Week 6 - ARDS Flashcards
1
Q
Most common cause of ARDS
A
Sepsis
2
Q
ARDS criteria
A
Within 1 week of known clinical risk; new or worsening symptoms
3
Q
Key symptom of ARDS
A
Refractory hypoxia (unresponsive hypoxia)
4
Q
Phases of ARDS
A
- Exudative phase
- Fibroporliferative phase
- Resolution phase
5
Q
Endothelial injury to alverolar capillary membrane causes… (2)
A
- Damaged type 2 alveolar cell (decreased production of surfactant –> atelactasis)
- Release of inflammatory mediators (leakage, vascular narrowing and obstruction, pulmonary edema, bronchoconstriction)
6
Q
Nursing diagnosis with ARDS patho
A
Impaired gas exchange
7
Q
Neutrophils are attracted and release mediators producing 4 changes in the lungs
A
- Increased pulmonary capillary membrane permeability (leak)
- destruction of elastin and collagen (decreased integrity)
- formation of pulmonary microemboli
- pulmonary artery vasoconstriction
8
Q
Exudative phase
A
- 1-7 days after injury
- neutrophils adhere
- engorgement of peribronchial and perivascular interstitial space
- intrapulmonary shunt
- damage to alveolar cells
- hyaline membranes
9
Q
Fibroproliferative phase
A
- 1-2 weeks after lung injury
- influx of neutrophils, monocytes, lymphocytes
- fibroblast proliferation
- dense and fibrous lung
- worsening of hypoxemia
10
Q
Fibrotic/Chronic late phase
A
- 2-3 weeks after injury
- lung is remodeled by collagenous and fibrous tissues
- decreased lung compliance
- low survival chance
- need long term mechanical ventilation
11
Q
Exudative phase s/s
A
- tachypnea
- restlessness
- apprehension
- moderate accessory muscle use
12
Q
Fibroproliferative phase s/s
A
- agitation
- dyspnea
- fatigue
- excessive accessory muscle use
- fine crackles
13
Q
ABGs
A
- refractory hypoxia (low PaO2 despite increase in O2 therapy)
- PaO2/FiO2 ratio < 200 mm/Hg
14
Q
Diagnostics
A
- opacities on x ray (atelactasis)
15
Q
Low tidal volume
A
- 6 ml/kg
