what is the goal of treatment (expected outcome) for a patient with acute respiratory failure?

How Is Acute Respiratory Failure Treated? The goal of any treatment for respiratory failure is to improve airflow to the lungs, with an eye to reestablishing a healthy equilibrium of oxygen and carbon dioxide in the blood. This may include:

Full Answer

What are the goals and outcomes for a respiratory examinator?

Goals and Outcomes 1 Patient will maintain clear, open airways as evidence by normal breath sounds, normal rate and depth of respirations, and ability to effectively cough up secretions after treatments and deep breaths. 2 Patient will demonstrate increased air exchange. 3 Patient will classify methods to enhance secretion removal. More items...

What is respiratory failure nursing care plan?

Respiratory Failure Nursing Care Plan Respiratory failure is a syndrome wherein the lungs fail to provide adequate oxygenation or ventilation in the blood. It is a life-threatening deterioration of the gas exchange function of the lungs which leads to hypoxemia and hypercapnia.

What are the goals and outcomes of a pulmonary function test?

Goals and Outcomes. Patient maintains optimal gas exchange as evidenced by usual mental status, unlabored respirations at 12-20 per minute, oximetry results within normal range, blood gases within normal range, and baseline HR for patient. Patient maintains clear lung fields and remains free of signs of respiratory distress.

What are the treatments for respiratory failure?

The goal of any treatment for respiratory failure is to improve airflow to the lungs, with an eye to reestablishing a healthy equilibrium of oxygen and carbon dioxide in the blood. This may include: A tracheostomy, which is a surgical procedure for introducing air to the lungs through a tube in the windpipe, bypassing the mouth and nose.

What is the primary objective in the treatment of respiratory failure?

The first objective in the management of respiratory failure is to reverse and/or prevent tissue hypoxia. Hypercapnia unaccompanied by hypoxemia generally is well tolerated and probably is not a threat to organ function unless accompanied by severe acidosis.

What is the treatment for acute respiratory failure?

Treatments for respiratory failure may include oxygen therapy, medicines, and procedures to help your lungs rest and heal. Chronic respiratory failure can often be treated at home. If you have serious chronic respiratory failure, you may need treatment in a long-term care center.

What is the goal of nursing care for a patient who has ARDS?

The goal of care for ARDS patients is to maximize perfusion in the pulmonary capillary system by increasing oxygen transport between the alveoli and pulmonary capillaries. To achieve the goal, you need to increase fluid volume without overloading the patient.

What are some nursing interventions for acute respiratory failure?

Nursing ManagementManage nutrition.Treating the underlying cause or injury.Improve oxygenation with mechanical ventilation.Suction oral cavity.Give antibiotics.Deep venous thrombosis prophylaxis.Stress ulcer prophylaxis.Observe for barotrauma.More items...•

Which treatment is most appropriate for a patient in respiratory distress?

Although no specific therapy exists for ARDS, treatment of the underlying condition is essential, along with supportive care, noninvasive ventilation or mechanical ventilation using low tidal volumes, and conservative fluid management.

Is acute respiratory failure treatable?

Acute respiratory failure is a short-term condition. It occurs suddenly and is typically treated as a medical emergency. Chronic respiratory failure, however, is an ongoing condition. It gradually develops over time and requires long-term treatment.

What is the nursing diagnosis for respiratory failure?

Diagnoses. Commonly used NANDA-I nursing diagnoses for patients experiencing decreased oxygenation and dyspnea include Impaired Gas Exchange, Ineffective Breathing Pattern, Ineffective Airway Clearance, Decreased Cardiac Output, and Activity Intolerance.

What is the appropriate intervention for patients with acute respiratory distress syndrome ARDS )?

What is the treatment for ARDS? Treatment for ARDS typically aims to increase blood oxygen levels, provide breathing support, and treat the underlying cause of the disease. Oxygen and Ventilation. Most ARDS patients are placed on a mechanical ventilator, usually in the intensive care unit of a hospital.

What do nurses do for respiratory distress?

Put the client in a 45-degree or 90-degree sitting position, and turn your client every hour to make sure that the fluid inside the lungs is not stagnant in one place. This will give parts of the lungs to breathe. Moving the client will also facilitate drainage as steroids are provided.

What is the role of nurse patient with respiratory problems?

A respiratory nurse can provide critical care in an emergency, but they also help patients learn how to monitor and live with respiratory conditions. Often respiratory nurses will work with patients who are receiving oxygen treatments or are dependent on ventilators to stay alive.

What do you teach a patient with respiratory failure?

Take a deep breath in through your nose. Slowly breathe out through your mouth with your lips pursed for twice as long as you inhaled. You can also practice this breathing pattern while you bend, lift, climb stairs, or exercise. It slows down your breathing and helps move more air in and out of your lungs.

What important independent nursing interventions should be used in caring for a child with respiratory dysfunction?

Collaborative nursing interventions in the care of a child with respiratory dysfunction include suctioning to remove respiratory secretions, administering oxygen, and provid- ing humidification and expectorant therapy to help main- tain clear airways.

