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409 > ARDS > Flashcards

ARDS Flashcards

1
Q

ARDS is…

A
  • sudden and life threatening
  • decline in gas exchange
  • failure to provide oxygenation
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2
Q

what are the parameters of ARDS

A

pH of < 7.35
PaO250 ((hypercapnea)
acute vs chronic

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3
Q

what are the 3 main reasons for ARDS

A

failure to ventilate
failure to oxygenate
failure to maintain airway

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4
Q

name some reasons for failure to ventilate

A

neuro: can be r/t to mental status, SC injury
muscular: IC muscles
inability to breathe in
guillian barre, myasthenia gravis
chest trauma

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5
Q

name some reasons for failure to oxygenate

A

diffuison abnormalities
dead space
shunting
alveoli functioning

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6
Q

name some reasons for failure to maintain airway

A 
chest trauma
hemothorax
barrel chest
positioning
diaphragm compression
mass
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7
Q

Acute Respiratory Failure can be the result of main reasons

A 
Lung Failure(type i)-gas exchange failure by  low O2 levels (hypoxemia)
Pump Failure(type II) - ventillatory failure by hypercapnea (lack of perfusion)
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8
Q

early signs of acute respiratory failure

A 
restlessness
fatigue
h/a
dyspnea
tachycardia
hypertension
hypoxemia
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9
Q

progressive signs of acute respiratory failure

A 
confusion
lethargy
tachycardia
tachypnea
central cyanosis
diaphoresis
respiratory arrest
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10
Q

why would you see confusion in a progressive sign of ARDS

A

brain is hypoxic and hypercapneic

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11
Q

how do you manage ARDS

A 
correct underlying cause
restore gas exchange in the lung
intubation/mechanical ventilation
abg
SaO2
VS
ICU Care
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12
Q

what is the most intense intervention you can do for a pt w/ ARDS?

A

proning

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13
Q

what is the pharmaceutical therapies that are executed for ARDS

A
  • lasix- shifts fluid from dead space to system for renal system to excrete
  • abx for infec
  • nitric oxide- inhaled vasodilator
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14
Q

def ARDS

A

a severe form of acute lung injury that results from:

  • severe inflammatory process
  • sudden and progressive pulmonary edema
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15
Q

what will the clinician find on the CXR with ARDS?

A

bilateral infiltrates and consolidation

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16
Q

will ARDS respond to oxygen- with or without PEEP?

A

no

17
Q

what other findings will the clinician find with ARDS

A

reduced lung compliance

death from MODS w/ sepsis

18
Q

what is a healthy persons natural PEEP?

A

3

19
Q

if on a vent, what is the lowest PEEP setting?

A

5

20
Q

If on a vent, what is a comfortable high PEEP setting?

A

15

21
Q

If on a vent, what is the absolute high PEEP setting?

A

20

22
Q

Direct factors a/w the dev of ARDS

A 
PNA
aspirations of gastric contents
pulmonary contusion
near drowning
toxic inhalation injury
23
Q

indirect factors a/w with the dev of ARDS

A 
severe trauma
multiple bone fracs
flail chest
head trauma
burns
multiple transfusions
drug overdose
pancreatitis
post cardiopulm bypass
24
Q

ARDS inflammation triggers the release of what

A

cellular and chemical mediators

25
Q

ARDS causes injury to the ….

A

alveolar capillary membrane

26
Q

severe ________-___________ __________ occurs

A

ventilation-perfusion mismatch

27
Q

ARDS also causes

A

alveolar collapse
small airway constriction
lung compliance decrease
shunting

28
Q

ARDS clinical manifestations

A 
resembles severe pulmonary edema
rapid onset dyspnea
        72 hr after precepit event
arterial hypoxemia
visible bilateral infiltrates
alveoli: good ventilation but poor perfusion
decr pulm compliance: stiff
29
Q

ARDS Recovery

A

oxygenation
CXR improvement
better lung compliance
SPO2 and gases imrove

30
Q

assessment of ARDS

A
  • develops bx 48-72 hrs
  • IC retractions
  • crackles
  • rapid onset dyspnea
  • arterial hypoxemia: refractory to O2 therapy
  • bilateral infiltrates
  • pulmonary edema?
  • BNP
31
Q

ARDS mgmt

A 
aggressive and supportive care
intubation/mechanical ventilation
        PEEP to improve oxygenation
abg's
SaO2, SpO2
circulatory support
fluid volume
nutrition
pharmacology
        sedatives
         analgesics
         neuromuscular blockade
         inhaled nitric oxide
rotoprone (special bed)
32
Q

what nutrients will help an ARDS patient?

A

vitamins
calories
PROTEIN

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