NR-341 Exam 1 Study Guide primary ALL ANSWERS SOLVED LATEST 2022 /100% CORRECT GUARANTEED GRADE A+
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Course
NR 341 (NR341)
Institution
Champlain College
• Diagnostic Tests
Acute respiratory failure
o ABGs, Chest x-rays, CT, pulmonary function tests, end tidal CO2 monitoring, bronchoscopy.
• Assessments
o Lung sounds, work of breathing, use of accessory muscles, chest expansion, nasal flaring, respiratory rate, pulse ox
• Interventi...
• diagnostic tests acute respiratory failure o abgs
bronchoscopy • assessments
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NR 341 (NR341)
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NR-341 Exam 1 Study Guide primary ALL ANSWERS
SOLVED LATEST 2022 /100% CORRECT GUARANTEED
GRADE A+
Acute respiratory failure
• Diagnostic Tests
o ABGs, Chest x-rays, CT, pulmonary function tests, end tidal CO2 monitoring, bronchoscopy.
• Assessments
o Lung sounds, work of breathing, use of accessory muscles, chest expansion, nasal flaring,
respiratory rate, pulse ox
• Interventions
o Ineffective airway clearance reposition patient
o ARF
▪ Causes: pulmonary edema, atelectasis, pneumonia, COPD, asthma, ARDS, thoracic,
spinal or head injuries, drug overdose, neuromuscular disorders
▪ Type 1 - hypoxemic or oxygenation failure
• PAO2 less th
• an 60 MMHG
o Normal PaO2 = 80 - 100
• Hypoventilation
o Hyperventilation causes further issues when trying to correct this
• Intrapulmonary shunting
o Blood did not get oxygenated and dispersed to rest of body system
o Blood that is shunted from the right side of the heart to the left
without oxygenation.
o Based on rate ventilation and perfusion: Rate of ventilation= rate of
perfusion; ratio of VQ = 1
o Based on amount of ventilation and perfusion:
▪ Normal ventilation (V) IS 4 L/MIN
▪ Normal perfusion (Q) IS 5L/Min
▪ Normal V/Q Ratio IS 4/5 or 0.8
▪ VQ scan patient must lie for 30 minutes
o Tissue hypoxia anaerobic metabolism and lactic acidosis
o Normal Cardiac output
▪ 600 – 1000 ML/MIN of O2
▪ Low cardiac output decrease O2 blood to tissues anaerobic
metabolism production of lactic acid metabolic acidosis
▪ Type 2 - hypercapnic or ventilator failure
• PACO2 > 50 MM HG
• Increase in PaCO2 (hypercapnia) due to decrease O2 in body and CO2 can be
blown off
• Increase in ventilation excess CO2 blown off (hypocapnia)
• VQ mismatch not 1:1
▪ Assessment of respirator failure: most common hypoxemia restlessness
▪ Medical management: O2, bronchodilators, corticosteroids, ventilators, transfusion,
, 2
nutritional support, hemodynamic monitoring
, 3
▪ HGB 12- 16
• Anemic is less than 8 HGB
o Respiratory failure causes
▪ Failure to ventilate
▪ Failure to oxygenate
▪ Failure to protect airway
Acute Respiratory Distress Syndrome (ARDS)
• Noncardiogenic pulmonary edema- pulmonary edema not caused by a cardiac problem.
• Diagnostic criteria
o 1. PaO2/FiO2(decimal) ratio of less than 200 – PaO2 divided by Fi02 … 100 divided 21 =
▪ Optimal Ratio 476.19
▪ ***Decreasing PA02 levels despite increased FIO2 administration
o 2. Bilateral infiltrates not explained by something else. (Normally air should be black, you will
see white puffy stuff all over if you have this)
• Risk Factors. 4 Factors
o Sepsis #1***
o Pneumonia
o Trauma
o Aspiration of Gastric contents
• Pathophysiology
o Basic underlying patho: damage to type II pneumocyte, which produces surfactant
o 4 steps
▪ 1. Injury to the lung that stimulates the inflammatory response (either direct or indirect)
with stimulates inflammatory response. Inflammatory cells and their mediators damage
the alveolocapillary membrane.
▪ 2. Onset of pulmonary edema (blood cell, cell debris, stuff)
▪ 3. Alveoli start to collapse. Production of surfactant stop and alveoli collapse. Lungs
become less compliant.
▪ 4.Lungs become stiff and noncompliant. Lung becomes fibrotic. Severe gas exchange
impairment.
• Diagnostic Tests
o Chest x-ray
• Symptoms or ARDS:
o Dyspnea and tachypnea and hypoxemia, that does not improve with supplemental oxygen
therapy.
o Elevated PACO2 > 50 MM of HG
o Decreased PAO2 < 60 MM of HG
o V/Q mismatch
o O2 Satureation < 90%
o Hyperventilation with normal breath sounds
o Respiratory alkalosis
o Increased temperature and pulse
o Worsening chest x-rays that progress to “white out”
o Increased PIP on ventilation
o Eventual severe hypoxemia not improved with O2 therapy
o Late stages -> Eventually will hypoventilate -> respiratory acidosis
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