How long after suctioning should you wait 20 minutes
before taking an ABG?
How long should suctioning be done for? less than 15 seconds
What are the normal PaO2 levels? 80-100 mmHg
How fast does the buffer system kick in? immediately, but it has a low threshold
How fast does the respiratory system effects are within minutes, the max effect is in 24 hours, it is more sustainable, but not
work? long term
How fast does the renal system work? effects take hours to days but are more sustainable
What ABG will aspirin overdose be? metabolic acidosis
What ABG will hypovolemic shock be? metabolic acidosis (lactic acid build up)
What ABG will high altitude cause? respiratory alkalosis
What ABG does the initial stage of hypoxia respiratory alkalosis (body is hyperventilating)
cause?
What ABG does COPD, PE, and pulmonary respiratory acidosis
edema cause?
What conditions might we see with anemia, hypovolemia, pulmonary embolism, cardiogenic shock, AMI
perfusion issues?
What conditions might we see with asthma, bronchitis, head injury, opioid overdose, fatigue, spinal cord injury, rib
ventilation issues? fractures, kyphosis
What conditions might we see with anemia, PE, AMI, asthma, opioid OD, SCI, rib fractures, diffusion limitation
oxygenation issues?
What is ventilation? movement of air into the alveoli
What is perfusion? getting blood to those alveoli
, What is oxygenation? the movement of oxygen fromthe alveoli to the blood (via diffusion)
- PaO2 < 60 mmHg
What are the ABGs with respiratory failure? - CO2 > 50 mmHg
- pH < 7.35
- failure of oxygenation
What are the classifications of respiratory
- failure of ventilation
failure?
- failure of both ventilation and oxygenation
What type of respiratory failure does toxin failure of ventilation
exposure cause?
- change in mental status, fatigue, restlessness, confusion, agitation
What are the early signs of respiratory
- anxiety (SNS response): tachycardia, tachypnea, mild HTN
failure?
- morning headache (due to issue with CO2 removal)
- tachycardia, bounding pulse, hypertension
- skin: cool, clammy, diaphoresis
- rapid, shallow breathing pattern
- dyspnea
What are the general signs of respiratory
- retractions, use of accessory muscles
failure?
- tripod position, nasal flaring
- pursed-lip breathing
- fatigue, muscle weakness
- unable to speak in full sentences
- paradoxical breathing
- coma
What are the late signs of respiratory - hypotension
failure? - dysrhythmias•
- seizures
- cyanosis
- crackles: may indicate pulmonary edema
- absent or diminished breath sounds: may indicate atelectasis or pleural effusion
What are the abnormal breath sounds with
- bronchial breath sounds over the lung periphery: often result from lung
respiratory failure?
consolidation that is seen with pneumonia
- pleural friction rub: presence of pneumonia that has involved the pleura
- frequent and early assessment
- CXR, ABG, CBC, ECG
- sputum and blood cultures
- serum electrolytes, CT, VQ scan
- ETCO2 monitoring
- oxygen delivery and ventilatory support
-> tolerated by the patient
What is the collaborative care for
-> maintain goal SaO2 by using lowest O2 concentration (FiO2) possible
respiratory failure?
-> oxygen delivery devices
-> noninvasive: NC, simple mask, venturi mask, NRB, CPAP, BIPAP
-> invasive: endotracheal tube, tracheostomy
-> ventilatory support
-> positive pressure ventilation (PPV)
-> CPAP, BIPAP (noninvasive)
-> invasive mechanical ventilation (ETT, Trach)