The document defines acute respiratory failure as abnormal gas exchange resulting from dysfunction of the respiratory system that is potentially life-threatening. It can be caused by issues in the lungs, chest wall, or central nervous system control of breathing. Signs include altered mental status, cyanosis, increased work of breathing, and abnormal blood gases. Diagnostic tests may include blood gases, chest x-ray, and pulmonary function tests. Risk factors include smoking, age, infection, and chronic lung disease. Treatment involves addressing the underlying cause, supplemental oxygen, bronchodilators, diuretics, and vasodilators. Nursing care focuses on monitoring respiratory status, clearing secretions, managing oxygen needs, and patient education.
The document discusses acute respiratory failure, defining it as a rapid and significant compromise in the lungs' ability to exchange carbon dioxide and oxygen. There are two main types: type 1 is impaired gas exchange seen as hypoxemia, while type 2 is impaired ventilation seen as hypercapnia. Causes include conditions affecting the lungs like pneumonia as well as non-pulmonary issues. Surgery, anesthesia, COPD and smoking can also impact pulmonary function and risk of postoperative respiratory failure. Good preoperative optimization is important to reduce risks.
Acute respiratory failure occurs when the pulmonary system can no longer meet the body's metabolic demands. It can be hypoxaemic, with an oxygen level below 60 mmHg, or hypercapnic, with a carbon dioxide level over 50 mmHg. Respiratory failure results from issues in oxygen intake and carbon dioxide removal, due to problems in ventilation, perfusion matching, gas exchange, or other pathologies. It is monitored clinically and with blood tests, and treated by addressing the underlying cause, providing supportive oxygen therapy or ventilation support like CPAP or mechanical ventilation if needed.
Respiratory failure and the acute respiratory distress syndrome (and shock) Jim Lavelle
The document provides an overview of respiratory failure and mechanical ventilation. It discusses the types and pathophysiology of respiratory failure, key ventilator settings, the definition and management of acute respiratory distress syndrome (ARDS), and some basics about shock. The goal is to help understand arterial blood gases, optimize ventilator settings, and improve survival in ARDS patients.
Early Detection And Management Of Respiratory FailureDang Thanh Tuan
This document discusses early detection and treatment of respiratory failure in children. It defines respiratory failure as inadequate gas exchange leading to low oxygen and/or high carbon dioxide levels. Evaluation involves arterial blood gas analysis to measure oxygen and carbon dioxide levels. Causes include airway obstruction, lung disease, neurological issues, and muscle problems. Three clinical profiles - mechanical, neuromuscular, and breathing control dysfunction - help guide diagnosis and treatment. Supportive care includes oxygen therapy and ventilation, while specific therapies target the underlying cause.
Acute respiratory failure is defined as low blood oxygen and high blood carbon dioxide levels caused by impaired gas exchange in the lungs. It can be caused by conditions affecting breathing muscles/nerves, lung diseases, injuries, or drugs/alcohol. Symptoms include shortness of breath, fatigue, and confusion. Treatment involves oxygen therapy, ventilator support if needed, and treating any underlying conditions. Nursing care focuses on positioning, infection prevention, nutrition, psychological support, and close monitoring of the patient.
1) Respiratory failure is defined as failure of oxygenation or carbon dioxide elimination and can be acute or chronic. It is classified as type 1 (hypoxemic) or type 2 (hypercapnic).
2) Causes of acute respiratory failure include hypoventilation, V/Q mismatching, intrapulmonary shunting, and diffusion abnormalities. Common causes are pneumonia, pulmonary edema, and ARDS.
3) Diagnosis involves clinical presentation, blood gas analysis, chest imaging, and pulmonary function tests. Management focuses on airway support, oxygen therapy, mechanical ventilation, and treating the underlying cause.
This document provides an overview of acute respiratory failure in pediatrics. It defines respiratory failure as the inability of the lungs to provide sufficient oxygen or remove carbon dioxide to meet metabolic demands. It describes the epidemiology, etiology, pathophysiology, monitoring, and management of both types of respiratory failure. The objectives are to recognize signs of respiratory failure, describe developmental differences between children and adults, list causes, review mechanisms, and discuss clinical interventions like ventilation support.
Respiratory failure can occur when the lungs cannot properly oxygenate the blood or eliminate carbon dioxide. This can be caused by issues with the lungs, chest wall, respiratory control center or respiratory muscles. Mechanical ventilation and artificial airways like endotracheal tubes or tracheostomies may be needed to support or replace inadequate breathing. Positive pressure ventilators deliver air under pressure through an artificial airway to oxygenate the blood. Nurses monitor patients on ventilators and manage artificial airways.
The document discusses acute respiratory failure, defining it as a rapid and significant compromise in the lungs' ability to exchange carbon dioxide and oxygen. There are two main types: type 1 is impaired gas exchange seen as hypoxemia, while type 2 is impaired ventilation seen as hypercapnia. Causes include conditions affecting the lungs like pneumonia as well as non-pulmonary issues. Surgery, anesthesia, COPD and smoking can also impact pulmonary function and risk of postoperative respiratory failure. Good preoperative optimization is important to reduce risks.
Acute respiratory failure occurs when the pulmonary system can no longer meet the body's metabolic demands. It can be hypoxaemic, with an oxygen level below 60 mmHg, or hypercapnic, with a carbon dioxide level over 50 mmHg. Respiratory failure results from issues in oxygen intake and carbon dioxide removal, due to problems in ventilation, perfusion matching, gas exchange, or other pathologies. It is monitored clinically and with blood tests, and treated by addressing the underlying cause, providing supportive oxygen therapy or ventilation support like CPAP or mechanical ventilation if needed.
Respiratory failure and the acute respiratory distress syndrome (and shock) Jim Lavelle
The document provides an overview of respiratory failure and mechanical ventilation. It discusses the types and pathophysiology of respiratory failure, key ventilator settings, the definition and management of acute respiratory distress syndrome (ARDS), and some basics about shock. The goal is to help understand arterial blood gases, optimize ventilator settings, and improve survival in ARDS patients.
Early Detection And Management Of Respiratory FailureDang Thanh Tuan
This document discusses early detection and treatment of respiratory failure in children. It defines respiratory failure as inadequate gas exchange leading to low oxygen and/or high carbon dioxide levels. Evaluation involves arterial blood gas analysis to measure oxygen and carbon dioxide levels. Causes include airway obstruction, lung disease, neurological issues, and muscle problems. Three clinical profiles - mechanical, neuromuscular, and breathing control dysfunction - help guide diagnosis and treatment. Supportive care includes oxygen therapy and ventilation, while specific therapies target the underlying cause.
Acute respiratory failure is defined as low blood oxygen and high blood carbon dioxide levels caused by impaired gas exchange in the lungs. It can be caused by conditions affecting breathing muscles/nerves, lung diseases, injuries, or drugs/alcohol. Symptoms include shortness of breath, fatigue, and confusion. Treatment involves oxygen therapy, ventilator support if needed, and treating any underlying conditions. Nursing care focuses on positioning, infection prevention, nutrition, psychological support, and close monitoring of the patient.
1) Respiratory failure is defined as failure of oxygenation or carbon dioxide elimination and can be acute or chronic. It is classified as type 1 (hypoxemic) or type 2 (hypercapnic).
2) Causes of acute respiratory failure include hypoventilation, V/Q mismatching, intrapulmonary shunting, and diffusion abnormalities. Common causes are pneumonia, pulmonary edema, and ARDS.
3) Diagnosis involves clinical presentation, blood gas analysis, chest imaging, and pulmonary function tests. Management focuses on airway support, oxygen therapy, mechanical ventilation, and treating the underlying cause.
This document provides an overview of acute respiratory failure in pediatrics. It defines respiratory failure as the inability of the lungs to provide sufficient oxygen or remove carbon dioxide to meet metabolic demands. It describes the epidemiology, etiology, pathophysiology, monitoring, and management of both types of respiratory failure. The objectives are to recognize signs of respiratory failure, describe developmental differences between children and adults, list causes, review mechanisms, and discuss clinical interventions like ventilation support.
Respiratory failure can occur when the lungs cannot properly oxygenate the blood or eliminate carbon dioxide. This can be caused by issues with the lungs, chest wall, respiratory control center or respiratory muscles. Mechanical ventilation and artificial airways like endotracheal tubes or tracheostomies may be needed to support or replace inadequate breathing. Positive pressure ventilators deliver air under pressure through an artificial airway to oxygenate the blood. Nurses monitor patients on ventilators and manage artificial airways.
Management of persistent hypoxemic respiratory failure in the icu garpestadDang Thanh Tuan
The document discusses management of persistent hypoxemic respiratory failure in ICU patients. It describes a case of a patient who developed this after abdominal surgery and peritonitis. It then discusses various ventilator strategies and their risks and benefits for improving oxygenation while minimizing lung injury, including low tidal volume ventilation, optimal levels of PEEP, recruitment maneuvers, prone positioning, and permissive hypercapnia. It summarizes several key clinical trials that have informed best practices.
Ventilatory management of Acute Hypercapnic Respiratory FailureVitrag Shah
Presentation on ventilatory management in Acute Hypercapnic Respiratory Failure
Updated information till 17/8/16
For powerpoint format, contact dr.vitrag@gmail.com
http://www.medicalgeek.com/presentation/36513-ventilatory-management-acute-hypercapnic-respiratory-failure-presentation.html
Download review articles and guidelines for ventilatory management in COPD & Asthma
http://www.medicalgeek.com/articles-and-news/36514-articles-ventilatory-management-copd-asthma.html
Acute respiratory failure is a life-threatening condition caused by the failure of oxygen and carbon dioxide exchange in the lungs. Prompt recognition and initiation of supportive treatments like oxygen supplementation are crucial for successful outcomes. Blood gas analysis helps differentiate between pulmonary and extra-pulmonary causes of hypoxemia and hypercapnia, with an increased alveolar-arterial oxygen difference being a sensitive indicator of respiratory diseases interfering with gas exchange. Management involves treating the underlying etiology, providing oxygen, and considering intubation and mechanical ventilation for persistent hypoxemia, progressive acidosis, or altered mental status.
Respiratory failure occurs when there is inadequate gas exchange due to dysfunction of the respiratory system. It can be hypoxemic (type 1), hypercapnic/ventilatory (type 2), or peri-operative (type 3). Causes of type 1 failure include V/Q mismatching and shunting, while type 2 is caused by hypoventilation from reduced drive or neuromuscular problems. The document discusses the physiology behind these types of failure, evaluates patients, and examines the work of breathing and components of the respiratory system that can fail.
This document discusses respiratory failure, which occurs when the respiratory system fails in gas exchange. It defines two main types - hypoxemic respiratory failure, defined as low blood oxygen, and hypercapnic respiratory failure, defined as high blood carbon dioxide. The document then covers the anatomy and physiology of respiration, diagnostic evaluation of respiratory failure, treatment including mechanical ventilation, and specific causes of respiratory failure like infection, airway obstruction, and cardiac issues.
The document discusses respiratory failure and its management. It begins by defining respiratory failure and describing the types. It then lists common causes and presents results of diagnostic tests for a patient, including abnormal blood gases, imaging findings, and clinical signs. Treatment for this patient's respiratory failure included mechanical ventilation, bronchodilators, diuretics, and oxygen therapy. Complications of respiratory failure mentioned include cardiac or respiratory arrest.
This document discusses respiratory distress and respiratory failure. Respiratory distress refers to increased work of breathing, while respiratory failure is the inability of the lungs to provide oxygen or remove carbon dioxide. Respiratory failure can be acute or chronic. It can occur due to problems with the respiratory pump (central nervous system issues, muscle weakness) or due to airway/lung dysfunction (conditions affecting gas exchange like asthma, pneumonia). Proper monitoring of patients with respiratory distress or failure includes clinical examination, blood gas analysis, and oximetry. Immediate treatment of acute respiratory failure focuses on oxygenation and ventilation. Chronic respiratory failure often has a more insidious onset and requires careful monitoring, especially during sleep or illness.
This document presents a case study of a 50-year-old male patient admitted to the pulmonology department with acute respiratory failure. The patient reported symptoms of breathlessness, cough with expectoration, fever and chest pain. On examination, the patient had elevated temperature, blood pressure, pulse and respiratory rate. Based on the patient's history of COPD and investigations, he was diagnosed with acute respiratory failure. His treatment plan included antibiotics, bronchodilators and corticosteroids.
This document discusses anesthesia considerations for patients with chronic lung disease undergoing surgery. It covers preoperative assessment of pulmonary function, intraoperative monitoring and lung isolation techniques, positioning, and one lung ventilation. Postoperative management focuses on analgesia and complications related to chronic lung conditions. Preoperative optimization aims to improve patient risk stratification and respiratory status prior to surgery.
This document discusses chronic respiratory failure and various treatment strategies. It covers topics such as acute respiratory failure, exacerbations of chronic obstructive airway disease, ventilation techniques, adjunctive treatments, lung recruitment strategies, hypercapnia, and lung replacement options including extracorporeal membrane oxygenation and novelung. The overall approach outlined is to maximize protective ventilation using adjuncts if needed, employ novelung for elevated carbon dioxide, and consider extracorporeal membrane oxygenation for continuing hypoxia. Reversibility of the patient's condition is emphasized over simply extending life.
Acute respiratory failure occurs when the respiratory system fails to maintain adequate gas exchange. There are two main types: hypoxemic respiratory failure, characterized by low oxygen levels, and acute ventilatory failure, characterized by high carbon dioxide levels. Hypoxemic failure is most common and can result from conditions that impair gas exchange like pneumonia or pulmonary edema. Ventilatory failure involves impaired breathing and can be caused by conditions that increase breathing workload like COPD. Diagnosis involves blood gas analysis and imaging. Treatment focuses on supporting oxygenation and ventilation through oxygen supplementation, ventilation support, and treating underlying causes.
Acute Respiratory Distress Syndrome (ARDS) is a clinical syndrome characterized by hypoxemia, bilateral pulmonary infiltrates, and respiratory failure. The document defines ARDS and discusses its etiology, pathophysiology, clinical features, diagnosis, and evidence-based treatment recommendations. Key points include low tidal volume ventilation to minimize lung injury, conservative fluid management, use of PEEP to recruit alveoli while limiting pressures, and treating the underlying cause of ARDS. Outcomes remain poor with high mortality rates, though some patients fully recover lung function over time.
Acute respiratory failure is defined by the sudden onset of severe impairment of pulmonary gas exchange
Characterized by the inability of the lungs to meet the body’s metabolic needs for the transport of oxygen (O2) into the blood and/or removal of carbon dioxide (CO2) from the blood.
Respiratory failure results from inadequate gas exchange by the respiratory system - Meaning that the arterial oxygen, carbon dioxide or both cannot be kept at normal levels.
The document provides objectives and information about acute respiratory failure. It aims to introduce acute respiratory failure, define it, classify it, explain its pathophysiology, risk factors, etiologies, clinical features, management and complications. Acute respiratory failure can be classified as hypoxemic (type I) or hypercapnic (type II). Hypoxemic respiratory failure involves low oxygen levels and normal or low carbon dioxide levels, while hypercapnic respiratory failure involves high carbon dioxide levels and often low oxygen levels as well. The most common cause of hypoxemic respiratory failure is ventilation-perfusion mismatching, while causes of hypercapnic respiratory failure include airway abnormalities and central nervous system issues.
This document provides information on chronic obstructive pulmonary disease (COPD) including its definition, pathophysiology, diagnosis, and pre-operative optimization. It defines COPD as a common lung disease characterized by persistent airflow limitation associated with an enhanced inflammatory response in the airways. The document discusses the types and features of COPD including chronic bronchitis and emphysema. It covers the risk factors, pathogenesis, pathology, and pathophysiology of COPD. Details are provided on pre-operative patient assessment including history, physical exam, investigations like chest x-ray, spirometry, ABG and optimization measures such as smoking cessation and bronchodilation therapy.
