63 mm Hg
4. PaO2 82 mm Hg, PaCO2 22 mm Hg
2. Restlessness
3. Confusion Lab Values
ABG Arterial Blood Gas
ARDS Low PaO2 pH
A B

? High CO2 7.35 7.45

Refractory Hypoxemia
?
?
? ? PaCO₂
B
A

0₂
35 45 63
Low PaO2 = Despite Oxygen delivery ?
C PaO₂
O O 47 80 100
PaO2
CO2

ARDS Pathophysiology
The alveoli become hard due to the capillaries around the Alveoli becoming inflamed O2 CO2
in out
& fluid-filled, creating a leaky barrier, which eventually fills up the little alveoli sac like
a sinking ship! THIS makes it impossible to get oxygen in & to get CO2 OUT!
Eventually clients DIE from hypoxia IF they are not on a ventilator early.
MEMORY TRICK PRIORITY DIAGNOSIS

• ARDS = HARD Alveoli • Impaired gas exchange

Causes Nursing Interventions for ARDS

• Sepsis - bloodborne infection that inflames the entire body
• Respiratory inflammation - pneumonia, inhaled toxin, Mechanical Ventilation
or even aspiration.
• Acute pancreatitis = HIGH risk for developing ARDS NCLEX TIP 0₂ PEEP (positive end-expiratory
pressure)
accidental release of active pancreatic enzymes & cytokines
into the bloodstream - which get sucked into the lungs
causing inflammation.

A.R.F. - ACUTE RESPIRATORY FAILURE

H High Fowler's position (HOB up)

2 types:
0₂
O Oral suctioning & Oxygen
HypOXemic failure LOW O2
(PaO2 60 or LESS) L Listen to lung sounds
HyperCapnic failure HIGH CO2
(PaCO2 Over 50 )
PaO2 <60
Y Yell for help! Notify HCP “provider”