Respiratory Distress vs. Respiratory Failure (Pediatric Nursing)

by Paula Ruedebusch

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    00:01 Now we're going to compare respiratory distress versus respiratory failure.

    00:04 In respiratory distress, your child is able to maintain their oxygenation by increasing their work of breathing.

    00:12 In respiratory failure, the child can no longer compensate for the inadequate oxygenation despite their increased respiratory rate and effort.

    00:20 This child is at risk for circulatory and respiratory system collapse.

    00:25 Signs and symptoms of respiratory distress include tachypnea, so an increased respiratory rate.

    00:31 The child does this to compensate.

    00:34 The child may have the nasal flaring and pursed lips, and this is an attempt to move more air into the system.

    00:40 The child may have stridor or wheezing as the airway is beginning to tighten.

    00:45 They may have an altered mental status, and they may be agitated.

    00:49 These children are getting air hungry.

    00:52 Their heart rate is going to increase to spread the blood faster throughout the body, and they're going to start with a delayed capillary refill due to the distal vasoconstriction.

    01:03 When a child progresses to respiratory failure, you're going to see their respiratory rate significantly increase.

    01:09 And this number says 60, but remember, that's going to vary based on the patient's age.

    01:13 The patient will begin retracting, and we saw that this can progress from mild to moderate to severe, based on the locations.

    01:21 The child may start grunting, and their skin may look mottled.

    01:23 Remember, this is the vasoactivity that's beginning.

    01:29 The child may have some head bobbing, and this is as their state of alertness begins to suffer.

    01:34 They're going to become even more air hungry, and their heart rate is going to decrease, and this shows that they're not really compensating very well.

    01:43 If there's not an immediate intervention, your patient can progress to respiratory arrest.

    01:48 This is where the patient's respiratory rate will decrease.

    01:51 They will have inefficient respirations, and the patient may become cyanotic and grey.

    01:59 The patient will stop moving air.

    02:03 Here's an example of a respiratory status scoring tool.

    02:06 Now, wherever you work, there's going to be different models that you can use, and you will assign points based on your patient.

    02:12 This gives the clinician an objective way to see if their patient's improving or declining.

    02:16 It's also good to use at the end of shift report to see if your patient's doing better or worse.

    02:21 Here's an example on the right of points assigned based on respiratory rate.

    02:25 This will give the child either 1, 2 or 3 points.

    02:29 Next, there will be a chart based on the presence and location of retractions, and the child will also get points based on this.

    02:36 Next, you'll check for the presence of dyspnea and assign points accordingly.

    02:40 Finally, the points will be assigned according to the findings on the auscultation exam, and the total will let the clinician know the patient's respiratory status score.

    About the Lecture

    The lecture Respiratory Distress vs. Respiratory Failure (Pediatric Nursing) by Paula Ruedebusch is from the course Respiratory Disorders – Pediatric Nursing.

    Included Quiz Questions

    1. Tachypnea
    2. Tachycardia
    3. Delayed capillary refill
    4. Bradycardia
    5. Hypotension
    1. Mottling
    2. Respiratory rate > 60/min
    3. Bradycardia
    4. Hypotension
    5. Delayed capillary refill
    1. Bradypnea
    2. Cyanosis
    3. Bradycardia
    4. Hypotension
    5. Tachypnea

    Author of lecture Respiratory Distress vs. Respiratory Failure (Pediatric Nursing)

     Paula Ruedebusch

    Paula Ruedebusch

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