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학습 자료 둘러보기 →| Concept | Description | Clinical Significance |
|---|---|---|
| Respiratory Failure (Impending) | Inability of the respiratory system to maintain adequate gas exchange (O2/CO2). | Life-threatening emergency. Early signs include increased work of breathing, tachypnea, hypoxemia, altered mental status. |
| Accessory Muscle Use | Recruitment of neck (SCM, scalene) and chest muscles to assist breathing. | Sign of severe respiratory distress and diaphragm fatigue. A key physical assessment finding. |
| Cyanosis | Bluish skin/mucous membrane color due to deoxygenated hemoglobin (>5 g/dL). | A late sign of hypoxemia. May not be visible in anemia or poor lighting. |
| Hypoxic Drive | In some severe COPD patients, the primary stimulus to breathe is low O2, not high CO2. | Rationale for cautious low-flow O2 therapy (1-3 L/min via NC) to avoid respiratory depression. |
| Assessment Finding | Indicates... | Priority & Action |
|---|---|---|
| New accessory muscle use, cyanosis, SpO2 < 90% | Impending Respiratory Failure | HIGHEST PRIORITY. Immediate intervention: Call RRT, prepare for advanced airway/ventilation support. |
| Tachycardia, mild hypertension, anxiety | Sympathetic nervous system activation (stress, pain, early hypoxemia). | Monitor closely. Address underlying cause (e.g., improve oxygenation, provide reassurance). |
| Low-grade fever, increased sputum | Possible infection contributing to COPD exacerbation. | Important to treat but not an immediate life threat. Obtain cultures, administer antibiotics as ordered. |
| Confusion, restlessness | Cerebral Hypoxemia or Hypercapnia (CO2 narcosis). | A critical change in mental status is a major red flag in respiratory patients. Requires urgent ABG (Arterial Blood Gas) analysis. |
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