This document discusses the pathophysiology of acute respiratory failure, including different types and underlying mechanisms. It presents a case study of a patient named John admitted with worsening asthma symptoms and hypoxemia. Key factors affecting John's condition are decreased lung compliance, increased airway resistance and dead space, and ventilation/perfusion mismatch leading to hypoxia. Mechanical ventilation aims to improve oxygenation by reducing the work of breathing and improving lung mechanics, but edema remains a risk that can counter these benefits.
Based on the information provided, this patient is experiencing hypoxic respiratory failure and is not adequately compensating despite high-flow oxygen therapy. Mechanical ventilation would be indicated to support oxygenation and ventilation until the underlying pneumonia improves with treatment.
This document summarizes information about several drugs used to treat respiratory conditions. It discusses antibiotics like Cipro which kill bacteria, and antihistamines like Allegra and Flonase which block histamine. Cipro treats infections by interfering with bacterial DNA synthesis. Flonase is a nasal spray that reduces nasal inflammation and relieves allergy symptoms. Allegra treats hay fever symptoms and hives without causing drowsiness like older antihistamines.
Antibiotics In Acute Respiratory Failureshabeel pn
abscess advanced trauma life support anterio advanced trauma life support antibiotics apically repositioned flap dental diseases dr dr shabeel drshabeel’s face eye trauma lidocaine anodontia management medical medicine misuse and abuse orthodontics teeth braces pharmacy pn preparation dental students for community based ed presentations s abscess abscess tooth active orthodonti shabeel shabeel"s shabeel’s shabeelpn trends of antimicrobial usage in dental practice View all
’s abscess abscess advanced trauma life support anterio abscess tooth active orthodontics adolescent advanced trauma life support aesthetic dentistry airway management alignment of teeth amalgam anesthesia in dentistry anesthetics in dentistry anterior open bite antibiotic resistanace antibiotics antibiotics and leukopenia aphthous ulcers apically repositioned flap apicoectomy appliances arch dental arch form orthodontics braces arch length orthodontics braces arch wire orthodontist braces ayurvedha baby teeth bloger boil books braces braces teeth cancer canker sore pain cavity preparation children community based learning congenitally missing teeth cosmetic dentistry csf leaks dental dental anesthetics dental restorations dental teeth dento alveolar fractures disease
Management of persistent hypoxemic respiratory failure in the icu garpestadDang Thanh Tuan
The document discusses management of persistent hypoxemic respiratory failure in ICU patients. It describes a case of a patient who developed this after abdominal surgery and peritonitis. It then discusses various ventilator strategies and their risks and benefits for improving oxygenation while minimizing lung injury, including low tidal volume ventilation, optimal levels of PEEP, recruitment maneuvers, prone positioning, and permissive hypercapnia. It summarizes several key clinical trials that have informed best practices.
Ventilatory management of Acute Hypercapnic Respiratory FailureVitrag Shah
Presentation on ventilatory management in Acute Hypercapnic Respiratory Failure
Updated information till 17/8/16
For powerpoint format, contact dr.vitrag@gmail.com
http://www.medicalgeek.com/presentation/36513-ventilatory-management-acute-hypercapnic-respiratory-failure-presentation.html
Download review articles and guidelines for ventilatory management in COPD & Asthma
http://www.medicalgeek.com/articles-and-news/36514-articles-ventilatory-management-copd-asthma.html
Acute respiratory failure is a life-threatening condition caused by the failure of oxygen and carbon dioxide exchange in the lungs. Prompt recognition and initiation of supportive treatments like oxygen supplementation are crucial for successful outcomes. Blood gas analysis helps differentiate between pulmonary and extra-pulmonary causes of hypoxemia and hypercapnia, with an increased alveolar-arterial oxygen difference being a sensitive indicator of respiratory diseases interfering with gas exchange. Management involves treating the underlying etiology, providing oxygen, and considering intubation and mechanical ventilation for persistent hypoxemia, progressive acidosis, or altered mental status.
Respiratory failure occurs when there is inadequate gas exchange due to dysfunction of the respiratory system. It can be hypoxemic (type 1), hypercapnic/ventilatory (type 2), or peri-operative (type 3). Causes of type 1 failure include V/Q mismatching and shunting, while type 2 is caused by hypoventilation from reduced drive or neuromuscular problems. The document discusses the physiology behind these types of failure, evaluates patients, and examines the work of breathing and components of the respiratory system that can fail.
This document discusses respiratory failure, which occurs when the respiratory system fails in gas exchange. It defines two main types - hypoxemic respiratory failure, defined as low blood oxygen, and hypercapnic respiratory failure, defined as high blood carbon dioxide. The document then covers the anatomy and physiology of respiration, diagnostic evaluation of respiratory failure, treatment including mechanical ventilation, and specific causes of respiratory failure like infection, airway obstruction, and cardiac issues.
The document discusses respiratory failure and its management. It begins by defining respiratory failure and describing the types. It then lists common causes and presents results of diagnostic tests for a patient, including abnormal blood gases, imaging findings, and clinical signs. Treatment for this patient's respiratory failure included mechanical ventilation, bronchodilators, diuretics, and oxygen therapy. Complications of respiratory failure mentioned include cardiac or respiratory arrest.
This document discusses respiratory distress and respiratory failure. Respiratory distress refers to increased work of breathing, while respiratory failure is the inability of the lungs to provide oxygen or remove carbon dioxide. Respiratory failure can be acute or chronic. It can occur due to problems with the respiratory pump (central nervous system issues, muscle weakness) or due to airway/lung dysfunction (conditions affecting gas exchange like asthma, pneumonia). Proper monitoring of patients with respiratory distress or failure includes clinical examination, blood gas analysis, and oximetry. Immediate treatment of acute respiratory failure focuses on oxygenation and ventilation. Chronic respiratory failure often has a more insidious onset and requires careful monitoring, especially during sleep or illness.
This document presents a case study of a 50-year-old male patient admitted to the pulmonology department with acute respiratory failure. The patient reported symptoms of breathlessness, cough with expectoration, fever and chest pain. On examination, the patient had elevated temperature, blood pressure, pulse and respiratory rate. Based on the patient's history of COPD and investigations, he was diagnosed with acute respiratory failure. His treatment plan included antibiotics, bronchodilators and corticosteroids.
This document discusses anesthesia considerations for patients with chronic lung disease undergoing surgery. It covers preoperative assessment of pulmonary function, intraoperative monitoring and lung isolation techniques, positioning, and one lung ventilation. Postoperative management focuses on analgesia and complications related to chronic lung conditions. Preoperative optimization aims to improve patient risk stratification and respiratory status prior to surgery.
This document discusses chronic respiratory failure and various treatment strategies. It covers topics such as acute respiratory failure, exacerbations of chronic obstructive airway disease, ventilation techniques, adjunctive treatments, lung recruitment strategies, hypercapnia, and lung replacement options including extracorporeal membrane oxygenation and novelung. The overall approach outlined is to maximize protective ventilation using adjuncts if needed, employ novelung for elevated carbon dioxide, and consider extracorporeal membrane oxygenation for continuing hypoxia. Reversibility of the patient's condition is emphasized over simply extending life.
Acute respiratory failure occurs when the respiratory system fails to maintain adequate gas exchange. There are two main types: hypoxemic respiratory failure, characterized by low oxygen levels, and acute ventilatory failure, characterized by high carbon dioxide levels. Hypoxemic failure is most common and can result from conditions that impair gas exchange like pneumonia or pulmonary edema. Ventilatory failure involves impaired breathing and can be caused by conditions that increase breathing workload like COPD. Diagnosis involves blood gas analysis and imaging. Treatment focuses on supporting oxygenation and ventilation through oxygen supplementation, ventilation support, and treating underlying causes.
Acute Respiratory Distress Syndrome (ARDS) is a clinical syndrome characterized by hypoxemia, bilateral pulmonary infiltrates, and respiratory failure. The document defines ARDS and discusses its etiology, pathophysiology, clinical features, diagnosis, and evidence-based treatment recommendations. Key points include low tidal volume ventilation to minimize lung injury, conservative fluid management, use of PEEP to recruit alveoli while limiting pressures, and treating the underlying cause of ARDS. Outcomes remain poor with high mortality rates, though some patients fully recover lung function over time.