What is respiratory failure?

Essentially, at its most basic level, respiratory failure is inadequate gas exchange. Not enough oxygen is being exchanged in your lungs, and therefore it’s not getting into circulation. There are three main types: Type I is low levels of oxygen in the blood (hypoxia) – also called hypoxemic respiratory failure.

What is perioperative respiratory failure?

Type III is also called perioperative respiratory failure is basically when patients get atelectasis after general anesthesia or shock. Type III is a subset of Type I. Your body desperately needs oxygenated blood to function.

How long after intubation can you aspirate?

Many facilities require patients to wait for 12-24 hrs post-intubation to resume regular oral intake as well as a swallow evaluation.

Why is it important to promote a calming environment for patients?

When patients are anxious or cannot focus it can increase their work of breathing and exacerbate the issue. Promote a calming environment so all the patient has to worry about is breathing.

Why do you need to suction your oropharyngeal airway?

Some patients with trauma or neurological injury may require frequent suctioning and/or oropharyngeal airway/nasopharyngeal airway/intubation to ensure adequate oxygen delivery

Why is oral care important?

If a patient is intubated or receiving oxygen via nasal cannula/face mask or tent, or other methods of delivery, oral care is essential to protect the mucous membrane and prevent infection. Cluster care. Decreases oxygen demands if the patient’s rest can be maximized. Promote appropriate nutrition.

What are the major causes of lung damage?

Trauma, medication (oversedation, for example), various disease processes (COPD, asthma, PE, pneumonia), damage to the actual lungs/surrounding tissue/spinal cord or nerves supporting the lungs/brain, and inhalation injuries are the major ones.

What is respiratory failure in nursing?

Respiratory Failure Nursing Care Plan. Respiratory failure is a syndrome wherein the lungs fail to provide adequate oxygenation or ventilation in the blood. It is a life-threatening deterioration of the gas exchange function of the lungs which leads to hypoxemia and hypercapnia.

What is a careful assessment?

Determines degree/ extent of respiratory distress. A careful assessment provides for early recognition and intervention for problem.

Why does air flow freely in COPD?

Rationale. Ventilation is the movement of air in and out of the lungs. Normally, air flows freely in order to facilitate oxygenation and gas exchange. In a patient with COPD, airways are obstructed and narrowed leading to alveolar hypoventilation and carbon dioxide retention.

What to do if your patient is struggling to maintain their airway?

Prepare for rapid sequence intubation , if necessary.For the love of the airway, tell your Respiratory Therapist if your patient is struggling to maintain their airway.

What is acute respiratory distress syndrome?

Acute respiratory distress syndrome (also known as ARDS) is an acute lung condition that is evidenced by bilateral pulmonary infiltrates, which is like fluid in the lungs, and also refractory hypoxemia.

What is refractory hypoxemia?

The definition of refractory hypoxemia is hypoxemia that is unresponsive to treatment and a PaO2 level that remains low despite increasing FiO2. This is measured with the PaO2/FiO2 ratio of <300 (mild), <200 (moderate), or <100 (severe).

What is ARDS in medical terms?

Acute respiratory distress syndrome (also known as ARDS) is an acute lung condition that is evidenced by bilateral pulmonary infiltrates, which is like fluid in the lungs, and also refractory hypoxemia. So what is refractory hypoxemia? This is hypoxemia that is unresponsive to treatment.

How to treat a PE patient?

If the patient has a PE, you’re going to administer the appropriate anticoagulants, such as heparin. So, the underlying cause has to be treated and routinely reevaluated for the patient to progress. So, you’ll monitor the hemodynamics of your patient. The damage and the decreased compliance in the lungs causes the pressure in those lungs to build up. This can cause pressure to increase on the vessels, especially the major vessels leading to decreased cardiac output. So, hypoxia can also cause ischemia to the heart muscle, ultimately leading to cardiogenic shock.

Why do we need to treat ARDS?

We need to treat the underlying cause so that the body’s immune system and inflammatory responses can decrease and stop causing these reactions in the lungs. Let’s take a look at our care plans, starting with the subjective data. So the patient with ARDS is going to be experiencing shortness of breath and weakness.

How to help a patient who is wheezing?

For example, if the patient is wheezing, a breathing treatment might help to open those airways up. Remember oxygen is necessary for our body to function. So, if your patient is low on it, they need to be supplemented. If possible, place your patient in a high Fowler’s position and encourage them to turn, cough and deep breathe. This allows for adequate inspiration and expiration and helps to remove secretions from the lungs for better gas exchange.

What is the role of a patient in oxygenation?

Patient maintains clear lung fields and remains free of signs of respiratory distress. Patient verbalizes understanding of oxygen and other therapeutic interventions. Patient participates in procedures to optimize oxygenation and in management regimen within level of capability/condition.

How is gas exchanged between the alveoli and the pulmonary capillaries?

