Ch. 27: Acute Respiratory Distress Syndrome Flashcards
1
Q
How is ARDS characterized by?
A
Pathologic changes in lung vasculature
Noncardiac pulmonary edema
Impaired gas exchange
More sever form of ALI
2
Q
Risk Factors for ARDS
A
Indirect pulmonary injury
Direct pulmonary injury
Whichever it is, systemic inflammatory response syndrome is activated AKA, SIRS
3
Q
Direct Pulmonary injuries
A
Aspiration Pneumonia Lung contusions w/ trauma Toxic inhalation Upper airway obstruction (relieved) SARS TB
4
Q
Indirect Pulmonary injuries
A
Sepsis Burns Trauma Blood transfusion Lung/Bone marrow transplant Overdose Drug reaction Bypass Pancreatitis
5
Q
Stage 1
A
Vague clinical symptoms Dyspnea Tachypnea Normal CXR Restlessness Use of accessory muscles Respiratory alkalosis
6
Q
Stage 2
A
Hypoxia becomes resistant to O2 supplement Patchy alveolar infiltrates in dependent areas Normal heart size Dysp/Tachyp Cyanosis Tachycardia Coarse crackles Hypoxemia Increased restlessness/agitation Increasing metabolic acidosis
7
Q
Stage 3
A
Decreased surfactant production Hyperdynamic hemodynamic parameters SIRS presentation Increased interstitial and alveolar inflammatory exudate Early deposition of collagen Generalized edema Poor skin integrity Decreased Platelets/Hgb Increased WBC Abnormal clotting factors
8
Q
Stage 4
A
Multiorgan involvement Decreased lung compliance Sepsis Pneumonia Difficulty maintaining adequate oxygenation Decreased UOP Decreased bowel sounds/motility Hypoxemia/hypercapnia CBC becoming worse
9
Q
Medical management of ARDS?
A
Oxygenation Mechanical Ventilation Positive Inotropes Vasoconstrictors Pulmonary Artery catheter Fluids ABX Bronchodialators/mucolytics Corticosteroids Treatment is supportive Positioning - continuous lateral rotation with prone positioning ECMO seen more dominantly with pediatrics
10
Q
Nursing Management of ARDS?
A
Positioning Hemodynamic monitoring Nutritional support Sedation Neuromuscular blockade Prevent nosocomial infection DVT prevention Skin care
