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Medical Diagnosis Acute Respiratory Failure secondary to COPD in Acute Exacerbations and Community Acquired Pneumonia- highrisk Definition ARF is a common life threatening process with myriad causes. It is characterized by failure of oxygenation, or ventilation, or both. Schematic Diagram
Predisposing Age- 71 years old Hereditary- Asthma Precipitating History of cigarette smoking (starts at 17y.o & stops at age 41y.o, 1pack/day) Occupational exposure (missionary at Saudi Arabia for 10 years now) Low Immune System
Allergens enter the upper respiratory tract
Stimulation and activation of B Lymphocytes
B Lymphocytes produces Immunoglobulin E(IgE)
IgE antibodies attached to mast cells and basophils in the bronchial walls
Atherosclerosis thoracic aorta Bronchiectasis both bases.reacting substance anaphylaxis ( SRS. Diagnostic Exam: Chest X-ray Minimal honeycomb changes in the bases.A) Increase blood flow to the area of insult Increase mucus production Chemical mediators induced capillary dilation Attraction of WBC to the area Fluid shifting from the vasculature and to the alveoli Signs/ symptoms: Crackles/Rales Productive Cough(whitish sputum in minimal amount) Contraction of the bronchial smooth muscles that encircles the airway (bronchospasm) Deposition of collagen below the basement membrane Edema of the airway Airway constriction or bronchoconstriction Medication: Salbutamol + ipratropium combivent Neb/ q6 Aminophylline Side drip D5W 500cc at 15 gtts/min Medication: NAC (Fluimucil) 600mg OD 1tab in 50mL H2O Hyperinflation of alveoli Narrowing of the airway Increase work of breathing Decreased elastic recoil Increase resistance to airflow Signs and symptoms: Weak cough. Fatigue of the muscles of ventilation . bilateral.Mast cells degranulation Mast cells releases chemical mediators of inflammation Medication: Hydrocortisone ( SoluCortef) 100mg IV q6H 29 Histamine bradykinin prostaglandins Slow. Impression: Pulmonary emphysema.
30 Ventilation.RR:20cp m.110bpm Paleness.altered sleep pattern. fatigue.Perfusion (V/Q) mismatch and shunt Medication: NAC(fluimucil) 600mg 1tab/ OD in 50 mL H2O Inadequate exchange of O2 and CO2 Interventions: >Oxygen administration through mechanical ventilator attached to ET Tube TV:500ml.BP. Hypoxemia ACUTE RESPIRATORY FAILURE Diagnostic Exam: ABG: O2: 99 % Increase PaCO2 Decrease PaO2 Increase HCO3 Respratory Acidosis with adequate O2 Signs and symptoms: Tachycardia.FiO2:100%.5 Seconds.140/80 Capillary refill.AC Mode >Monitor pulse oximetry >Elevated head of bed and advised to sit-up in his bed. drowsiness.feeling of physically drained Recovery Death COMPLICATIONS: Tissue hypoxia Subsequent organ damage Chronic respiratory failure Tension pneumothorax Lobar atelectasis Pneumonia Pulmonary edema Medication: Amiodarone (codarone) 200mg 1tab OD NGT . >Turned the client on his side every 2 hours.
complications - Interventions .signs/ symptoms - Diagnostic Exams .31 Legend : Pathophysiology Medications .