Acute Respiratory Failure & ARDS - Concept Map
Acute Respiratory Failure & Acute Respiratory Distress Syndrome (ARDS)
Related concepts
Acute Respiratory Failure (ARF)
Sub concepts
- Type I Failure (Hypoxaemic)
- Type II Failure (Hypercapnic)
- Pathophysiological mechanisms
- Clinical manifestations
- Diagnostic criteria
Relationship to central
Core pathophysiological condition characterized by inadequate gas exchange
Acute Respiratory Distress Syndrome (ARDS)
Sub concepts
- Pathophysiology and alveolar-capillary membrane damage
- Triggers and risk factors
- Diagnostic criteria (bilateral infiltrates, non-cardiogenic pulmonary oedema)
- Clinical progression
- Complications
Relationship to central
Severe inflammatory lung injury resulting in refractory hypoxaemia
Pulmonary Embolism (PE)
Sub concepts
- Virchow's Triad (venous stasis, hypercoagulability, endothelial injury)
- Risk factors
- Acute manifestations
- Diagnostic assessment
- Anticoagulation management
Relationship to central
Critical complication of respiratory failure; thromboembolic obstruction of pulmonary artery
Mechanical Ventilation
Sub concepts
- Ventilation modes and parameters
- PEEP and oxygenation
- Lung-protective ventilation strategies
- Nursing care of ventilated patients
- Ventilator alarm management
- VAP prevention bundle
Relationship to central
Essential respiratory support intervention for ARF and ARDS patients
Nursing Assessment & Prioritization
Sub concepts
- Early warning signs (restlessness, agitation, mental status changes)
- ABG interpretation
- Vital sign monitoring
- Oxygen saturation assessment
- Airway, breathing, circulation prioritization
Relationship to central
Clinical recognition and Maslow-based prioritization framework for respiratory emergencies
Pharmacological Management
Sub concepts
- Anticoagulants (Heparin, LMWH, Warfarin, DOACs)
- Monitoring parameters (aPTT, PT/INR)
- Antidotes and reversal agents
- Sedation and analgesia
- Bleeding risk management
Relationship to central
Medication interventions for anticoagulation, sedation, and supportive care
Infection Prevention & Complications
Sub concepts
- Ventilator-associated pneumonia (VAP)
- Barotrauma and volutrauma
- Heparin-induced thrombocytopenia (HIT)
- Multi-organ dysfunction
- Pulmonary fibrosis in ARDS survivors
Relationship to central
Preventing and managing ventilator-associated and iatrogenic complications
Patient Education & Prevention
Sub concepts
- Anticoagulant safety counseling
- DVT/PE prevention strategies
- Lifestyle and activity modifications
- Family communication and involvement
- Post-critical care rehabilitation
Relationship to central
Health promotion and disease prevention aligned with RA 9173 nursing standards
Concept connections
- Acute Respiratory FailureType I Hypoxaemic FailureARF is classified into Type I with oxygenation as the primary problem
- Acute Respiratory FailureType II Hypercapnic FailureARF is classified into Type II with ventilation and CO2 retention as the primary problem
- Type I Hypoxaemic FailureARDSARDS is a specific severe form of Type I failure characterized by refractory hypoxaemia
- ARDSMechanical VentilationNearly all ARDS patients require intubation and mechanical ventilation with PEEP support
- Pulmonary EmbolismAcute Respiratory FailurePE causes Type I respiratory failure through V/Q mismatch and shunting
- Mechanical VentilationVAP Prevention BundleVAP prevention is essential nursing care for mechanically ventilated patients to reduce complications
- Pulmonary EmbolismAnticoagulationAnticoagulation therapy is the mainstay treatment for PE prevention of clot propagation
- Virchow's TriadPulmonary EmbolismThe three factors of venous stasis, hypercoagulability, and endothelial injury explain PE pathophysiology and risk
- ARDS TriggersAlveolar-Capillary Membrane DamageEach trigger initiates the inflammatory cascade resulting in diffuse membrane damage
- Refractory HypoxaemiaARDS Hallmark FeatureRefractory hypoxaemia that does NOT improve with supplemental oxygen is the defining characteristic separating ARDS from other hypoxaemia causes
- Surfactant LossAtelectasisLoss of surfactant leads to alveolar collapse and atelectasis, worsening V/Q mismatch
- PEEPAlveoli RecruitmentPEEP maintains positive pressure at end-expiration, keeping alveoli open and improving oxygenation in ARDS
- Low Tidal Volume StrategyLung ProtectionUsing 6 mL/kg tidal volumes prevents barotrauma and volutrauma in mechanically ventilated ARDS patients
- Prone PositioningARDS OxygenationProne positioning improves V/Q matching and recruits dependent lung regions in moderate-to-severe ARDS
- Mental Status ChangesEarly Hypoxaemia RecognitionRestlessness, agitation, and confusion are among the EARLIEST clinical signs of hypoxaemia and must not be dismissed
- ABG InterpretationType DifferentiationABG values define whether respiratory failure is Type I or Type II and guide oxygen delivery strategy
- D-dimer TestPE ScreeningNormal D-dimer helps rule out PE in low-risk patients; elevated D-dimer is sensitive but not specific
- CTPA ImagingPE DiagnosisCT pulmonary angiography is the gold-standard confirmatory test for PE
