Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NUR 206: Development > ARDS > Flashcards

ARDS Flashcards

1
Q

ARDS definition

A

Rapid onset of noncardiac pulmonary edema

Progressive refractory hypoxemia

Extensive lung tissue inflammation

Small blood vessel injury

Multisystem organ failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Pathophysiology of ARDS

A

Acute lung injury

Unregulated systemic inflammatory response

Damaged capillary membranes leak

Damage alveolar membrane

Fluid enters alveoli

Significant tissue hypoxia results

Metabolic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Risk Factors for ARDS

Direct Insults

A

Direct insults

Aspiration of gastric contents
Inhalation injuries
Smoke inhalation
Salt water inhalation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Risk Factors for ARDS

Indirect Insults

A

Indirect insults

Overall body sepsis
Trauma
Gastrointestinal infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

The greatest risk factor for ARDS is

A

Aspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Initial manifestations of ARDS begin

A

24–48 hours post insult

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Early signs of ARDS

A

Dyspnea and tachypnea are early signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

S/S of ARDS

A

Progressive respiratory distress
Hypoxia
Hypercapnia
Agitation, confusion, and lethargy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Diagnostic Tests for ARDS

A

ABG analysis to determine oxygen levels

Chest x-ray to determine fluid in lungs

Blood tests such as CBC, blood chemistry, and blood cultures

Sputum culture to determine cause of infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Pharmacological Therapy

A

No definitive drug therapy

Nitric oxide

  • Reduces intrapulmonary shunting
  • Improves oxygenation

Surfactant therapy

NSAIDS and corticosteroids are being studied

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Nonpharmacologic Therapy

A 
Mechanical ventilation
Artificial airways
Proper nutrition
Adequate amounts of fluids
Other clinical therapies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

The mainstay of ARDS management is

A

Mechanical Ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Types of ventilators
Negative vs Positive pressure
Noninvasive

A

Negative-pressure ventilators
*Create negative pressure externally to draw chest outward and air into lungs

Positive-pressure ventilators
*Push air into lungs

Noninvasive ventilation (NIV)

  • Uses face mask
  • Sleep apnea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

ARDS

What is happening?

A

A: Atelectasis
R: Refractory hypoxemia (hallmark sign)
D: Decreased lung compliance
S: Decreased surfactant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q 
Complications of Mechanical Ventilation
Why?
HAP
Barotrauma, pneumothorax
Cardiovascular effects
GI effects
A

Hospital-acquired pneumonia (HAP): loss of humidity and filtering from upper airway
Barotrauma: PEEP
Pneumothorax: PEEP
Cardiovascular effects: Increased pressure in the chest decreases cardiac output
Gastrointestinal effects: Misplacement of tube (monitor for abdominal distention)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Artificial Airways
What do they do?
Oropharangeal vs Naropharangeal

A

Inserted to maintain patent air passage

Oropharyngeal airways
*Stimulate gag reflex

Nasopharyngeal airways

  • Better tolerated by alert clients
  • Frequent oral care important
17
Q

Artificial Airways

Endotracheal tubes

A

General anesthesia, emergency situations
Specialized education to insert
Guided by laryngoscope
Client unable to speak while tube in place

18
Q

Artificial Airways

Tracheostomies

A

Long-term airway support
Opening to trachea through neck
Percutaneous or surgical insertion

19
Q

Nursing Considerations

Fluids and Nutrition

A

Monitor I & O
Renal perfusion
Catheter
Arterial line

20
Q

What effect does Mechanical Ventilation have on Cardiac Output?

A

increased intrathoracic pressure can decrease CO sec return of blood to the heart. Urine Output is an early sign.

21
Q 
Other Clinical Therapies for ARDS
Position?
Medications?
I/O?
Swan Ganz?
A

Prone positioning

Antibiotics
Low-molecular-weight heparin

Careful fluid replacement
Attention to nutrition

Swan-Ganz line to monitor

  • Pulmonary artery pressures
  • Cardiac output
22
Q

Weaning from ventilator support
When to start?
Why wean?

