Test 4 Ch. 28 ARDS

Question 1

Pathologic and structural changes in ARDS

Answer 1

• Interstitial and intraalveolar edema and hemorrhage
• Alveolar consolidation
• Intraalevolar hyaline membrane formation
• Pulmonary surfactant deficiency or qualitative abnormality
• Atelectasis

Question 2

Causes of ARDS

Answer 2

• Sepsis: most common cause of ARDS
• Aspiration
• Severe trauma
• pna
• Drug abuse

Question 3

Berline Definition of ARDS PF ratio

Answer 3

pao2/fio2 (fio2 in decimal form)

Question 4

Normal

Answer 4

PaO2/FIO2 above 400

Question 5

Mild ARDS

Answer 5

PF between 200 to 300

Question 6

Moderate ARDS

Answer 6

PF 100 to 200

Question 7

Severe ARDS

Answer 7

PF less than equal to 100

Question 8

Clinical manifestations of ARDS (3)

Answer 8

• atelectasis
• alveolar consolidation
• increased alveolar capillary membrane thickness

Question 9

Chest Assessment Findings (3)

Answer 9

• Dull percussion note
• Bronchial breath sounds
• Crackles

Question 10

Vital signs

Answer 10

Increased RR
Increased HR

Question 11

Radiologic Findings (4)

Answer 11

• Increased opacities
• Whiter
• “ground- glass appearance
• honeycomb

Question 12

ARDS have lower

Answer 12

compliance

Question 13

ARDS pts are often susceptible to pulmonary

Answer 13

barotrauma

Question 14

ARDS protocol

Answer 14

• High rr
• Low vt
• High PEEP

Question 15

used for pts with profound hypoxemia

Answer 15

Inhaled nitric oxide (iNO)

Question 16

ECMO

Question 17

Is a strategy to improve oxygenation

Answer 17

prone ventilation

Question 18

Questions from the back
In response to injury the lungs of a pt w/ ARDS undergo which of the following changes
1. Atelectasis
2. Decreased alveolar capillary membrane permeability
3. Interstitial and intraalveolar edema
4. Hemorrhagic alveolar consolidation

Answer 18

1. Atelectasis
2. Interstitial and intraalveolar edema
3. Hemorrhagic alveolar consolidation

Question 19

Which of the following is/ are recommended ventilation straggles for most pts w/ ARDS
1. High tidal volumes
2. Low respiratory rates
3. High respiratory rates
4. Low tidal volumes

Answer 19

3. High respiratory rates
4. Low tidal volumes

Question 20

Common chest assessment findings in ARDs include the following:
1. Diminished breath sounds
2. Dull percussion note
3. Bronchial breath sounds
4. Crackles

Answer 20

2. Dull percussion note
3. Bronchial breath sounds
4. Crackles

Question 21

During the early stages of ARDSnthe pt commonly demonstrates which one of the following ABG values
a. Decreased pH
b. Decreased PaCO2
c. Increased HCO-3
d. Normal PaO2

Answer 21

b. Decreased PaCO2

Question 22

Which of the following oxygenation indices is/ are associated w/ ARDS’
a. Increased VO2
b. Decreased DO2
c. Increased SvO2
d. Decreased Qs/ Qt

Answer 22

B. Decreased DO2