Acute respiratory failure is defined by the sudden onset of severe impairment of pulmonary gas exchange
Characterized by the inability of the lungs to meet the body’s metabolic needs for the transport of oxygen (O2) into the blood and/or removal of carbon dioxide (CO2) from the blood.
Respiratory failure results from inadequate gas exchange by the respiratory system - Meaning that the arterial oxygen, carbon dioxide or both cannot be kept at normal levels.
The document provides objectives and information about acute respiratory failure. It aims to introduce acute respiratory failure, define it, classify it, explain its pathophysiology, risk factors, etiologies, clinical features, management and complications. Acute respiratory failure can be classified as hypoxemic (type I) or hypercapnic (type II). Hypoxemic respiratory failure involves low oxygen levels and normal or low carbon dioxide levels, while hypercapnic respiratory failure involves high carbon dioxide levels and often low oxygen levels as well. The most common cause of hypoxemic respiratory failure is ventilation-perfusion mismatching, while causes of hypercapnic respiratory failure include airway abnormalities and central nervous system issues.
This document provides information on chronic obstructive pulmonary disease (COPD) including its definition, pathophysiology, diagnosis, and pre-operative optimization. It defines COPD as a common lung disease characterized by persistent airflow limitation associated with an enhanced inflammatory response in the airways. The document discusses the types and features of COPD including chronic bronchitis and emphysema. It covers the risk factors, pathogenesis, pathology, and pathophysiology of COPD. Details are provided on pre-operative patient assessment including history, physical exam, investigations like chest x-ray, spirometry, ABG and optimization measures such as smoking cessation and bronchodilation therapy.
This document discusses the pathophysiology of acute respiratory failure, including different types and underlying mechanisms. It presents a case study of a patient named John admitted with worsening asthma symptoms and hypoxemia. Key factors affecting John's condition are decreased lung compliance, increased airway resistance and dead space, and ventilation/perfusion mismatch leading to hypoxia. Mechanical ventilation aims to improve oxygenation by reducing the work of breathing and improving lung mechanics, but edema remains a risk that can counter these benefits.
Based on the information provided, this patient is experiencing hypoxic respiratory failure and is not adequately compensating despite high-flow oxygen therapy. Mechanical ventilation would be indicated to support oxygenation and ventilation until the underlying pneumonia improves with treatment.
This document summarizes information about several drugs used to treat respiratory conditions. It discusses antibiotics like Cipro which kill bacteria, and antihistamines like Allegra and Flonase which block histamine. Cipro treats infections by interfering with bacterial DNA synthesis. Flonase is a nasal spray that reduces nasal inflammation and relieves allergy symptoms. Allegra treats hay fever symptoms and hives without causing drowsiness like older antihistamines.
Antibiotics In Acute Respiratory Failureshabeel pn
abscess advanced trauma life support anterio advanced trauma life support antibiotics apically repositioned flap dental diseases dr dr shabeel drshabeel’s face eye trauma lidocaine anodontia management medical medicine misuse and abuse orthodontics teeth braces pharmacy pn preparation dental students for community based ed presentations s abscess abscess tooth active orthodonti shabeel shabeel"s shabeel’s shabeelpn trends of antimicrobial usage in dental practice View all
’s abscess abscess advanced trauma life support anterio abscess tooth active orthodontics adolescent advanced trauma life support aesthetic dentistry airway management alignment of teeth amalgam anesthesia in dentistry anesthetics in dentistry anterior open bite antibiotic resistanace antibiotics antibiotics and leukopenia aphthous ulcers apically repositioned flap apicoectomy appliances arch dental arch form orthodontics braces arch length orthodontics braces arch wire orthodontist braces ayurvedha baby teeth bloger boil books braces braces teeth cancer canker sore pain cavity preparation children community based learning congenitally missing teeth cosmetic dentistry csf leaks dental dental anesthetics dental restorations dental teeth dento alveolar fractures disease
Chapter 7 respiratory system pharmacologyjlutakome
The document summarizes information about several medications used in the respiratory system:
- Allegra is an antihistamine that works by blocking histamine to relieve symptoms of allergies such as sneezing and itchy eyes. Side effects can include cough and stomach upset.
- Hycodan is an antitussive containing hydrocodone and homatropine to suppress coughs caused by colds. It should only be used short-term due to risk of overdose and side effects like nausea.
- Flonase is a corticosteroid nasal spray used to reduce inflammation in the nose from conditions like sinusitis or polyps. It has minimal side effects like a burning sensation or dryness in
The document discusses interpretation of spirometry data. It provides normal values for measures like FEV1, FVC and FEF25-75. An obstructive pattern is defined as a decreased FEV1/FVC ratio below 0.7, with decreased FEV1 and possibly decreased FVC. A restrictive pattern shows a normal or mildly reduced FEV1 but reduced FVC. Acceptability and repeatability criteria for spirometry tests are outlined.
The document provides information on spirometry testing including:
- Contraindications and patient preparation for the test
- Procedures for slow vital capacity, forced vital capacity, and maximum voluntary ventilation tests
- Interpretation of test results including distinguishing obstructive, restrictive, and mixed abnormalities and assessing severity
- Potential errors in test performance and assuring technical acceptability of results
Antibiotics are commonly used therapies in critical care to optimize patient outcomes. Antibiotic stewardship programs aim to optimize antibiotic use to improve patient care while minimizing unintended consequences like antibiotic resistance. Such programs typically establish antimicrobial management teams to implement interventions like guidelines for appropriate antibiotic selection, dosing, and duration to reduce inappropriate use. However, inappropriate antibiotic use remains common, contributing to increased patient morbidity, costs and antibiotic resistance.
Acute pulmonary failure occurs when abnormal gas exchange results from dysfunction of the respiratory system that threatens life. Risk factors include smoking, infections, lung disease, and neurological or muscular disorders. Symptoms include altered mental status, cyanosis, respiratory distress, and abnormal blood gases. Treatment focuses on stabilizing the patient, treating the underlying cause, and supporting respiratory function through oxygen, ventilation, suctioning, and positioning. Nursing care aims to maintain the airway, enhance gas exchange and nutrition, prevent complications, and provide education to the patient.
This document provides an overview of acute respiratory distress syndrome (ARDS) including its definition, pathophysiology, clinical presentation, diagnosis, and management. Some key points:
- ARDS is characterized by acute hypoxemic respiratory failure due to widespread inflammation and fluid buildup in the lungs.
- Treatment involves supportive care with mechanical ventilation using low tidal volumes, maintaining adequate oxygen levels, treating the underlying cause, and considering rescue therapies for severe cases like prone positioning or extracorporeal membrane oxygenation.
- Mortality remains high at around 26-58% depending on severity, with the most common causes of death being complications of the initial insult or secondary infections like pneumonia. Ongoing research focuses on
The document discusses venting. In a few short sentences, it introduces the topic of venting without providing many details. The document does not have enough context or information to generate a multi-sentence summary while maintaining accuracy.
RESPIRATORY FAILURE of all 4 types .pptxshaikashraf14
1. Respiratory failure is a condition where the respiratory system fails in gas exchange due to dysfunction of respiratory components.
2. The respiratory center located in the brainstem controls rhythmic breathing through various centers that regulate rate and depth.
3. Chemoreceptors in the brainstem and carotid/aortic bodies sense changes in blood gases and stimulate breathing in response to hypoxia and hypercapnia.
4. The type of respiratory failure is classified based on blood gas abnormalities and can be hypoxemic, hypercapnic, or involve both.
Post operative care unit , anesthesia pacuraazz4ever
The document discusses the structure and contents of a crash cart in the post anesthesia care unit (PACU). It describes 5 drawers in the crash cart containing various medications, equipment, and supplies needed for emergencies. These include medications for cardiac arrest, intubation, hypotension and more. Equipment includes airways, catheters, surgical tools. Monitoring, oxygen supplies and suction are also available in the PACU. Post-operative patient evaluation assesses respiratory, cardiovascular and renal function among other things.
Anaesthesic Considerations in COPD.pptxsanikashukla2
The document discusses anaesthetic considerations for patients with chronic obstructive pulmonary disease (COPD). It defines COPD and its subtypes chronic bronchitis and emphysema. It describes taking a thorough history including dyspnea, cough, smoking history and current medications. The physical exam focuses on signs of respiratory distress and lung examination. Key investigations include spirometry, chest X-ray and blood gases which may show respiratory acidosis or chronic respiratory failure. Preoperative planning considers optimizing the patient's pulmonary status and intraoperative management focuses on lung-protective ventilation.
1) Acute respiratory distress syndrome (ARDS) is a life-threatening lung condition caused by direct or indirect injury to the lungs whereby the alveolar capillary membrane becomes damaged and permeable, resulting in pulmonary edema.
2) ARDS is characterized by hypoxemia, reduced lung compliance, and diffuse pulmonary infiltrates seen on chest imaging.
3) Treatment involves supportive care in an intensive care unit including mechanical ventilation, supplemental oxygen, and positioning therapies like prone positioning to improve oxygenation.
Chronic Obstructive Pulmonary Disease (COPD) is a common lung disease characterized by persistent respiratory symptoms and airflow limitation. It includes chronic bronchitis and emphysema. The main risk factor is cigarette smoking. Symptoms include dyspnea, cough, and sputum production. Diagnosis is confirmed by spirometry showing airflow limitation. Management involves smoking cessation, bronchodilators, pulmonary rehabilitation, oxygen therapy, and treating exacerbations with corticosteroids and antibiotics.
1) Respiratory failure occurs when the respiratory system fails in gas exchange, and can be hypoxaemic (low oxygen tension) or ventilatory (insufficient carbon dioxide elimination). Common causes include COPD, asthma, and neuromuscular fatigue.
2) Acute respiratory distress syndrome (ARDS) is the clinical manifestation of acute pulmonary inflammatory states that damage the alveolar-capillary membrane. Risk factors include sepsis, pneumonia, aspiration, trauma, and pancreatitis.
3) Treatment of respiratory failure focuses on correcting symptoms like hypoxemia, interrupting pathogenesis, and treating the underlying cause. Mechanical ventilation may be necessary for severe cases.
This document provides an overview of respiratory failure and acute respiratory distress syndrome (ARDS). It discusses the diagnosis of respiratory failure using blood gases and imaging tests. The pathophysiology of ARDS involves generalized lung inflammation that leads to pulmonary edema. Mechanical ventilation aims to improve gas exchange while avoiding lung damage, using low tidal volumes and optimizing positive end-expiratory pressure levels. The treatment of respiratory failure focuses on addressing the underlying cause, symptoms, and pathogenesis.
1. The document discusses respiratory failure, describing it as a failure to maintain adequate gas exchange resulting in hypoxemia and potentially hypercapnia.
2. Types of respiratory failure are classified as type 1 (hypoxemic) or type 2 (hypercapnic), and common causes of each type are provided.
3. Diagnostic testing and management approaches are outlined, focusing on arterial blood gas analysis, oxygen therapy using devices like nasal cannulas or Venturi masks, and treating the underlying cause.
Acute respiratory distress syndrome (ARDS) is a severe lung condition characterized by rapid onset of breathing difficulties. It occurs when lung tissue becomes severely inflamed and swollen, limiting oxygen intake. Risk factors include age over 65, chronic lung disease, smoking, sepsis, trauma, and large blood transfusions. Treatment focuses on identifying the cause, giving supplemental oxygen, positioning the patient, and using mechanical ventilation with low pressures and volumes to protect the lungs. Preventing complications like infections and blood clots is also important for recovery.
This document discusses respiratory failure, which occurs when the respiratory system fails in gas exchange. It outlines the components of the respiratory system and centers in the brainstem that control breathing. There are four types of respiratory failure described based on gas exchange abnormalities: hypoxemic, hypercapnic, perioperative, and respiratory failure in shock. Diagnosis involves arterial blood gas analysis and evaluating for underlying causes. Treatment focuses on supporting oxygenation and ventilation, treating specific causes, and mechanical ventilation if needed.
This document discusses dyspnea (shortness of breath) and cough, including their definitions, causes, types, complications, assessments, and management. Dyspnea is a subjective symptom often seen in lung diseases and disorders that can decrease lung function. Its treatment varies and may include oxygen therapy, medications like opioids, bronchodilators, and non-pharmacological interventions. Cough is a reflex to clear the lungs and airways and can indicate various respiratory conditions. Nursing focuses on airway clearance and monitoring for dyspnea and cough.
Acute respiratory distress syndrome (ARDS) occurs when fluid builds up in the tiny, elastic air sacs (alveoli) in your lungs. The fluid keeps your lungs from filling with enough air, which means less oxygen reaches your bloodstream. This deprives your organs of the oxygen they need to function.
1. The document discusses acute respiratory distress syndrome (ARDS), describing its pathophysiology, causes, diagnosis, treatment and prognosis.
2. ARDS is characterized by hypoxemia, reduced lung compliance and diffuse pulmonary infiltrates leading to respiratory failure. Common causes include sepsis, pneumonia and trauma.
3. Treatment involves treating the underlying cause, supportive care including mechanical ventilation with low tidal volumes, and managing fluid levels and oxygenation. Prognosis depends on severity of illness, with reported mortality ranging from 41-65%.
COPD is characterized by airflow limitation caused by chronic inflammation in the lungs. It affects over 80 million people worldwide and is predicted to become the third leading cause of death by 2020. The main risk factors are tobacco smoke and indoor air pollution. Symptoms include cough, sputum production and exertional dyspnea. Diagnosis involves lung function tests showing reduced FEV1 and FEV1/FVC ratio. Management focuses on smoking cessation and bronchodilators.
World Laparoscopy Hospital provides learning by doing. It provides real-world laparoscopic surgery experience by allowing the trainee to get hands-on directly with whatever surgeons are learning and developing a sense of empowerment. After taking this laparoscopic training course, surgeons and gynecologists can perform laparoscopic surgery them self on their patients with confidence.
The anesthetic problems during minimal access surgery
are related to the cardiopulmonary effects of pneumoperitoneum, carbon dioxide (CO2) absorption, extraperitoneal
gas insufflation, venous embolism, and inadvertent injuries
to intraabdominal organs. Optimal anesthetic care of
patients undergoing laparoscopic surgery is very much
important. Good anesthetic techniques facilitate riskfree surgery and allow early detection and reduction of
complications.
In young patients, fit for diagnostic laparoscopy, general
anesthesia is the preferred method and does not impose
any increased risk. Adequate anesthesia and analgesia
are essential and endotracheal intubation and controlled
ventilation should be considered. The pneumoperitoneum
can be created safely under local anesthesia provided that
the patient is adequately sedated throughout the procedure.
For successful laparoscopy under local anesthesia, intravenous (IV) medication for sedation should be given
The anesthetic problems during minimal access surgery are related to the cardiopulmonary effects of pneumoperitoneum, carbon dioxide (CO2) absorption, extraperitoneal
gas insufflation, venous embolism, and inadvertent injuries to intraabdominal organs.
This document provides information about strokes, including types, symptoms, risk factors, diagnosis, and treatment. It discusses the two main types of strokes: ischemic, caused by blockage of blood vessels in the brain, and hemorrhagic, caused by bleeding in the brain. Symptoms of stroke can include weakness, numbness, vision problems, dizziness, and confusion. Risk factors include age, high blood pressure, atrial fibrillation, diabetes, smoking, obesity, and family history. Diagnosis involves physical exams, imaging tests like CT scans and MRIs, and blood tests. Treatment focuses on preventing future strokes through medications like blood thinners, statins, and blood pressure medications as well as rehabilitation therapies.
Telemetry monitoring allows cardiac patients to move freely while their heart is monitored. It is used for patients who need continuous EKG monitoring but do not require intensive care. A diagnostic information system can aggregate over 5,000 different patient test results into a standardized, easy to read format. This increases efficiency and accuracy of patient care. Mechanical ventilators deliver gas into a patient's airways to support breathing. Modes include time cycled, volume cycled and flow cycled ventilation. Intensive care units aim to reduce stress and promote recovery through factors like natural lighting, family involvement and reduced noise.
Telemetry allows for remote cardiac monitoring of patients who do not require intensive care unit placement but still need monitoring. It transmits data from a patient's heart to monitoring staff while allowing the patient mobility. An ideal intensive care unit environment focuses on reducing stress for patients through access to natural light, views, family involvement, and other therapeutic elements. Laboratory tests aim to be precise, accurate, sensitive and specific to reliably determine medical conditions and distinguish those with a condition from those without.
1. Congestive heart failure occurs when the heart muscle is unable to pump blood efficiently, often due to conditions that stiffen or weaken the heart such as high blood pressure or coronary artery disease.
2. As the heart pumps less effectively, blood moves more slowly through the body and the heart has to work harder. The heart chambers may enlarge and fluid can build up in the lungs and other organs, causing congestion.
3. Treatment focuses on managing fluid levels, improving heart function, and treating the underlying cause. Medications target the renin-angiotensin-aldosterone system and sympathetic nervous system, while diuretics help remove excess fluid.
This document provides information on cardiac failure or congestive heart failure (CHF). CHF occurs when the heart muscle is too weak or stiff to pump blood efficiently. As a result, blood moves through the heart and body more slowly and pressure in the heart increases. The heart cannot pump enough oxygen and nutrients to meet the body's needs. Risk factors include hypertension, diabetes, dyslipidemia, coronary artery disease, and sleep disorders. Diagnosis involves physical exam, blood tests, chest x-ray, echocardiogram, and other cardiac tests. Treatment focuses on managing symptoms through lifestyle changes, medications like ACE inhibitors, beta blockers, diuretics, and devices or procedures for severe cases. Nursing care addresses
This document provides information on acute kidney failure (ARF), including its definition, risk factors, pathophysiology, diagnosis, and nursing care considerations. ARF occurs when the kidneys are unable to excrete waste from the body due to high levels of toxins. It is characterized by three phases: onset, maintenance, and recovery. Nursing interventions focus on monitoring fluid balance, electrolytes, output, diet, and preventing infections to support the patient's recovery.
Acute renal failure occurs when the kidneys are unable to excrete waste products from the body, causing them to accumulate in the blood. It can be caused by conditions that decrease renal blood flow or damage the kidneys. Patients are classified as oliguric, excreting less than 500mL of urine per day, or nonoliguric, excreting more than 500mL daily. Risk factors include advanced age, diabetes, heart or liver disease. Diagnosis involves urine and blood tests to check kidney function and imaging tests in some cases. Treatment focuses on treating the underlying cause, managing fluid balance and electrolytes, and dialysis in severe cases.
An acute myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow to the heart is blocked causing damage to heart muscle. Diagnosis involves ECGs, blood tests of cardiac markers, and symptoms like chest pain. Treatment focuses on restoring blood flow through medications and preventing further complications. Nursing interventions for an MI aim to support cardiac output and tissue perfusion, manage pain and activity levels, and provide education on lifestyle changes and medication management upon discharge.
An acute myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow to the heart is blocked, injuring the heart muscle. Risk factors include previous cardiovascular disease, older age, smoking, high cholesterol, diabetes, high blood pressure, obesity, and chronic kidney disease. Treatment involves restoring blood flow through procedures like angioplasty or thrombolysis, along with medications like aspirin, nitroglycerin, and statins. Recovery involves cardiac rehabilitation with exercise training and lifestyle changes to manage risk factors and prevent future heart attacks.
A 58-year-old male was admitted to the hospital on June 22, 2014 with abdominal pain and was placed under the care of Dr. Mark Cacho and Dr. Brandt Lojo. Over the next three days, the doctors ordered various tests, medications, and procedures for the patient, including a complete blood count, plain saline solution, antibiotics, and an endoscopy with biopsy, which was performed on the third day. The patient was advised to rest after the endoscopy procedure and follow a diet of small, frequent meals while avoiding acidic foods.
The document outlines a treatment plan for ulcers, including medications to take (ranitidine, omeprazole, amoxicillin), avoiding certain exercises and foods, quitting smoking, following up with a doctor, and seeking immediate care for severe symptoms like abdominal pain or bloody vomit. Exercise is recommended but to avoid straining the abdomen. The patient should reduce stress, not stop medications without consulting their doctor, and contact their doctor if symptoms worsen or new ones arise.
Smoking and aging are major risk factors for duodenal ulcers. Smoking decreases the secretion of bicarbonate from the pancreas and increases the secretion of hydrochloric acid and pepsin into the stomach and duodenum. This increases the concentration and activity of acid and pepsin in the digestive tract. The duodenal mucosa cannot withstand the digestive action of hydrochloric acid and pepsin, damaging the mucosa and preventing it from secreting enough mucus to act as a protective barrier against hydrochloric acid. This decreases the resistance of the mucosa and destroys blood vessels, leading to further erosion of the mucosa and pain and bleeding in the abdomen.
The physical assessment examines the head, scalp, hair, face, eyelids, eyes, ears, mouth, neck, skin, nails, upper extremities, lower extremities, thoracic cavity, and abdomen. For each area, normal findings and actual findings are described and analyzed. The assessment found abnormalities in the skin, with black and blue areas on the lower back, and the abdomen, which was distended with tenderness on palpation. Otherwise, the physical exam was normal with no alterations noted.
The document contains multiple sections from nursing notes on different patients. It includes assessments of patients' symptoms and concerns, nursing diagnoses, objectives for interventions, details of interventions provided and their rationales, and evaluations of outcomes. Key information includes patients presenting with anxiety about their health, pain, knowledge deficits, and weight gain related to changes in diet. Nurses addressed these issues through monitoring, education, and lifestyle counseling aimed at reducing anxiety and pain levels, increasing knowledge, and identifying unhealthy eating habits within 8 hours of interventions.
Patient X, a 58-year-old grocery store manager, was experiencing abdominal pain several nights a week and occasional discomfort in the afternoon. An endoscopy revealed a peptic ulcer and infection with Helicobacter pylori bacteria. He was prescribed medication to reduce stomach acid and instructed to return for another endoscopy in 6 months. Peptic ulcer disease is common in the Philippines and a leading cause of death, especially among those with poor lifestyles. The duodenum is responsible for digesting food using enzymes secreted by the pancreas and bile from the liver and gallbladder.
This document summarizes four drugs used in combination to treat Helicobacter pylori infection and duodenal ulcers: clarithromycin, omeprazole, amoxicillin, and bismuth subsalicylate. It provides the classification, indication, contraindications, side effects, and important nursing considerations for each drug. The drugs are commonly administered together to eradicate H. pylori bacteria and treat associated gastritis and duodenal ulcers. Nurses should monitor patients for anticipated responses and side effects and educate them about proper administration and potential symptoms like black stools.
Patient X, a 58-year-old man, has been hospitalized since June 27th. During his hospitalization, he has reminded his daughters to focus on their education and advised his son to live a healthy lifestyle without drinking or smoking. As a person in middle adulthood, Patient X is experiencing the developmental task of generativity versus stagnation, which involves establishing stability and transmitting cultural values to younger generations. An endoscopy found ulceration in Patient X's duodenal area and tested positive for H. pylori infection and damage to the stomach lining.
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
Assessment and Planning in Educational technology.pptxKavitha Krishnan
In an education system, it is understood that assessment is only for the students, but on the other hand, the Assessment of teachers is also an important aspect of the education system that ensures teachers are providing high-quality instruction to students. The assessment process can be used to provide feedback and support for professional development, to inform decisions about teacher retention or promotion, or to evaluate teacher effectiveness for accountability purposes.
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
Denis is a dynamic and results-driven Chief Information Officer (CIO) with a distinguished career spanning information systems analysis and technical project management. With a proven track record of spearheading the design and delivery of cutting-edge Information Management solutions, he has consistently elevated business operations, streamlined reporting functions, and maximized process efficiency.
Certified as an ISO/IEC 27001: Information Security Management Systems (ISMS) Lead Implementer, Data Protection Officer, and Cyber Risks Analyst, Denis brings a heightened focus on data security, privacy, and cyber resilience to every endeavor.
His expertise extends across a diverse spectrum of reporting, database, and web development applications, underpinned by an exceptional grasp of data storage and virtualization technologies. His proficiency in application testing, database administration, and data cleansing ensures seamless execution of complex projects.
What sets Denis apart is his comprehensive understanding of Business and Systems Analysis technologies, honed through involvement in all phases of the Software Development Lifecycle (SDLC). From meticulous requirements gathering to precise analysis, innovative design, rigorous development, thorough testing, and successful implementation, he has consistently delivered exceptional results.
Throughout his career, he has taken on multifaceted roles, from leading technical project management teams to owning solutions that drive operational excellence. His conscientious and proactive approach is unwavering, whether he is working independently or collaboratively within a team. His ability to connect with colleagues on a personal level underscores his commitment to fostering a harmonious and productive workplace environment.
Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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Main Java[All of the Base Concepts}.docxadhitya5119
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
This presentation was provided by Steph Pollock of The American Psychological Association’s Journals Program, and Damita Snow, of The American Society of Civil Engineers (ASCE), for the initial session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session One: 'Setting Expectations: a DEIA Primer,' was held June 6, 2024.
Executive Directors Chat Leveraging AI for Diversity, Equity, and InclusionTechSoup
Let’s explore the intersection of technology and equity in the final session of our DEI series. Discover how AI tools, like ChatGPT, can be used to support and enhance your nonprofit's DEI initiatives. Participants will gain insights into practical AI applications and get tips for leveraging technology to advance their DEI goals.
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
International FDP on Fundamentals of Research in Social Sciences
at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
Physiology and chemistry of skin and pigmentation, hairs, scalp, lips and nail, Cleansing cream, Lotions, Face powders, Face packs, Lipsticks, Bath products, soaps and baby product,
Preparation and standardization of the following : Tonic, Bleaches, Dentifrices and Mouth washes & Tooth Pastes, Cosmetics for Nails.
2. DEFINITION
Acute respiratory failure occurs when
dysfunction of the respiratory system results in
abnormal gas exchange that is potentially life-
threatening. Each element of this definition is
important to understand. The term acute implies
a relatively sudden onset (from hours to days)
and a substantial change from the patient’s
baseline condition.
3. DEFINITION
Dysfunction of the respiratory system
indicates that the abnormal gas exchange may
be caused by abnormalities in any element of
the respiratory system (e.g., a central nervous
system abnormality affecting the regulation of
breathing or a musculoskeletal thoracic
abnormality affecting ventilation), in addition to
abnormalities of the lung itself.
4. DEFINITION
The term respiration refers, in a broad
sense, to the delivery of oxygen (O2) to
metabolically active tissues for energy usage
and the removal of carbon dioxide (CO2) from
these tissues. Respiratory failure is a failure of
the process of delivering O2 to the tissues
and/or removing CO2 from the tissues.
5. DEFINITION
Abnormalities in the periphery (e.g.,
cyanide poisoning, pathologic distribution of
organ blood flow in sepsis) can also lead to
tissue hypoxia; although these conditions
represent forms of respiratory failure in the
broadest terms, this chapter focuses on
respiratory failure resulting from dysfunction of
the lungs, chest wall, and control of respiration.
6. PHYSICAL
ASSESSMENT
Clinical manifestations of respiratory distress reflect
signs and symptoms of hypoxemia, hypercapnia, or
the increased work of breathing necessary. These
include:
• Altered mental status (agitation, somnolence)
• Peripheral or central cyanosis or decreased oxygen
saturation on pulse oximetry
Manifestations of a "stress response" including
tachycardia, hypertension, and diaphoresis
7. PHYSICAL
ASSESSMENT
• Evidence of increased respiratory work of
breathing including accessory muscle use, nasal
flaring, intercostal indrawing, suprasternal or
supraclavicular retractions, tachypnea
• Evidence of diaphragmatic fatigue (abdominal
paradox)
• Abnormal arterial blood gas results
8. PHYSICAL
ASSESSMENT
• ARF : CXR Findings
• Clear CXR with hypoxemia and normocapnia.-
Pulmonary embolus, R to L shunt, Shock
• Diffusely white (opacified) CXR with hypoxemia and
normocapnia - ARDS, NCPE, CHF, pulmonary
fibrosis
• Localized infiltrate - pneumonia, atelectasis, infarct
• Clear CXR with hypercapnia - COPD, asthma,
overdose, neuromuscular weakness
9. DIAGNOSTIC
EXAMINATIONS
First Tests To Order:
• pulseoximetry
SpO2 <80%
• arterial blood gases
pH<7.38; PaO2 <60 mmHg (or <50
mmHg in chronic lung disease) on
room air; PaCO2 >50 mmHg on room
air
11. DIAGNOSTIC
EXAMINATIONS
• CXR
diffuse or patchy infiltrates; pneumothorax;
pulmonary effusion; hyperinflation; asymmetric
opacification of lung fields; asymmetric
lucency of lung fields
pulmonary function tests
PEFR <35% to 50% of predicted; FEV <35%
to 50% of predicted; FVC <50% to 70% of
predicted; FEV1 <50% of predicted; NIF above
-25 cm H2O
14. RISK FACTORS
• cigarette smoking
• young age
• old age
• pulmonary infection
• chronic lung disease
• airway obstruction
• alveolar abnormalities
15. RISK FACTORS
• perfusion abnormalities
• cardiac failure
• peripheral nerve abnormalities
• muscle system abnormalities
• opiate and sedative medications
• toxic fumes and gases
16. RISK FACTORS
• traumatic spinal injury
• traumatic thoracic injury
• central nervous system disorders
• acute vascular occlusion
• pneumothorax
• hypercoagulable states
17. Respiratory failure can arise from an
abnormality in any of the components of the
respiratory system, including the airways, alveoli,
central nervous system (CNS), peripheral nervous
system, respiratory muscles, and chest wall.
Patients who have hypoperfusion secondary to
cardiogenic, hypovolemic, or septic shock often
present with respiratory failure.
18. Ventilatory capacity is the maximal
spontaneous ventilation that can be maintained
without development of respiratory muscle fatigue.
Ventilatory demand is the spontaneous minute
ventilation that results in a stable Pa CO2.
19. Normally, ventilatory capacity greatly exceeds
ventilatory demand. Respiratory failure may result
from either a reduction in ventilatory capacity or an
increase in ventilatory demand (or both). Ventilatory
capacity can be decreased by a disease process
involving any of the functional components of the
respiratory system and its controller. Ventilatory
demand is augmented by an increase in minute
ventilation and/or an increase in the work of breathing
20.
21. The management of acute respiratory
failure can be divided into an urgent resuscitation
phase followed by a phase of ongoing care. The
goal of the urgent resuscitation phase is to stabilize
the patient as much as possible and to prevent any
further life-threatening deterioration. Once these
goals are accomplished the focus should then shift
towards diagnosis of the underlying process, and
then the institution of therapy targeted at reversing
the primary etiology of the ARF.
23. MEDICATIONS
The goals of therapy in cardiogenic
pulmonary edema are to achieve a pulmonary
capillary wedge pressure of 15-18 mm Hg and a
cardiac index greater than 2.2 L/min/m2 while
maintaining adequate blood pressure and organ
perfusion.
24. MEDICATIONS
These goals may have to be modified
for some patients. Diuretics, nitrates, analgesics,
and inotropes are used in the treatment of acute
pulmonary edema.
25. MEDICATIONS
• First-line therapy generally includes a loop diuretic such
as furosemide, which inhibits sodium chloride
reabsorption in the ascending loop of Henle.
• Furosemide (Lasix)
This allows both superior potency and a
higher peak concentration despite an increased
incidence of adverse effects, particularly ototoxicity
26. MEDICATIONS
• Metolazone (Zaroxolyn)
Has been used as adjunctive therapy in
patients initially refractory to furosemide. It has been
demonstrated to be synergistic with loop diuretics in
treating refractory patients and causes a greater loss
of potassium. Metolazone is a potent thiazide-related
diuretic that sometimes is used in combination with
furosemide for more aggressive diuresis. It is also
used for initiating diuresis in patients with a degree of
renal dysfunction.
•
27. MEDICATIONS
Nitrates reduce myocardial oxygen
demand by lowering preload and after load. In
severely hypertensive patients, nitroprusside
causes more arterial dilatation than
nitroglycerin. Nevertheless, in view of the
possibility of thiocyanate toxicity and the
coronary steal phenomenon associated with
nitroprusside, IV nitroglycerin may be the initial
therapy of choice for afterload reduction.
•
28. MEDICATIONS
• Nitroglycerin sublingual (Nitro-Bid, NitroMist,
Nitrostat, Nitrolingual)
Sublingual nitroglycerin tablets and spray are
particularly useful in the patient who
presents with acute pulmonary edema with
a systolic blood pressure of at least 100
mm Hg. As with sublingual nitroglycerin
tablets, the onset of action of nitroglycerin
spray is 1-3 minutes, with a half-life of 5
minutes. Administration of the spray may be
easier, and it can be stored for as long as 4
years.
29. MEDICATIONS
• Nitroprusside sodium (Nitropress)
Nitroprusside produces vasodilation of
venous and arterial circulation. At higher
dosages, it may exacerbate myocardial
ischemia by increasing heart rate. It is easily
titratable.
30. MEDICATIONS
Morphine IV is an excellent adjunct in
the management of acute pulmonary edema. In
addition to anxiolysis and analgesia, its most
important effect is venodilation, which reduces
preload. It also causes arterial dilatation, which
reduces systemic vascular resistance and may
increase cardiac output.
31. MEDICATIONS
• Morphine sulfate (Duramorph, Astramorph)
Morphine sulfate is the drug of choice
for narcotic analgesia because of its reliable and
predictable effects, safety profile, and ease of
reversibility with naloxone. Morphine sulfate
administered IV may be dosed in a number of
ways and commonly is titrated until the desired
effect is obtained.
32. MEDICATIONS
• Dopamine
Dopamine is a positive inotropic agent that
stimulates both adrenergic and dopaminergic
receptors. Its hemodynamic effects depend on the
dose. Lower doses stimulate mainly dopaminergic
receptors that produce renal and mesenteric
vasodilation; higher doses produce cardiac stimulation
and renal vasodilation. Doses of 2-10 µg/kg/min can
lead to tachycardia, ischemia, and dysrhythmias.
Doses higher than 10 µg/kg/min cause
vasoconstriction, which increases afterload.
33. MEDICATIONS
• Norepinephrine (Levophed)
Used in protracted hypotension after
adequate fluid replacement. It stimulates beta1- and
alpha-adrenergic receptors, which leads to
increased cardiac muscle contractility and heart
rate, as well as vasoconstriction. As a result,
norepinephrine increases systemic blood pressure
and cardiac output. Adjust and maintain infusion to
stabilize blood pressure (eg, 80-100 mm Hg
systolic) sufficiently to perf
34. MEDICATIONS
• Dobutamine
Dobutamine produces vasodilation and
increases the inotropic state. At higher dosages, it
may cause increased heart rates, thus exacerbating
myocardial ischemia. It is a strong inotropic agent
with minimal chronotropic effect and no
vasoconstriction.
35. MEDICATIONS
Bronchodilators are an important
component of treatment in respiratory failure
caused by obstructive lung disease. These
agents act to decrease muscle tone in both
small and large airways in the lungs. This
category includes beta-adrenergics,
methylxanthines, and anticholinergics.
36. MEDICATIONS
• Terbutaline (Brethaire, Bricanyl)
Terbutaline acts directly on beta2
receptors to relax bronchial smooth muscle,
relieving bronchospasm and reducing airway
resistance.
37. MEDICATIONS
• Albuterol (Proventil)
Albuterol is a beta-agonist useful in the
treatment of bronchospasm. It selectively
stimulates beta2-adrenergic receptors of the
lungs. Bronchodilation results from relaxation of
bronchial smooth muscle, which relieves
bronchospasm and reduces airway resistance.
38. NURSING
DIAGNOSIS
1. Ineffective Airway Clearance May be related to
Bronchospasm, Increased production of secretions; retained
secretions; thick, viscous secretion
Possibly evidenced by
Statement of difficulty breathing
Changes in depth/rate of respirations, use of accessory
muscles
Abnormal breath sounds, e.g., wheezes, rhonchi, crackles
Cough (persistent), with/without sputum production
39. NURSING
DIAGNOSIS
2. Impaired Gas Exchange May be related to Altered oxygen
supply (obstruction of airways by secretions, bronchospasm;
air-trapping) Alveoli destruction
Possibly evidenced by
Dyspnea
Confusion, restlessness
Inability to move secretions
Abnormal ABG values (hypoxia and hypercapnia)
Changes in vital signs
Reduced tolerance for activity
40. NURSING
DIAGNOSIS
3. Nutrition: imbalanced, less than body requirements May be
related to Dyspnea; sputum production, Medication side
effects; anorexia, nausea/vomiting , Fatigue
Possibly evidenced by
Weight loss;
loss of muscle mass,
poor muscle tone
Reported altered taste sensation;
aversion to eating,
lack of interest in food
41. NURSING
DIAGNOSIS
4. Knowledge Deficit May be related to Lack of
information/unfamiliarity with information resources,
Information misinterpretation, Lack of recall/cognitive
limitation
Possibly evidenced by
Request for information
Statement of concerns/misconception
Inaccurate follow-through of instructions
Development of preventable complications
42. NURSING
DIAGNOSIS
5. Self-Care deficit, specify—intolerance to activity,
decreased strength/endurance, depression,
severe anxiety.
6. Home Maintenance, ineffective—intolerance to
activity, inadequate support system, insufficient
finances, unfamiliarity with neighborhood
resources.
44. NURSING
INTERVENTIONS
• Auscultate breath sounds. Note adventitious breath
sounds, e.g., wheezes, crackles, rhonchi.
• Assess/ monitor respiratory rate. Note inspiratory/
expiratory ratio.
• Note presence/ degree of dyspnea, e.g., reports of “air
hunger,” restlessness, anxiety, respiratory distress, use of
accessory muscles. Use 0–10 scale or American Thoracic
Society’s “Grade of Breathlessness Scale” to rate
breathing difficulty. Ascertain precipitating factors when
possible. Differentiate acute episode from exacerbation of
chronic dyspnea.
45. NURSING
INTERVENTIONS
• Assist patient to assume position of comfort, e.g.,
elevate head of bed, have patient lean on overbed
table or sit on edge of bed.
• Keep environmental pollution to a minimum, e.g.,
dust, smoke, and feather pillows, according to
individual situation.
• Encourage/ assist with abdominal or pursed-lip
breathing exercises.
46. NURSING
INTERVENTIONS
• Observe characteristics of cough, e.g., persistent,
hacking, moist. Assist with measures to improve
effectiveness of cough effort.
• Increase fluid intake to 3000 mL/day within cardiac
tolerance. Provide warm/ tepid liquids. Recommend
intakeof fluids between, instead of during, meals.
• Monitor/ graph serial ABGs, pulse oximetry, chest x-ray.
47. NURSING
INTERVENTIONS
• Assess respiratory rate, depth. Note use of accessory
muscles, pursed-lip breathing, inability to speak/
converse.
• Elevate head of bed, assist patient to assume
position to ease work of breathing. Include periods of
time in prone position as tolerated. Encourage deep-
slow or pursed-lip breathing as individually needed/
tolerated.
• Assess/ routinely monitor skin and mucous
membrane color.
48. NURSING
INTERVENTIONS
• Expectoration of sputum; suction when
indicated.
• Auscultate breath sounds, noting areas of
decreased airflow and/or adventitious sounds.
• Palpate for fremitus.
• Monitor level of consciousness/ mental status.
Investigate changes.
49. NURSING
INTERVENTIONS
• Assess dietary habits, recent food intake.
Note degree of difficulty with eating.
Evaluate weight and body size (mass).
• Auscultate bowel sounds.
• Give frequent oral care, remove
expectorated secretions promptly, provide
specific container for disposal of
secretions and tissues.
50. NURSING
INTERVENTIONS
• Encourage a rest period of 1 hr before and after
meals. Provide frequent small feedings.
• Avoid gas-producing foods and carbonated
beverages.
• Avoid very hot or very cold foods.
• Weigh as indicated.
• Administer supplemental oxygen during meals
as indicated.