Nursing care on Respiratory Failure

Any rapid changes in respiratory fuction resulting in hypoxemia, haypercarnea or both is known as respiratory failure.

Hypxaemia:- whaen a patient receive less than 60% of O2 concentration is called hypoxaemia.

Hypercapnea:- when patient have insufficient  CO2 removal which causes increased PCO2 level .

Etiology :-

• Pulmonary disoders
• severe infection 
• pulmonary embolism 
• COPD
• Lung cancer
• Atelectasis
• Non pulmonary disorders
• Drug reaction 
• Head injury 
• Nuro-muscular disorder
• prolonged mechanical ventilation

Diagnostic Evaluation:-

• ABG reporting
• chest x-ray
• pulmonary spirometory
• CT scan

Clinical menifestation:-

• Hypoxaemia
• hypercapnia
• respiratory acidosis
• headache
• hypotention
• cynosis
• disorientation
• cardiac dysrhythmias
• Trachycardia
• restlessness
• patient may be loss his/her conscousness

Managment:-

• Pharmocological managment
• Bronchodialator to treat shrink and swellon bronchus
• Mucolytic drugs to treat excessive mucous production.
• Corticosteroids to booste the effect of drug.
• Antibiotic drugs to treat infection of lungs.
• Oxygen tharapy to full fill oxygen demand of body 

Nursing Managment 

1. Assessment:-

• Assess the patient condition.
• Check vital ,specially respiratory rate.
• Check airway clearness.
• Assess dietory pattern.
• Assess the respiratory depth, rhythm.
• Nursing Diagnosis :-
• Ineffective airway clearness R/T Excessive mucous production
• Impaired gaseous exchanges R/T Alveolar hypoventilation
• Altered cardiac output R/T Decrease venous return.
• Altered acid base balance R/T overzealous oxygen therapy
• Nutrition level less than body requirment R/T less intake or prolanged ventilator attechment.
• Nursing managment :-
1. Goal:-  Effective secretion clearing 
• Perform a comprehensive respiratory assessment like respiratory rate, depth,rhythm.
• Instruct patient in use of incentive spiramatory.
• Provide opportunity for rest period.
• Anticipate needs for emotional support.
• Administered prescribed drugs.

                2. Goal:- Maintain good O2 saturation.

• Assess  ABG report.
• Performed Neurological examination.
• Avoid sedation, and narcotic drugs.
• Administor prescribed oxygen concentration.
• If patient is intubated monitor carefully.
• Gave oral care properly.

                3. Goal:- Maintain cardiac output.

• Continuous cardiac monitoring.
• Assess heart sound.
• Provide fluid tharapy.
• Avoid fluid overload.
• Assess neck vein distention.
• Serial assessment of blood gases.

                4. Goal :-  Stabilized arterial blood gases.

• Administor oxygen therapy continuously at prescribed concentration(FIO2)
• Administor Albumine inj as per prescribtion.
• Closely monitor arterial blood gas analysis.

                5. goal:- maintain weight with 5% of basline weight.

• Assess nutritional status.
• Maintain adequeat nutrition with prescribed parenteral feeding.
• Avoid large glucose loads to meet caloric needs.
• Avoid Amino acid loads.
• Comformplacement of nosogestric tube in the stomach before initiating feeding.