Causes: CONCEPT MAP

• Airway Obstruction
- Laryngotracheobronchitis Management Principles:
- Acute hypertrophic tonsillitis Primary objective: reverse and prevent
Acute Respiratory hypoxemia !
- Foreign body, trauma, Asthma
• Alveolar and pleural disease. Failure Secondary objective: control PaCO2 and
- Pneumonia, pulmonary edema, embolism, respiratory acidosis !
empyema, pneumothorax, ARDS Treatment of underlying disease
Other common causes Patient’s CNS and CVS must be monitored
Decreased respiratory drive (severe brain and treated.
injury, large lesions of brainstem, use of Sudden and life-threatening
sedatives) deterioration of the gas
Dysfunction of the chest wall exchange function of the lung
(Musculoskeletal disorders- muscular and indicates failure of lungs to Nursing Interventions / Roles:
dystrophy, polymyositis,GBS, etc) provide adequate oxygenation Maintain bed rest to reduce O2 requirement.
Dysfunction of the lung parenchyma (PNA, or ventilation for the blood. Keep the patient in semi-folwers position to
Status asmaticus, Lobar atelectasis, promote chest expansion and ventilation.
pulmonary edema Administer O2 to reduce hypoxemia and
relieve respiratory distress.
Assess respiratory status to detect early
Clinical Manifestations: Pump failure: Lung failure: signs of hypoxemia.
• Respiratory Gas exchange failure Ventilatory failure Monitor and record vital signs, tachycardia
- Difficult of breathing, shortness of breath, manifested by manifested by and tachypnea may indicate hypoxemia.
dyspnea, tachypnea, orthopnea, hypoxaemia hypercapnia Monitor pulse oximetry to detect a drop in
hyperventilation, use of accessory muscles
SaO2.
and nasal flaring
Provide suctioning, assist with turning,
• Neurologic
coughing, and deep breathing, and perform
- Confusion, drowsiness, disorientation, and
chest physiotherapy and postural drainage
coma
Types: to facilitate removal of secretion.
• Cardiovascular
Type I – Acute hypoxemic respiratory failure Report deteriorating: ABGS (PaO2 and
- Tachycardia, cyanosis, diaphoresis,
• PO2 < 50 mmHg on room air. PaCo2)
chest pain, peripheral vasodilatation
• Usually seen in patients with acute pulmonary edema CBC, and Chemistry to detect electrolyte
with hypotension
or acute lung injury. imbalance result use of diuretics.
Type II – Acute hypercapnic respiratory failure Maintain diet restrictions, fluid restrictions
• PCO2 > 50 mmHg (if not a chronic CO2 retainer). • and a low Na diet may be necessary to avoid
Diagnostic test indications:
This is usually seen in patients with an increased work fluid overload.
ABGs levels show hypoxemia, acidosis/
of breathing due to airflow obstruction or decreased M.V may indicated: monitor M.V. to prevent
alkalosis, and hypercapnia
respiratory system compliance complication and optimize PaO2.
Chest x-ray shows pulmonary infiltration and
Type III – Combined hypoxemic and hypercapnic
atelectasis
failure
Hematology reveals increased WBCs and
ESR.
Sputum study identifies organism Jenievy May F. Señerez
BSN36