- Heparin MonitoringHIT ComplicationHeparin-induced thrombocytopenia is a serious complication requiring platelet count monitoring
- Warfarin TherapyVitamin K ConsistencyConsistent vitamin K intake is essential for stable INR control and warfarin efficacy
- Head of Bed ElevationVAP PreventionMaintaining head of bed at 30-45 degrees reduces aspiration risk and is a core VAP prevention strategy
- Daily Sedation InterruptionWeaning ReadinessDaily sedation holidays allow assessment of patient's readiness to wean from mechanical ventilation
- Oral Care with ChlorhexidineBacterial Colonization PreventionChlorhexidine rinses reduce bacterial colonization of the oropharynx and lower VAP risk
- High Pressure AlarmObstruction IdentificationHigh-pressure alarms indicate potential airway obstruction from secretions, kinking, or patient factors
- Low Pressure AlarmLeak or DisconnectionLow-pressure alarms suggest a leak or disconnection in the ventilator circuit requiring immediate assessment
- Manual VentilationEmergency ResponseManual bag-valve-mask ventilation is the critical intervention when ventilator problems cannot be quickly resolved
- Oxygenation SupportAirway-Breathing-Circulation PrioritizationEnsuring adequate oxygenation is the first priority in the ABCs of emergency assessment and aligns with Maslow hierarchy
- RA 9173 Nursing PracticeAdvanced Practice Nursing SkillsComplex respiratory management reflects the expanded nursing scope under Philippine Nursing Licensure regulations
- Critical Care NursingContinuous Patient MonitoringICU and respiratory critical care requires constant vital sign, ABG, and oxygenation monitoring per nursing standards
- Patient EducationPE PreventionTeaching about DVT/PE risk reduction, anticoagulant safety, and activity modification are essential post-discharge nursing interventions
Diagrams
Acute Respiratory Failure & ARDS - Complete Concept Map
Comprehensive mind map showing the hierarchical organization of all key concepts in Acute Respiratory Failure and ARDS, including pathophysiology, clinical manifestations, diagnostic criteria, management strategies, and nursing priorities. Central to the NLE exam focus on rapid assessment and airway-breathing-circulation prioritization.
Type I vs Type II Respiratory Failure - Diagnostic & Management Flowchart
Decision tree flowchart for differentiating Type I (hypoxaemic) from Type II (hypercapnic) respiratory failure using ABG values, identifying the underlying problem, determining the cause, and selecting appropriate oxygen delivery strategy. Essential for NLE exam prioritization.
ARDS Pathophysiology & Progression - Sequential Process Flow
Sequential process flowchart showing ARDS pathophysiology from trigger event through alveolar-capillary membrane damage, surfactant loss, atelectasis, and progression to refractory hypoxaemia. Illustrates why ARDS is a specific diagnosis separate from general respiratory failure and guides intervention selection.
Pulmonary Embolism Assessment & Management - Clinical Decision Pathway
Clinical decision pathway for PE assessment using Virchow's Triad risk factors, CTPA confirmation, haemodynamic stratification, and management selection. Integrates anticoagulation monitoring and nursing priorities aligned with NLE exam emphasis on acute recognition and intervention.
Mechanical Ventilation Alarms & Nursing Response - Quick Reference
Quick-reference flowchart for systematic response to ventilator alarms. High-pressure alarm suggests obstruction requiring suctioning, circuit checks, or tube repositioning. Low-pressure alarm suggests leak or disconnection. Emphasizes the critical intervention: if unsure, manually ventilate with bag-valve-mask and call for help. Essential for ICU competency.
Anticoagulation Monitoring & Safety - Drug-Specific Guidelines
Comprehensive anticoagulation monitoring flowchart comparing heparin, LMWH, warfarin, and DOACs. Shows monitoring parameters, target ranges, antidotes, and patient safety education focused on bleeding risk. Critical for NLE exam questions on PE/DVT management and drug monitoring.
VAP Prevention Bundle & Ventilated Patient Care - Evidence-Based Protocol
Evidence-based VAP prevention bundle and ventilated patient care protocol. Integrates ETT confirmation, positioning, oral care, daily sedation interruption, and weaning assessment. Addresses suctioning technique and patient communication. Aligns with WHO and Philippines hospital guidelines for ICU practice.
ARDS Severity Progression & Ventilation Strategy States
State diagram showing ARDS severity progression from trigger event through mild, moderate, and severe stages, with corresponding ventilation strategies. Illustrates how PEEP requirements and low tidal volume strategies escalate with severity. Shows pathways to either recovery or complications.
ARDS Triggers - Distribution by Frequency
Pie chart showing the relative frequency of ARDS triggers seen in clinical practice. Sepsis is the most common trigger at approximately 40%, followed by aspiration, trauma, and pancreatitis. Important for NLE exam focus on recognizing the most likely etiology in case scenarios.