Acute Respiratory Failure Flashcards
7 cards from real CCRN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Acute Respiratory Failure flashcards as text
A patient has a PaO2 of 55 mmHg on room air with a normal PaCO2. This finding is most consistent with which type of respiratory failure?
Answer: Type I (hypoxemic) respiratory failure
Type I respiratory failure is defined by hypoxemia (PaO2 < 60 mmHg) with a normal or low PaCO2.
Which arterial blood gas finding defines Type II respiratory failure?
Answer: PaCO2 > 45 mmHg with hypoxemia
Type II (hypercapnic) failure is defined by alveolar hypoventilation with PaCO2 > 45 mmHg.
A widened alveolar-arterial (A-a) oxygen gradient with hypoxemia suggests which mechanism?
Answer: Ventilation-perfusion mismatch or shunt
A widened A-a gradient indicates a gas-exchange problem such as V/Q mismatch, shunt, or diffusion impairment.
Which condition causes hypoxemia that does NOT correct with 100% supplemental oxygen?
Answer: Intrapulmonary shunt
True shunt allows blood to bypass ventilated alveoli, so it responds poorly to increased FiO2.
A patient with a COPD exacerbation has pH 7.28, PaCO2 68, HCO3 30. This represents:
Answer: Acute-on-chronic respiratory acidosis
The elevated HCO3 shows chronic retention, while the low pH with high CO2 indicates an acute worsening.
Which early clinical sign most reliably indicates impending respiratory failure in an alert patient?
Answer: Increasing accessory muscle use with rising respiratory rate
Escalating work of breathing and tachypnea signal that the patient is failing to maintain gas exchange.
A patient's PaCO2 is rising and they are becoming somnolent despite supplemental oxygen. The priority intervention is:
Answer: Provide ventilatory support (NIV or intubation)
Rising CO2 with declining mental status reflects ventilatory failure requiring assisted ventilation, not just more oxygen.