Test 4 Ch. 28 ARDS Flashcards
Pathologic and structural changes in ARDS
- Interstitial and intraalveolar edema and hemorrhage
- Alveolar consolidation
- Intraalevolar hyaline membrane formation
- Pulmonary surfactant deficiency or qualitative abnormality
- Atelectasis
Causes of ARDS
- Sepsis: most common cause of ARDS
- Aspiration
- Severe trauma
- pna
- Drug abuse
Berline Definition of ARDS PF ratio
pao2/fio2 (fio2 in decimal form)
Normal
PaO2/FIO2 above 400
Mild ARDS
PF between 200 to 300
Moderate ARDS
PF 100 to 200
Severe ARDS
PF less than equal to 100
Clinical manifestations of ARDS (3)
- atelectasis
- alveolar consolidation
- increased alveolar capillary membrane thickness
Chest Assessment Findings (3)
- Dull percussion note
- Bronchial breath sounds
- Crackles
Vital signs
Increased RR
Increased HR
Radiologic Findings (4)
- Increased opacities
- Whiter
- “ground- glass appearance
- honeycomb
ARDS have lower
compliance
ARDS pts are often susceptible to pulmonary
barotrauma
ARDS protocol
- High rr
- Low vt
- High PEEP
used for pts with profound hypoxemia
Inhaled nitric oxide (iNO)
ECMO
Is a strategy to improve oxygenation
prone ventilation
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
- Atelectasis
- Interstitial and intraalveolar edema
- Hemorrhagic alveolar consolidation
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
- High respiratory rates
- Low tidal volumes
Common chest assessment findings in ARDs include the following:
1. Diminished breath sounds
2. Dull percussion note
3. Bronchial breath sounds
4. Crackles
- Dull percussion note
- Bronchial breath sounds
- Crackles
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
b. Decreased PaCO2
Which of the following oxygenation indices is/ are associated w/ ARDS’
a. Increased VO2
b. Decreased DO2
c. Increased SvO2
d. Decreased Qs/ Qt
B. Decreased DO2
