ARDS Basics
What is the hallmark sign of ARDS?
Refractory hypoxemia
This oxygen device delivers the most precise FiO2
Venturi mask
This is the priority when a patient with pneumonia becomes confused
Assess oxygenation
What quick relief inhaler is used for asthma?
Albuterol
Earliest sign of respiratory distress?
Tachypnea
What are some direct causes of ARDS?
Aspiration, near drowning, COVID 19, smoking
This ventilator setting prevents alveolar collapse at end-expiration
Positive End-Expiratory Pressure (PEEP)
This is the first action when a chest tube becomes disconnected
Place in the end in sterile water
This medication class reduced inflammation in ARDS
Steroids
This breathing pattern is characterized by periods of apnea alternating with deep, rapid breathing.
Cheyne-Stokes respiration
What is seen on a chest x-ray with ARDS?
Bilaterial infiltrates ("white out")
What are some causes of a high-pressure ventilator alarm?
Kink in the tube, biting, trying to talk, mucus plugs, fighting the vent (bucking)
Which patient should be transferred to the ICU immediately?
A) COPD patient with a SpO1 90% on 3L nasal cannula
B) ARDS patient with RR 38 and the use of accessory muscles
C) Pneumonia patient with fever 103°F
D) Asthma patient requesting another albuterol treatment
B) ARDS patient with RR 38 and the use of accessory muscles
What must a patient be on before giving a neuromuscular blocking agent?
Sedatives and intubated
This condition causes tracheal deviation away from the affected side
Tension pneumothorax
This ABG pattern is common early in ARDS
Respiratory alkalosis
This position improves oxygenation in ARDS by recruiting posterior alveoli.
Which order should the nurse implement FIRST?
A) administer IV steroids for asthma
B) Increase PEEP from 10 to 14
C) Obtain ABG for rising CO2
D) Suction patient with coarse crackles and visible secretions
D) Suction patient with course crackles and visible secretions
What does a neuromuscular blocking agent do?
Paralyzes respiratory muscles
This ABG pattern is seen in late-stage COPD exacerbations
Respiratory acidosis
This complication results from stiff, noncompliant lungs in late ARDS?
Fibrosis
This oxygenation index is used to determine ARDS severity and guide escalation of care
PaO2/FiO2 ratio
Which patient should the nurse see FIRST?
a) COPD patient with pursed-lip breathing
B) Pneumonia patient with new confusion
C) Asthma patient with a RR 28
D) ARDS patient with a PaO2 58 on FiO2 100%
D) ARDS patient with a PaO2 58 on FiO2 100%
Which medication requires the nurse to monitor blood pressure closely?
A) Propofol
B) Methylprednisolone
C) Furosemide
D) PEEP 10
A) Propofol
This test must be performed before drawing ABGs from the radial artery
Allen test