respiratory failure-help


can anyone tell me how you distinguish between the early and late stages of respiratory failure? Please? I have searched and searched with nothing to contrast the two. I know the PaCo2 will increase and the PaO2 will decrease. The patient can be hypoxemic or hypercapneic. Am I on the right boat?

Daytonite, BSN, RN

4 Articles; 14,603 Posts

Specializes in med/surg, telemetry, IV therapy, mgmt. Has 40 years experience.

It is all in the pathophysiology process going on. The PaCO2 is the culprit. It becomes elevated because of compromised lung mechanics in people who have an upper airway obstruction or whose pulmonary muscle is fatigued. Follow the progressive steps of what happens as CO2 increases and O2 decreases and the symptoms that are created to get the early and late stages. Respiratory failure happens when the patient cannot remove carbon dioxide from their alveoli which results in carbon dioxide retention and hypoxemia. Oxygen reaches the alveoli but cannot be absorbed and used properly. The lungs can move air but cannot move gasses in and out properly so oxygenation of the blood isn't occurring. Respiratory failure occurs because the lungs fail and CO2 is to blame. PaCO2 is greater than 45mmHg in these cases.

Here are the progressive signs:

  • dyspnea
  • headaches
  • restlessness
  • confusion
  • tachycardia
  • cyanosis
  • dysrhythmias
  • decreased level of consciousness
  • altered respirations and breath sounds


237 Posts


Thank you so very much!!! I hope that one day I will be able to help out my fellow colleagues as much as you have helped me and others out!!! Thank you and bless you.

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