(^126) Medical-Surgical Nursing Demystified
- elevated carbon dioxide (PaCO 2 ) >50 mmHg without underlying lung
disease - arterial oxygen saturation (SaO 2 ) <90 percent
- pH <7.30 (respiratory acidosis)
- Pulse oximetry shows low oxygen saturation.
- Increased WBC count due to infection.
TREATMENT
- Oxygen therapy to meet body’s needs via nasal canula or mask.
- Administer bronchodilators to enhance airflow through airways in lungs:
- albuterol, levalbuterol, metaproterenol, terbutaline
- Administer anticholinergics to treat bronchospasm:
- ipratropium
- Intubation to maintain patent airway and assist mechanical ventilation.
- Administer anesthetic to ease intubation:
- propofol
- Mechanical ventilation to support respiratory effort.
- Administer neuromuscular blocking agent to ease mechanical ventilation so
the patient won’t fight ventilator:- pancuronium, vecuronium, atracurium
- Administer steroids to decrease inflammatory response within lungs:
- hydrocortisone, methylprednisolone, prednisone
- Administer anticoagulant to reduce risk of clot formation:
- heparin, warfarin
- Administer analgesic for discomfort and to decrease myocardial oxygen
demand:- morphine
- Administer histamine-2 blockers or proton pump inhibitors to reduce chances
of stress-induced gastric ulcer:- famotidine, ranitidine, nizatidine, cimetidine
- omeprazole, esomeprazole, lansoprazole, rabeprazole, pantoprazole
- Administer antibiotics to treat infection (or may be preventative):
- selected according to results of culture and sensitivity study