Gas is exchanged between the alveoli and the pulmonary capillaries via diffusion. Diffusion of oxygen and carbon dioxide occurs passively, according to their concentration differences across the alveolar-capillary barrier. These concentration differences must be maintained by ventilation (airflow) of the alveoli and perfusion ( blood flow) ...

How does hypoventilation affect gas exchange?

Rapid and shallow breathing patterns and hypoventilation affect gas exchange. Increased respiratory rate, use of accessory muscles, nasal flaring, abdominal breathing, and a look of panic in the patient’s eyes may be seen with hypoxia.

What are cue points in performing an assessment related to impaired gas exchange?

The patient’s general appearance may give clues to respiratory status. Observing the individual’s responses to activity are cue points in performing an assessment related to Impaired Gas Exchange.

Why is close monitoring important?

When administering oxygen, close monitoring is imperative to prevent unsafe increases in the patient’s PaO 2 which could result in apnea. If the patient is permitted to eat, provide oxygen to the patient but in a different manner (changing from mask to a nasal cannula). More oxygen will be consumed during the activity.

How to know if you have impaired gas exchange?

Changes in behavior and mental status can be early signs of impaired gas exchange. Cognitive changes may occur with chronic hypoxia. Monitor for signs and symptoms of atelectasis: bronchial or tubular breath sounds, crackles, diminished chest excursion, limited diaphragm excursion, and tracheal shift to affected side.

Does leaning forward help with dyspnea?

Leaning forward can help decrease dyspnea, possibly because gastric pressure allows better contraction of the diaphragm. Maintain an oxygen administration device as ordered, attempting to maintain oxygen saturation at 90% or greater. Supplemental oxygen may be required to maintain PaO 2 at an acceptable level.

What are the common goals and expected outcomes for Ineffective Airway Clearance?

The following are the common goals and expected outcomes for Ineffective Airway Clearance. Patient will maintain clear, open airways as evidence by normal breath sounds, normal rate and depth of respirations, and ability to effectively cough up secretions after treatments and deep breaths.

When to stop suctioning and provide supplemental oxygen?

Stop suctioning and provide supplemental oxygen if the patient experiences bradycardia, an increase in ventricular ectopy, and/or significant desaturation.

Why is coughing ineffective?

Coughing is a mechanism for clearing secretions. An ineffective cough compromises airway clearance and prevents mucus from being expelled. Respiratory muscle fatigue, severe bronchospasm, or thick and tenacious secretions are possible causes of ineffective cough.

Why is continuous assessment necessary?

Continuous assessment is necessary in order to know possible problems that may have lead to Ineffective Airway Clearance as well as name any concerns that may occur during nursing care.

What is the first priority for a patent airway?

Maintaining patent airway is always the first priority, especially in cases like trauma, acute neurological decompensation, or cardiac arrest. Auscultate lungs for presence of normal or adventitious breath sounds, as in the following: Abnormal breath sounds can be heard as fluid and mucus accumulate.

How does splinting help with coughing?

The proper sitting position and splinting of the abdomen promote effective coughing by increasing abdominal pressure and upward diaphragmatic movement. Controlled coughing methods help mobilize secretions from smaller airways to larger airways because the coughing is done at varying times. Ambulation promotes lung expansion, mobilizes secretions, and lessens atelectasis.

What is labored breathing?

Labored breathing may be a sign of respiratory infection that needs an appropriate treatment of antibiotics. Use pulse oximetry to monitor oxygen saturation; assess arterial blood gases (ABGs) Pulse oximetry is used to detect changes in oxygenation. Oxygen saturation should be maintained at 90% or greater.

What is the goal of therapy in acute hypercapnic respiratory failure?

The goal of therapy in acute hypercapnic respiratory failure is guarantee a set (blank) ventilation.

What is the goal of mechanical ventilation?

The goal of mechanical ventilation is either to support the patient until the underlying problem resolves or to maintain support of the patient with chronic ventilatory problems.

What is the most common cause of respiratory muscle fatigue?

Excessive (blank) is the most common cause of respiratory muscle fatigue. Work of breathing. Only patients with rapidly reversible conditions should undergo (blank) ventilation in acute setting. Noninvasive. The goal of therapy in acute hypercapnic respiratory failure is guarantee a set (blank) ventilation. Minute.

What is NIV for CHF?

CHF or left ventricular failure with pulmonary edema is treated with NIV. It is a first choice for eligible patients over intubation because it reduces both preload and afterload for the overworked heart.

How much blood flow is needed for alkalosis?

Alkalosis and hypocapnia reduce cerebral blood flow. This should be used cautiously and for brief periods of time. 25 to 30 mm Hg.

Is intubation good for COPD?

A. It appears to be a first choice over intubation in treating a cute respiratory failure in COPD exacerbations but is not as useful for severe stable COPD.

Does splinting the airway at the auto-pEEP level lessen the effect of the auto-p?

Application of extrinsic PEEP. Splinting the airway at the auto-PEEP level seems to lessen the effect of the auto-PEEP.

Causes

Respiratory Failure Nursing Care Plan

Objectives

Rationale For Intervention

References