ARDS I
The nurse would carefully assess a patient with which of the following for the development of ARDS?
1. Gastroenteritis
2. Type II Diabetic
3. Sepsis
4. Cellulitis
3. Sepsis (and aspiration are the most likely to develop ARDS).
Which clinical manifestation is highly indicative of ARDS (as opposed to some other complications)? 1. Tachypnea 2. Dyspnea 3. Anxiety 4. Refractory hypoxemia
4. Refractory hypoxemia
A client with ARDS was anxious all morning. They are now less responsive & difficult to arouse. This is likely due to:
A. Hypoxia
B. Hypercapnia (hypercarbia)
C. Alkalosis
D. Hyperkalemia
B. Hypercapnia (hypercarbia)
Hypercapnia/Hypercarbia is defined by an increase in carbon dioxide in the bloodstream.
Interpret the following blood gas result: pH = 7.49, PaO2 = 55, PaCO2 = 29, HCO3- = 25.
Respiratory alkalosis with hypoxemia
pH: 7.49 Alkalosis (7.35-7.45 Normal)
PaO2: 55 is Low (75-100mmHg Normal, oxygen in arterial blood)
PaCO2: 29 Low (35-45 Normal)
HCO3: 25 Normal (22-26 Normal)
The nurse inspects the chest of a patient with ARDS and notices the musculature in between the ribs "dipping in" with breathing. This would be accurately documented as:
Intercostal retractions
The nurse should implement which of the following interventions for a mechinally ventilated patient?
1. Spread out activities
2. Maintain HOB less than 30 degrees
3. Explain all care activities
4. Oral care once a day
3. Explain all care activities
What is the reason a patient would receive Rocoronium or Succinylcholine?
They are non-sedating, non-amnesic and non-analgesic drugs. Sometimes used in severe ARDS patients who are mechanically ventilated and who need paralytic agents to prevent barotrauma and have better respirations with the vent.
**Typically found in Rapid Sequence Intubation (RSI) kits and used for initial intubation.
What are the expected outcomes (goal) of mechanical ventilation for a patient with ARDS for the O2 saturation measurement and the PaO2 measurement?
O2 sat > 90% and PaO2 >60 mmHg
PEEP is increased from 5 to 10 for a patient with ARDS. What is a major pulmonary complication the nurse should assess for related to this change?
Barotrauma (such as pneumothorax)
The nurse is assessing a patient on a ventilator who started a "weaning trial" 30 minutes ago. Provide three (3) assessment findings that indicate the trial is unsuccessful and needs to be stopped?
1. Tachypnea 2. Tachycardia 3. Labored breathing 4. O2 saturation dropping 5. Any other signs of increasing respiratory distress