Care of Critically Ill Patients with Respiratory Problems Flashcards

Vocabulary flashcards covering core critical care concepts including pulmonary embolism, respiratory failure classifications, ARDS, mechanical ventilation complications, chest trauma, and DIC.

Pulmonary Embolism

A life-threatening medical emergency that occurs when blood circulation through the pulmonary artery is interrupted by a thrombus or emboli such as fat, air, or cancer cells.

Saddle Embolism

A specific type of pulmonary embolism that occurs at the bifurcation or split of the main pulmonary artery.

V/Q Ratio

The ratio of ventilation to perfusion, calculated as the amount of air entering the lungs divided by the capillary blood flow; normal baseline is $4\,\text{Liters}$ of air to $5\,\text{Liters}$ of blood per minute, equaling $0.8$.

Dead Space (V/Q Mismatch)

A classification of V/Q mismatch in which ventilation is adequate but perfusion is inadequate, preventing oxygen from entering the bloodstream.

Shunt (V/Q Mismatch)

A classification of V/Q mismatch characterized by adequate capillary blood flow (perfusion) but inadequate alveolar ventilation.

D-dimer Test

A diagnostic laboratory blood test that measures a protein fragment resulting from clot breakdown to help determine if a blood clot is present.

Heparin

A fast-acting indirect thrombin inhibitor administered IV or subcutaneously that enhances antithrombin III activity to inhibit thrombin and prevent conversion of fibrinogen to fibrin; monitored via aPTT with protamine sulfate as its antidote.

Warfarin

An oral Vitamin K antagonist anticoagulant with a slow onset of $3$ to $5\,\text{days}$ that inhibits Vitamin K-dependent clotting factors; monitored via PT/INR with a therapeutic INR target of $2$ to $3$ and Vitamin K as its antidote.

IVC Filter

A small metal device surgically placed in the inferior vena cava to prevent blood clots from entering the heart and lungs, frequently used for clients unable to take anticoagulants.

Embolectomy

The surgical removal of an embolus obstructing blood flow within a pulmonary vessel.

Acute Respiratory Failure

A state of impaired gas exchange clinically defined by ABG values of $\text{PaO}_2 < 60\,\text{mm Hg}$, $\text{SaO}_2 < 90\%$, or $\text{PaCO}_2 > 50\,\text{mm Hg}$ with $\text{pH} < 7.30$.

Ventilatory Failure

A type of respiratory failure caused by a physical problem with the functioning of the chest wall, lungs, or respiratory muscles (especially the diaphragm), or a defect in the respiratory control center of the brain.

Oxygenation (Gas Exchange) Failure

A type of respiratory failure where ventilation is normal but pulmonary perfusion is decreased, preventing sufficient oxygenation of blood at the alveolar level and leading to right-to-left shunting.

Acute Respiratory Distress Syndrome (ARDS)

A severe, life-threatening form of acute respiratory failure caused by acute injury to the alveolar-capillary membrane, characterized by refractory hypoxemia, non-cardiac pulmonary edema, decreased pulmonary compliance, and dense ground-glass infiltrates on chest X-ray.

Refractory Hypoxemia

A state of severe hypoxemia that persists and fails to improve even when administered $100\%$ oxygen.

Berlin Criteria

Diagnostic criteria used to confirm ARDS, requiring onset within $7\,\text{days}$ of a known clinical event, non-cardiac origin, bilateral lung infiltrates on imaging, and a decreased $\text{PaO}_2/\text{FiO}_2$ ratio.

Barotrauma

Pulmonary structure damage caused by excess positive pressure during mechanical ventilation, which can cause alveoli damage, pneumothorax, subcutaneous emphysema, or pneumomediastinum.

Volutrauma

Lung tissue injury resulting from excess volume delivered to the lungs during mechanical ventilation.

Ventilator-Acquired Pneumonia (VAP)

A pulmonary infection resulting from bacterial colonization occurring within $48\,\text{hours}$ of mechanical ventilation and subsequent aspiration into the lower respiratory tract.

Ventilator Bundle

A combination of evidence-based nursing interventions designed to reduce VAP, including head of bed elevated to $30^\circ$, ulcer prophylaxis, aspiration prevention, oral care every $2\,\text{hours}$ with chlorhexidine or toothbrushing every $8\,\text{hours}$, and daily sedation interruption.

Flail Chest

A chest trauma condition caused by fractures of at least $2$ ribs in one area, resulting in paradoxical chest wall movement (inward movement during inspiration and outward movement during expiration).

Tension Pneumothorax

A life-threatening medical emergency where air enters the intrapleural space through a one-way valve mechanism and cannot escape, resulting in mediastinal shift to the unaffected side, compression of the vena cava, decreased cardiac output, hypotension, and tracheal deviation.

Needle Decompression

An urgent medical intervention performed by a physician where a needle is inserted into the intrapleural space to relieve built-up pressure and trapped air in a tension pneumothorax.

Disseminated Intravascular Coagulation (DIC)

A condition triggered by underlying pathologies that activates the coagulation cascade throughout the body, causing widespread microvascular thrombi, organ failure, depletion of clotting factors, and severe hemorrhage.

DIC Laboratory Profile

A set of diagnostic laboratory findings characteristic of DIC, including increased PT/PTT, increased D-Dimer, decreased fibrinogen, and a decreased platelet count.