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.

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Written by Li Fang Xiao
Internal Medicine
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Is respiratory failure serious?

Respiratory failure is a relatively severe disease, with the most common causes being chronic obstructive pulmonary disease (COPD) or heart failure, which are frequently seen in clinical settings. Respiratory failure can be definitively diagnosed by performing blood gas analysis. Clinically, patients will exhibit symptoms of breathing difficulty, such as orthopnea or wheezing. In blood gas analysis, oxygen saturation is often below 90%, and the partial pressure of oxygen is less than 60 mmHg. These indicators can diagnose respiratory failure. Although respiratory failure is a serious condition, it can be recoverable through active symptomatic treatment, identifying the underlying cause, and eliminating aggravating factors.

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Written by Peng Miao Yun
Internal Medicine
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How to administer oxygen for respiratory failure

If patients with respiratory failure undergo oxygen therapy, it is necessary to choose different therapy plans based on the type of respiratory failure. In the case of Type I respiratory failure, there is simply a lack of oxygen. For Type II respiratory failure, there is not only a lack of oxygen but also an accumulation of carbon dioxide. Therefore, for Type I respiratory failure, the oxygen flow can be higher, over five liters per minute, and the patient can continuously receive oxygen without causing significant side effects. However, for Type II respiratory failure, it is essential to control the oxygen flow at a low rate, under three liters per minute, otherwise, it may lead to other complications.

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Written by Wang Li Bing
Intensive Care Medicine Department
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How to administer oxygen for respiratory failure.

First, we should evaluate whether the patient has type I or type II respiratory failure based on arterial blood gas analysis. Type I respiratory failure is primarily characterized by low oxygen tension, indicating a state of hypoxia, with normal carbon dioxide tension, in which case high-flow oxygen therapy can be administered. In type II respiratory failure, both the oxygen tension is low and the carbon dioxide tension is high. In this case, only low-flow oxygen therapy should be given, or non-invasive ventilation, or endotracheal intubation connected to mechanical ventilation may be employed.

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Written by Peng Miao Yun
Internal Medicine
1min 6sec home-news-image

Care of Patients with Respiratory Failure

In the nursing care of patients with respiratory failure, it is important to strictly monitor vital signs daily, as respiratory failure is considered an emergency and critical condition clinically. Observe the patient's blood pressure, consciousness state, and respiratory rate. At the same time, good skin care and oral care should be maintained to prevent aspiration pneumonia and bedsores. Most importantly, secretions should be cleared in a timely manner, including phlegm. Conscious patients should be encouraged to cough forcefully. For patients who are weak in coughing, assist them in turning and patting their backs regularly to facilitate the expulsion of phlegm. For comatose patients, mechanical suction can be used to maintain airway patency. It is advisable to avoid factors that may cause breathing difficulties, such as cold wind and poor air circulation. Pay attention to enhancing physical exercise appropriately, preventing colds, and maintaining a regular lifestyle.

doctor image
home-news-image
Written by Peng Miao Yun
Internal Medicine
1min 29sec home-news-image

Care for patients with respiratory failure

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.