ARDS and PE

Question 1

ARDS

Answer 1

non-cardiac pulmonary edema and disruption of the alveolar
-capillary membrane

Question 2

Direct injury ARDS

Answer 2

Impacts lung tissue
– Aspiration
– Near drowning
– Pulmonary contusion
– Toxic inhalation (ex: smoke from
house fire)
– Oxygen toxicity
– Pneumonia

Question 3

Indirect injury

Answer 3

Cause insult to the body with release of mediators
(immune response) in overabundance, causing harm to
the patient
– Sepsis
– Cardiopulmonary bypass
– Embolism
– DIC
– Multisystem trauma
– Eclampsia
– Pancreatitis
– Drug overdose
– Transfusion related lung injury

Question 4

3 phases of ARDS

Answer 4

Exudative
Proliferation
Healing

Question 5

Exudative Phase

Answer 5

24 hours of insult
S/S tachypnea, restlessness, apprehension, CLOC

Question 6

Proliferation

Answer 6

4- 21 days after onset
Pulmonary edema resolves
Lungs less compliant, WOB increases, Pulmonary hypertension
S/S agitation, dyspnea, fatigue, crackles, excessive use of accessory muscles.

Question 7

Recuperative Phase

Answer 7

2-3 weeks after initial insult
Lungs are stiff
MODS

Question 8

Assessment of ARDS

Answer 8

Low PaCO2 - respiratory alkalosis
CXR may appear normal and then white out

Question 9

ARDS Treatment

Answer 9

Oxygen
PEEP
Ventilation
Tissue Perfusion
Costicosteroids?

Comfort - sedation. pain relief
Positioning

Question 10

Pulmonary Embolism

Answer 10

Clot or embolism in the pulmonary arteries

V/Q mismatch

Question 11

S/S PE

Answer 11

– Dyspnea
– Pleuritic chest pain
– Cough
– Tachycardia
– Tachypnea
– Heart palpitations
– Anxiety/apprehension
– Leg swelling
– Diaphoresis
– Hemoptysis
– Wheezing
– Syncope

Question 12

Diagnostics PE

Answer 12

– ABG
– D-Dimer
– EKG
– CXR
– CT
* Spiral CT
– V/Q Scan
– US
* Duplex venous
– Pulmonary Angiogram

Question 13

Treatment PE

Answer 13

Oxygen
Thrombolytics - heparin
Monitor for bleeding