A

When: Begins after underlying process corrected

T-piece, CPAP
SIMV, PSV

Why: Reconditioning respiratory muscles
Terminal weaning

23
Q

Modes with positive pressure ventilators

A

Continuous positive airway pressure (CPAP)
Bilevel ventilator (BiPAP)
Assist-control mode ventilation (ACMV)
Synchronized intermittent mandatory ventilation (SIMV)
Positive end-expiratory pressure (PEEP)
Pressure-support ventilation (PSV)
Pressure-control ventilation (PCV)

24
Q

Ventilator settings

A

Rate, tidal volume, oxygen concentration

12–15 ventilator breaths per minute initially

25
Q

Symptoms of Barotrauma

*Pneumothorax

A

Tracheal Deviation
Asymmetrical Chest Rise
Absent Lung Sounds
Rice Crispies from air trapped

26
Q

Aspirating secretions through a catheter

When to suction?

Effects on patient?

A

Sterile technique
Open-tipped, whistle-tipped
Yankauer device for oral suctioning

Nursing decision to suction

  • Based on clinical need, not fixed schedule
  • Suctioning irritates mucous membranes

Uncomfortable for patient
Patient may feel panicked by loss of oxygen

27
Q

Nursing diagnoses may include:

Risk for \_\_\_\_\_
Ineffective \_\_\_\_\_
Ineffective \_\_\_\_\_
Impaired \_\_\_\_\_
Decreased \_\_\_\_\_
Dysfunctional \_\_\_\_\_
Imbalanced \_\_\_\_\_
Acute \_\_\_\_\_
A

Nursing diagnoses may include:

Risk for Acute Confusion
Ineffective Airway Clearance
Ineffective Breathing Pattern
Impaired Gas Exchange
Decreased Cardiac output
Dysfunctional Ventilator Weaning Response
Risk for Imbalanced Fluid Volume
Imbalanced Nutrition: Less Than Body Requirements
Risk for Infection
Acute Pain
Anxiety
28
Q

Client Goals with Planning

Be oriented \_\_\_\_\_
Receive adequate \_\_\_\_\_
Be free of \_\_\_\_\_\_
Maintain \_\_\_\_\_
Maintain \_\_\_\_\_
Receive adequate \_\_\_\_\_
Be free of \_\_\_\_\_
Have no development of \_\_\_\_\_
Manage \_\_\_\_\_
Cope with or be free from \_\_\_\_\_
A

Goals may include that client will:

Be oriented with each interaction
Receive adequate ventilatory support
Be free of pulmonary tissue damage
Maintain patent airways
Maintain adequate cardiac output
Receive adequate nutrition
Be free of signs, symptoms of infection
Have no development of thrombosis
Manage pain successfully
Cope with or be free from anxiety
29
Q

Common Interventions

Monitor-

A

Lab work and specimens
Suction airways as needed

Monitor

  • Vital signs hourly
  • Oxygenation status
  • Neurological status
  • Lung and heart sounds
30
Q

Position Interventions

A

Maintain HOB at 30° or higher

Prone position as tolerated 3–4x/day

31
Q

Common Medication Interventions

A

Provide analgesia, anxiolytics, sedation

Beta-agonist to maintain patent airways

32
Q

Common Interventions

Fluid balance?

Glucose levels?

Pulses?

A

Monitor hemodynamic status

Monitor renal function
Place Foley catheter
IV fluids as needed

Monitor glucose levels

Assess peripheral pulses

33
Q

Interventions

Maintain patent airway

A

Maintain patent airway

  • Suction as needed
  • Obtain sputum for culture
  • Chest physiotherapy as ordered
  • Secure endotracheal or tracheostomy tube
  • Maintain adequate hydration
34
Q

Interventions

Promote spontaneous ventilation

A

Promote spontaneous ventilation

Assess, document

Respiratory rate, VS, O2 saturation every 15–30 minutes

Promptly report worsening data

Administer O2 as ordered, monitor response

Place in Fowler or high-Fowler

Minimize activity, energy expenditures

35
Q

ARDS Pneumonic

A

A- atelectasis
R- refractory hypoxemia
D- decreased lung compliance
S- surfactant (damaged)

NUR 206: Development (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions