What is the difference between acute and chronic respiratory failure?
Acute respiratory failure
- occurs when resp. system is unable to exchange sufficient oxygen and carbon dioxide to maintain blood flow
- life threatening condition
Chronic respiratory failure
- respiratory function deteriorates slowly
- gas exchange is permanently impaired
What is the difference between Type I and Type II acute resp. failure?
Type I: Hypoxaemic
- resp. failure caused by a failure of oxygenation
- insufficient oxygen diffuses from the alveoli to the pumonary capillary bed
Type II: Hypercapnic
- resp. failure caused by inability to ventilate and excrete carbon dioxide
- insufficient carbon dioxide diffuses from the pulmonary capillary bed to the alveoli
Is it possible to have a mixture of both Type I and II acute resp. failure?
Yes.
Define pneumothorax, haemothorax and pleural effusion.
Pneumothorax
- air between the visceral and parietal space
Haemothorax
- collection o fblood in the interpleural space
Pleural effusion
- a build up of infective tissue
- exudate in the pleural space
What is the difference between open and tension pneumothorax?
Open pneumothorax:
- caused either by penetrating trauma or surgery
Tension pneumothorax:
- life threatening condition that results from a progressive deterioration and worsening of a simple pneumothorax
- associate with the formation of a one-way valve at the point of a rupture in the lung
Name FIVE nursing assessment and managements for UWSD.
- monitor water in seal chamber
- keep bottles lower than the height of the pt chest
- DO NOT clamp ICC for >60 secs unless full expansion of lung
- observe insertion site for air leak and surgical emphysema
- auscultate pt’s chest for breath sounds at start of shift and PRN
- ensure adequate pain relief
- encourage deep breathing and coughing
- maintain clean dry dressing
What are the factors that increase a pt’s risk of pulmonary embolism?
In your own time, look up the detailed explanation in your lecture notes.
- venous stasis
- hypercoagulability
- injury to endothelial cells
Name FOUR indications for NIPPV.
- elevated resp. rate
- dyspnoea (difficulty breathing)
- increase WOB & increase use of accessory muscles
- decrease SpO2 usually less than 90% on high flow O2
- PaCO2 greater than 45mmHg
- acidosis (pH <7.35)
- TO PREVENT INTUBATION
Name FIVE common complications associated with NIPPV.
- barotrauma
- hypotension
- aspiration risk
- gastric distension
- increase ICP
- facial and nasal pressure sores
- epistaxis
