Nursing care for respiratory failure in a patient with pulmonary edema and acidosis metabolic

Abstract

ABSTRACT Impaired performance of the respiratory muscle pump or lung dysfunction can lead to a severe condition of respiratory failure. Therefore, mechanical ventilation is used to sustain the life of individuals with this syndrome. Furthermore, this condition is harmful to the body and can cause complications. This study aimed to describe nursing care provided to patients with respiratory failure. The design was a case study with narrative analysis. The data were collected in October 2022 at a Government Teaching Hospital in Bandung. The nursing assessment shows that the patient (Mr. S) was unconscious and unresponsive to pain stimuli under sedation. The patient was in moderate acute respiratory distress syndrome, receiving mechanical ventilation with synchronized intermitten mandatory ventilation pressure control and pressure support (SIMV PCPS) mode, and was breathing spontaneously. Furthermore, there were rhonchi breath sounds, temporary gurgling sounds, pitting edema in the upper and lower extremities, and anuria. Impaired spontaneous breathing is the key nursing concern for this patient, along with poor airway clearance as well as fluid and electrolyte imbalance. In conclusion, ventilation is the primary management of the patient with respiratory failure. This intervention should be given appropriately to reduce the disease’s symptoms and the risk of complications. Therefore, maintaining a low tidal volume, prone position, continuous respiratory assessment, minimizing sedation, suctioning, and chest physiotherapy are essential to achieve a good outcome.