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THREATS TO FLUID AND ELECTROLYTE BALANCE
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ST. PETERSBURG COLLEGE
COLLEGE OF NURSING
ASSOCIATE DEGREE NURSING PROGRAM
NUR 2731C - NURSING IV
UNIT VIIA
THREATS TO FLUID AND ELECTROLYTE BALANCE
Overview: This module covers the etiology, pathophysiology, and clinical manifestations of acute respiratory
failure (ARF) and acute respiratory distress syndrome (ARDS). Chest problems of pneumothorax, hemothorax,
and tension pneumothorax will be presented. Advanced oxygen delivery, chest tubes, BIPAP/CPAP, and
ventilator basics. Included will be the nursing and interprofessional management of patients with these clinical
diagnoses.
Key Terms
Acute Respiratory Failure (ARF)
Adult Respiratory Distress Syndrome (ARDS)
Chest tubes
Crepitus
Endotracheal tubes
Hemothorax
Mechanical ventilation
Noninvasive Positive Pressure Ventilation
Pneumothorax
Positive end expiratory pressure (PEEP)
Tension Pneumothorax
Ventilation perfusion mismatch (V/Q mismatch)
Ventilator Acquired Pneumonia (VAP)
LEARNING ACTIVITIES
Students are responsible to read all pages pertinent to the topic and review information covered in
previous courses.
1.
Read: See Unit Objectives and Content Outline for readings. Use your textbook(s) index to
locate content readings and/or use credible links (listed) as additional resources of information.
2.
Review: Additional resources located in the course
3.
Interactive Learning Activities in class
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4.
ATI Practice Exams and Required/Recommended Activities
5.
Evolve Adaptive Quizzing
UNIT OBJECTIVES
1. Discuss the causes, pathophysiology, diagnostic tests, assessment, nursing management, and
collaborative care appropriate to the patient with Acute Respiratory Failure (ARF)- Hypoxemic and
Hypercapnic
2. Discuss the causes, pathophysiology, diagnostic tests, assessment, nursing management, and
collaborative care appropriate to the patient with Acute Respiratory Distress Syndrome (ARDS)
3. Prioritize assessments and interventions to prevent or reverse complications that may result from acute
respiratory failure (ARF) and Acute Respiratory Distress Syndrome (ARDS).
4. Apply the nursing process based on prioritization of care of the patients with ARF and ARDS.
5. Compare the indications, complications and nursing interventions for patient(s) requiring noninvasive
positive pressure ventilation, intubation, and mechanical ventilation.
6. Describe the purpose, function, and nursing responsibilities for patients with chest tubes and chest tube
drainage systems.
7. Compare and contrast BIPAP (bi level positive airway pressure) and CPAP (Continuous Positive
Airway Pressure).
8. Discuss the causes, assessments, and interventions appropriate for the patient with hemothorax,
pneumothorax, or tension pneumothorax.
9. Calculate Critical Care Math
CLINICAL EXAMPLES: Acute Respiratory Failure: Hypoxemic and Hypercapnic and Adult Respiratory
Distress Syndrome (ARDS)
For each clinical example, explain the following:
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THREATS TO FLUID AND ELECTROLYTE BALANCE
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a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
Pathophysiology and etiology of the disease process
Potential/Actual complications associated with the disease
Assessment findings
Diagnostic/Lab test findings
Treatment (including medications)
Nursing Diagnoses
Expected Outcomes
Independent & collaborative interventions
Evaluation of Interventions
Discharge Planning
CONTENT OUTLINE
I.
Artificial Airways
a. Endotracheal Tubes (ETT)
i. Oral
ii. Nasal
b. Confirmation and alignment of ETT (endotrachealtube)
II.
BIPAP versus CPAP-
a. Compare and contrast
b. Uses
c. Nursing Interventions
d. RT’s role
III. Mechanical Ventilation
a. Two types (Negative Pressure and Positive Pressure)
Complications of Positive Pressure Ventilation
a. Ventilator – Associated Pneumonia (VAP)
b. Impaired cerebral blood flow
c. Stress ulcers and GI Bleeding
d. Muscle atrophy/contractures/mobility complications
e. Psychosocial/emotional distress
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f. Ventilator disconnection or malfunction (alarms)
g. Nutritional therapy
h. Weaning from Mechanical ventilation
1.
ACUTE RESPIRATORY FAILURE (ARF)
a. Etiology and Pathophysiology
b. Clinical Manifestations
c. Diagnostic Studies
d. Collaborative Care
e. Nursing Management
2.
ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS)
a.
Etiology and Pathophysiology
b. Clinical Manifestations
c. Diagnostic Studies
d. Collaborative Care
e. Nursing Management
3. Hemothorax, Pneumothorax, and Tension Pneumothorax
Type
Causes
Nursing Assessment
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Nursing Interventions
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THREATS TO FLUID AND ELECTROLYTE BALANCE
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Hemothorax
Pneumothorax
Tension Pneumothorax
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