Care for patients with respiratory failure

Written by Peng Miao Yun
Internal Medicine
Updated on September 03, 2024
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Patients with respiratory failure are always emergency and critically ill patients in clinical settings. For patients with respiratory failure, we need to pay close attention in nursing: first, strictly monitor the patient's vital signs, observe the frequency of respiration, blood pressure, and consciousness state; take good care of the skin and oral cavity to prevent dependent pneumonia and bedsores; and timely remove the patient’s sputum. Encourage conscious patients to cough more and expectorate sputum. For those with weak coughs, assist regularly with turning and patting the back to facilitate the removal of sputum. For comatose patients, mechanical suction or tracheostomy for mechanical ventilation can be performed. At the same time, avoid factors that can induce respiratory difficulty such as cold air and poor air circulation. Patients with respiratory failure consume a lot of energy, especially those on mechanical ventilation, who are in a stress state with increased catabolism. Therefore, daily protein intake should be increased, encourage the patient to eat more to enhance nutrition, and provide a diet high in protein, high in fat, and low in carbohydrates.

Other Voices

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Written by Wang Ji Zhong
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Is respiratory failure reversible?

Respiratory failure has a high mortality rate and can easily lead to the impairment of multiple organ functions, seriously endangering the life of the patient. The mortality rate largely depends on whether the condition can be diagnosed and treated early. In cases of respiratory failure, if the progression is rapid and the body does not have particularly good metabolism, it can easily affect life. Acute respiratory failure is generally curable; it often occurs because carbon dioxide retention leads to hypoxia in the body. At this time, providing high-flow oxygen can effectively alleviate the symptoms and additional appropriate medication can be administered based on the condition to facilitate a return to normal. However, chronic respiratory failure caused by conditions like chronic bronchitis and pulmonary heart disease are major causes of respiratory failure. In such cases, it is only possible to slow the progression of the disease; returning to a normal state is rather unlikely. Therefore, patients with chronic respiratory failure generally need long-term home oxygen therapy to ensure that the hypoxic condition can be improved.

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Written by Han Shun Li
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Does respiratory failure spread?

Respiratory failure is a condition characterized by significant decline in respiratory function and is clinically very serious, being a common critical and acute illness. Respiratory failure itself is not contagious, but certain diseases that cause respiratory failure can be contagious. For example, if it is caused by infectious pulmonary tuberculosis, then the tuberculosis can be transmitted, but respiratory failure itself is not contagious.

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Can respiratory failure be cured?

Whether respiratory failure can be cured depends on the causes of the respiratory failure and the severity of the condition. Respiratory failure can potentially be cured. For example, acute left heart failure can lead to pulmonary congestion and subsequent respiratory failure. This condition primarily manifests as a decrease in oxygen tension, and by conducting a blood gas analysis, if the oxygen tension is found to be less than 60 mmHg, it can be diagnosed as respiratory failure. However, with symptomatic treatments such as vasodilation and diuretics, once the left heart failure is alleviated, the respiratory failure will also improve. On the other hand, for diseases intrinsic to the lungs, such as chronic obstructive pulmonary disease or severe pulmonary infections, these chronic conditions cannot be completely cured. The symptoms of respiratory failure can only be managed with medication or ventilators.

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Classification of Causes of Respiratory Failure

Respiratory failure, if categorized by its cause, can be divided into pump failure and lung failure. Pump failure refers to the failure of the respiratory pump, which comprises the central nervous system that drives or regulates respiratory movement, the peripheral nervous system, neuromuscular tissues, and the thoracic cage, collectively known as the respiratory pump. Respiratory failure caused by dysfunction of these components is called pump failure. Another type is lung failure, which results from airway obstruction, pulmonary tissue and vascular pathology, and is termed lung failure. Lung failure can lead to type I or type II respiratory failure, whereas pump failure typically presents as type II respiratory failure.

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Respiratory Failure Nursing Care Plan

For patients with respiratory failure, treatment is one aspect, and nursing is equally important. A nursing plan should be developed in advance, starting with keeping the airway clear to avoid aspiration of liquids or food into the trachea. It is necessary to frequently help the patient turn and pat their back to facilitate the expulsion of phlegm, while also enhancing nutrition and increasing the intake of various nutrients. During the remission period of respiratory failure, persist in exercising, performing exercises like knee protections to strengthen the activity of the respiratory muscles. Adapt clothing according to seasonal and climatic changes to avoid catching a cold. In nursing, it is important to maintain vital signs, pay attention to the care of the skin and oral mucosa, promptly clear phlegm, and avoid factors that trigger breathing difficulties, such as the stimulation from cold wind and cold air. Maintain regular life patterns, engage in appropriate physical exercise, and prevent the occurrence of colds.