Respiratory

Failure

Ns. Beti Kristinawati, S.Kep., M.Kep., Sp. Kep. MB

Anatomy
 Purpose of the Respiratory System

 Meet the Need for Oxygen for Metabolism

 Removing Co2 as a Residual Cell Metabolism
Functions of Respiration and Non-Respiration of the Lungs

 Respiration = exchange of gases O2 and CO2.

 Acid base balance = CO2 balance.
 Fluid balance = fluid loss of 200 – 500 cc / day at a breath frequency of 14 –
16 x / min.
 Balance of body temperature.
 Helps venous blood return to the atrium during the inspiration process.
 Protection against infection.
2. Complaince
 Yaitu hubungan antara perubahan tekanan dengan perubahan volume
dan aliran.
 Kondisi yang menurunkan complaince :
 Atelektasis
 Pneumonia
 Edema paru
 Fibrosis paru
 Efusi pleura
 Pneumothoraks
 Distensi abdomen
2. OXYGEN CONTENT (cao2)
The amount of O2 carried by blood
Plasma = 3 ml/L of blood
Hemoglobin = 200 ml /L
Factors That Affect Oxygen Transport
 Space loss (Dead Space Ventilation)
 Depending on COP(Q) and O2 content (CaO2)
 Movement of a number of gases in the bronchial tree that do not
participate in gas exchange
 Ventilation of alveoli movement of gas in and out of the alveoli
and along with gas exchange
Ventilation Regulations
 Ventilation Regulations
Control of ventilation arrangements is carried out
by the nervous system and the concentration of
gases present in the blood.
 The center of respiration (MO) regulates:
 Center I /E = posterior MO
 Kemoreceptor Center = anterior MO
 Apnea center and pneumothorax = Pons
1. Stimulated ventilation consists of:
 PaCO2
 PH of blood
 PaO2
2. Kemorecepttor
 PONS = change in concentration of H + & HCO3 in LCS
 Peripheral = Carotid artery, Arcus aorta, changes in concentration of H+
& PaO2
 Respiratory Failure: Respiraty
Failure
Understanding:
 Respiratory system failure to maintain the exchange of
O2 and CO2 in amounts that can result in impaired
life.
1. Type I Respiratory Failure
(Normokapnu hypoxemia)
Normal CO2, Low Oxygen
2. Type II Respiratory Failure
(Hypercapnu hypoxemia)
High CO2, Low Oxygen
3. Mixed Respiratory Failure (I and II)
Mechanism of Respiratory Failure:

1. Hypoventilation
2. V/Q mismatching
MECHANISM 1
Hypoventilation
 Cause
 Respiratory control nervous system damage or depression
(stroke, head injury, brain tumor, poisoning)
 Neuromuscular disorders (peny. SGB, Myasthenia Gravis,
paralisa)
 Obstruction
 Lung Restrictions
Mechanism 2
V : Q MISSMATCHING

 V: Q missmatching
(V/Q = ventilation: perfusion)
 Low V/Q (< 1) (Perfusion greater than ventilation)
high V/Q (> 1)
 (Ventilation is greater than perfusion)
Diagnostic Actions

 Blood Gas Analysis (pH, pO2, pCO2)

 Photo thoracic
 Supporting laboratory
Thoracic photo examination
 The Nursing Process

Subjective Data
 History of Disease
 Trigger Factor
 Symptoms of difficulty breathing
 Symptoms of Hypoxemia

Objective Data
 Signs of respiratory distress
 Signs of hypoxemia
 Signs of hyperkapnoe
 Signs and Symptoms

• Apnoe
• Coughing, phlegm
• Cyanosis
• Changes in breathing patterns: reduced, increased,
fatigue
• Cardiovascular changes : Nadi, TD, Central Venous
Pressure, EKG
 Nursing Interventions

• Address the Causes (medical collaboration)

• Odema lung
• COPD
• Stroke
• Increased ICT, etc.
• Maintaining the airway and improving ventilation
• Optimize oxygen transport and decrease oxygen
consumption
• Overcoming infection
• Prevent complications