DISEASE CAUSE PATHOPHYSIOLOGY SIGNS AND

SYMPTOMS
DIAGNOSTIC
TEST
TREATMENT MEDICAL
MGT
NURSING MGT
Acute Respiratory
Failure

is a sudden and
life-threatening
deterioration of
the gas exchange
function of the
lung and indicates
failure of the lungs
to provide
adequate
oxygenation or
ventilation for the
blood.


Is dened as a
decrease in arterial
oxygentension
(PaO2) to less than
50 mm Hg
(hypoxemia) and
an increase in
arterial carbon
dioxide tension
(PaCO) to greater
than
50mmHg(hypercap
nia), with an
arterial pH of less
than 7.35
Ventilatory failure
mechanisms leading to
acute respiratory failure
include impaired
function of the

Central Nervous
System
drug overdose,
head trauma,
infection,
hemorrhage,
sleep apnea

Neuromuscular
Dysfunction
myasthenia gravis,
GuillainBarr
syndrome,
amyotrophic
lateral sclerosis,
spinal cord trauma
Musculoskeletal
Dysfunction
chest trauma,
kyphoscoliosis,
malnutrition

Pulmonary
Dysfunction
COPD,
Asthma
cystic brosis

Oxygenation failure
mechanisms leading to
acute respiratory failure
include
In the postoperative
period, especially after
major thoracic or
abdominal surgery,
inadequate ventilation
and respiratory failure
may occur because of
several factors. During
this period, for
example, acute
respiratory failure may
becaused by the effects
of anesthetic,
analgesic, and sedative
agents, which may
depress respiration (as
described earlier) or
enhance the effects of
opioids and lead to
hypoventilation.
Pain may interfere with
deep breathing and
coughing. A
ventilationperfusion
mismatch is the usual
cause of respiratory
failure after major
abdominal, cardiac, or
thoracic surgery.
EARLY SIGNS
ARE ;
restlessness,
fatigue,
headache,
dyspnea,
air hunger,
tachycardia,
and
increased
blood
pressure.

HYPOXEMIA
PROGRESSES:

confusion,
lethargy,
tachycardia,
tachypnea,
central
cyanosis,
diaphoresis,
and finally
respiratory
arrest.

The
objectives of
treatment
are to correct
the
underlying
cause and to
restore
adequate gas
exchange in
the lung.
Intubation
and
mechanical
ventilation
may be
required to
maintain
adequate
ventilation
and
oxygenation
while the
underlying
cause is
corrected.
Assisting with
intubation and
maintaining
mechanicalventila
tion.

The nurse
assesses the
patients
respiratory status
by monitoring the
level of
responsiveness,
arterial blood
gases, pulse
oximetry, and
vital signs.

The nurse
assesses the entire
respiratory system
and implements
strategies (eg,
turning schedule,
mouth care, skin
care, range of
motion of
extremities) to
prevent
complications.

The nurse also
assesses the
patients
understanding of
the management
strategies that are
used and initiates
some form of
communication
to enable the
patient to express

pneumonia,
acute respiratory
distress syndrome,
heart failure,
COPD,
pulmonary
embolism, and
restrictive lung
diseases.
concerns and
needs to the
health care team.

The nurse
addresses the
problems that led
to the acute
respiratory
failure. As the
patients status
improves, the
nurse assesses the
patients
knowledge of the
underlying
disorder and
provides teaching
as appropriate to
address the
disorder.