ARDS

Question 1

Hypoxemic 3

Answer 1

Lack of oxygenation- PaO2 <60
Causes: V/Q mismatch, shunting, diffusion problem-fluid in lungs, oversedation, vent sept defect, neuromuscular dz, COPD, Pneumonia, pulm edema, fibrosis, ARDS,
S/S: tachypnea, accessory muscle use, cyanosis late sign, fatigue, low SpO2 80, dyspnea, agitation/disorientation,

Question 2

Hypercap 3

Answer 2

PaCO2>45 & pH<7.35
Causes: CNS depression, chest wall problem-rib fx, asthma/COPD (air trapping), neuromuscular dz drug OD,TBI
S/Bradypnea then tachy, tripod pursed breathing, disorientation-early sign, am headache, progressive somnolence, cardiac dysrhythmias( indicate acidosis) , dyspnea

Question 3

What interventions are used to treat ARDS? Treat

Answer 3

Treat underlying cause!, oxygen therapy, steroids, bronchodilators, diuretics, abx

Question 4

What is hypoxemia with measurement
What is Hypercapnia with measurement

Answer 4

Low 02 Pa02 < or= to 60 on 60% 02
High CO2 >45 and pH<7.35

Question 5

best indication of hypo/hyper

Answer 5

ABGs tb 67-2

Question 6

Assessment of Hyper/hypo 5

Answer 6

ABG
Respiratory rate and depth
work of breathing
activity level
auscultation

Question 7

Diagnostic testing for hyper/hypo
5

Answer 7

CXR ct/VQ
ABGs
Pulse Ox
CBC
ETCO2

Question 8

Interventions for Respiratory Failure

Answer 8

Mobilization of secretions, good lung down
PPV
Tx underlying cause

Question 9

What does ARDS stand for

Answer 9

Acute Respiratory Distress Syndrome

Question 10

Patho ARDS-5
What causes ARDS 11

Answer 10

Fluid in alveoli sac leads to collapse of sac, hypoxemia, fast onset high mortality rate can be direct or indirect
Sepsis #1, Aspiration of gastric contents, pneumonia, shock, Chest trauma, embolism, near drowning, acute pancreatitis, burns, blood t, drug overdose.

Question 11

Patho ARDS Exudative state 7

Answer 11

Injury or exudative state- 1-7 days
Fluid, damage to alveoli cells, atelectisis, hyaline membrane formation, fibrosis refactory hypoxemia

Question 12

ARDS Proliferation state 3

Answer 12

1-2 weeks, lungs have dense fibrotic tissue, pulmonary hypertension,

Question 13

ARDS Fibrotic stage 4

Answer 13

2-3 weeks chronic
Further scarring and remodeling dead space not all patients.

Question 14

Complications of ARDS 12

Answer 14

VAP bundle, Barotrauma, Volutrama-Alveolar tears, Stress ulcers, Renal failure, cath infections, DEcreased Cardiac output, DIC< Trach ulceration, PI, Delirium, Skin breakdown

Question 15

Interventions for ARDS

Answer 15

Maintain airway
pa02>60
PPV
PEEP
ECMO
Prone
Nutrition fluid balance