COMPLEX MIDTERM 1
WEEK 1: CARING FOR CLIENTS REQUIRING COMPLEX RESPIRATORY CARE: LOWERING RESPIRATORY DISORDERS & RESPIRATORY FAILURE
Fourth Edition: -Ch30 (p. 623-638 -PDF: pg1846) -Ch40 (p. 930-937 – PDF: pg 2713*)
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COMPLEX MIDTERM 1
WEEK 1: CARING FOR CLIENTS REQUIRING COMPLEX RESPIRATORY CARE: LOWERING RESPIRATORY DISORDERS & RESPIRATORY FAILURE
Fourth Edition: -Ch30 (p. 623-638 -PDF: pg1846) -Ch40 (p. 930-937 – PDF: pg 2713*)
-Ch70 (PDF: pg 5241) –Ch 68 (p.1742-1755 – PDF – 5128*) *Also need to read from Ch 19 about Acid/ Base
RESPIRATORY FAILURE & COMPLEX RESPIRATORY CARE
Objective:
-hypoxemic vs hypercapnic -differentiate between hypoxia + hypoxemia
-common pathologies and disorder that contribute to respiratory failure (venous thromboembolism + chest trauma)
-differentiate between hypoxia + hypoxemia
-ID the following V/G relationships: normal unit; V/Q mismatch; shunt; dead space
-Describe ARDs
-describe key concepts related to non-invasive + invasive resp support: (Peep, pressure support) + modes of ventilation (volume, pressure)
-describe nursing interventions related to resp failure
Overview:
-primary fxn of lungs is gas exchange
-process of effective gas exchange: ventilation, perfusion, diffusion: problems with any of the 3 can result in HYPOXEMIA or HYPERCARBIA
-Respiratory Assessment: inspection, ausc, palpation, percussion
-Ausc- AS fine crackles (hair rubbing), stridor (whitle), pleural friction rub (rubing together, coarse and rough)
-Cheyne strokes – crescendo, goes up and then weans
-Kussmul – deep and rapid resps
-Palpation – sub cut emphysemia feels like rice krispies
-Percussion- check for typamny, dullness etc
Hypoxemia- low oxygen in BLOOD Hypoxia – low oxygen in TISSUES
Ventilation: air moving in and out Perfusion: movement of blood capillaries
Diffusion: movement of gases between the alveoli and RBC
-think about: RBC - end organ perfusion, end organ oxygenation
-think about adventitious sounds: stridor, pleural friction rub, cheyne-stokes, breathing pattern, kussmal-Palpation: subcutaneous emphysema -tachypnea or bradypnea? 20-10
CONTINUED.....
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