NLE Respiratory Nursing — Acute Respiratory Failure & ARDSConcept Map

Concept

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

Concept

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

Concept

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

Concept

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

Concept

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

Concept

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

Concept

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

Concept

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

To

Type I Hypoxaemic Failure

From

Acute Respiratory Failure

Strength

strong

Relationship

ARF is classified into Type I with oxygenation as the primary problem

To

Type II Hypercapnic Failure

From

Acute Respiratory Failure

Strength

strong

Relationship

ARF is classified into Type II with ventilation and CO2 retention as the primary problem

To

ARDS

From

Type I Hypoxaemic Failure

Strength

strong

Relationship

ARDS is a specific severe form of Type I failure characterized by refractory hypoxaemia

To

Mechanical Ventilation

From

ARDS

Strength

strong

Relationship

Nearly all ARDS patients require intubation and mechanical ventilation with PEEP support

To

Acute Respiratory Failure

From

Pulmonary Embolism

Strength

strong

Relationship

PE causes Type I respiratory failure through V/Q mismatch and shunting

To

VAP Prevention Bundle

From

Mechanical Ventilation

Strength

strong

Relationship

VAP prevention is essential nursing care for mechanically ventilated patients to reduce complications

To

Anticoagulation

From

Pulmonary Embolism

Strength

strong

Relationship

Anticoagulation therapy is the mainstay treatment for PE prevention of clot propagation

To

Pulmonary Embolism

From

Virchow's Triad

Strength

strong

Relationship

The three factors of venous stasis, hypercoagulability, and endothelial injury explain PE pathophysiology and risk

To

Alveolar-Capillary Membrane Damage

From

ARDS Triggers

Strength

strong

Relationship

Each trigger initiates the inflammatory cascade resulting in diffuse membrane damage

To

ARDS Hallmark Feature

From

Refractory Hypoxaemia

Strength

strong

Relationship

Refractory hypoxaemia that does NOT improve with supplemental oxygen is the defining characteristic separating ARDS from other hypoxaemia causes

To

Atelectasis

From

Surfactant Loss

Strength

strong

Relationship

Loss of surfactant leads to alveolar collapse and atelectasis, worsening V/Q mismatch

To

Alveoli Recruitment

From

PEEP

Strength

strong

Relationship

PEEP maintains positive pressure at end-expiration, keeping alveoli open and improving oxygenation in ARDS

To

Lung Protection

From

Low Tidal Volume Strategy

Strength

strong

Relationship

Using 6 mL/kg tidal volumes prevents barotrauma and volutrauma in mechanically ventilated ARDS patients

To

ARDS Oxygenation

From

Prone Positioning

Strength

moderate

Relationship

Prone positioning improves V/Q matching and recruits dependent lung regions in moderate-to-severe ARDS

To

Early Hypoxaemia Recognition

From

Mental Status Changes

Strength

strong

Relationship

Restlessness, agitation, and confusion are among the EARLIEST clinical signs of hypoxaemia and must not be dismissed

To

Type Differentiation

From

ABG Interpretation

Strength

strong

Relationship

ABG values define whether respiratory failure is Type I or Type II and guide oxygen delivery strategy

To

PE Screening

From

D-dimer Test

Strength

moderate

Relationship

Normal D-dimer helps rule out PE in low-risk patients; elevated D-dimer is sensitive but not specific

To

PE Diagnosis

From

CTPA Imaging

Strength

strong

Relationship

CT pulmonary angiography is the gold-standard confirmatory test for PE

To

HIT Complication

From

Heparin Monitoring

Strength

strong

Relationship

Heparin-induced thrombocytopenia is a serious complication requiring platelet count monitoring

To

Vitamin K Consistency

From

Warfarin Therapy

Strength

strong

Relationship

Consistent vitamin K intake is essential for stable INR control and warfarin efficacy

To

VAP Prevention

From

Head of Bed Elevation

Strength

strong

Relationship

Maintaining head of bed at 30-45 degrees reduces aspiration risk and is a core VAP prevention strategy

To

Weaning Readiness

From

Daily Sedation Interruption

Strength

strong

Relationship

Daily sedation holidays allow assessment of patient's readiness to wean from mechanical ventilation

To

Bacterial Colonization Prevention

From

Oral Care with Chlorhexidine

Strength

moderate

Relationship

Chlorhexidine rinses reduce bacterial colonization of the oropharynx and lower VAP risk

To

Obstruction Identification

From

High Pressure Alarm

Strength

strong

Relationship

High-pressure alarms indicate potential airway obstruction from secretions, kinking, or patient factors

To

Leak or Disconnection

From

Low Pressure Alarm

Strength

strong

Relationship

Low-pressure alarms suggest a leak or disconnection in the ventilator circuit requiring immediate assessment

To

Emergency Response

From

Manual Ventilation

Strength

strong

Relationship

Manual bag-valve-mask ventilation is the critical intervention when ventilator problems cannot be quickly resolved

To

Airway-Breathing-Circulation Prioritization

From

Oxygenation Support

Strength

strong

Relationship

Ensuring adequate oxygenation is the first priority in the ABCs of emergency assessment and aligns with Maslow hierarchy

To

Advanced Practice Nursing Skills

From

RA 9173 Nursing Practice

Strength

moderate

Relationship

Complex respiratory management reflects the expanded nursing scope under Philippine Nursing Licensure regulations

To

Continuous Patient Monitoring

From

Critical Care Nursing

Strength

strong

Relationship

ICU and respiratory critical care requires constant vital sign, ABG, and oxygenation monitoring per nursing standards

To

PE Prevention

From

Patient Education

Strength

strong

Relationship

Teaching about DVT/PE risk reduction, anticoagulant safety, and activity modification are essential post-discharge nursing interventions