all about ARDS
severe inflammatory process causing diffuse _____ _____ that results in sudden & progressive __________ ______
what is alveolar damage & pulmonary edema
decreased CO s/s in ARDS pt: (which are incorrect, if any): low BP, tachycardia, reduced UO, edema in ankles, feet, or abdomen, fatigue, dizziness, confusion, weakness, shallow breathing, fainting, anxiety, weight loss, dull-looking skin that may be cold & clammy, liver enlargement
what is shallow breathing (it is rapid), weight loss (it is gain),
supportive txments
what is prone positioning, sedation, paralysis, & nutritional support
propofol & nursing considerations
what is a sedative; use cautiously w CVD, lipid disorder, increased ICP, can cause apnea, bradycardia, hypotension, buring & pain at insertion site, can turn urine green, assess resp. status & hemodynamics, maintain patent airway, assess level of sedation
BNP (Plasma Brain Natriuretic Peptide) level
what is helpful in distinguishing ARDS from cardiogenetic pulmonary edema
cause
what is direct injury to the lungs (smoke inhalation) or indirect insult to the lungs (shock)
ABG
what is respiratory alkalosis (initially)
goal of PEEP
what is a PaO2 >60 mm Hg or an oxygen saturation level of >90% at the lowest possible FiO2
the occurrence of _____________ not only increases the risk of ventilator complications but also affects the comfort of patients
what is pt-ventilator asynchrony (PVA)
if not diagnosed or treated
what is fatality within 72 hours of onset
pt status monitored by what 3 things
what is ABG analysis, pulse oximetry, & bedside pulmonary function testings
"stiff lungs"
what is decreased pulmonary compliance (difficult to ventilate)
Pulmonary Artery Catheterization Criteria
what is...
- occurrence of an ALI or a hx of systemic or pulmonary risk factors
- acute onset of resp. distress
- diffuse, bilateral infiltrates on chest x-ray
- no clinical evidence of left-sided hF (left atrial HTN)
nursing action (to the pt) when patient is given a neuromuscular blocking agent (education)
what is reassurement that the paralysis is a result of the medication & is temporary
must be provided to compensate for the severe respiratory dysfunction
what is aggressive, supportive care (ET Intubation & Mechanical Ventilation)
3 priorities
what is circulatory support, adequate fluid volume, & nutritional support
mild, moderate, & severe
what is classifications according to the severity of hypoxemia experienced by the pt:
mild: >200 but <300
moderate: >100 but <200
severe: <100
(PaO2/FIO2)
first consideration of nutritional support
what is enteral feeding (formulas have been developed that provide large amounts of fat calories rather than carbohydrates)
Rocuronium & Pancuronium
what are examples of neuromuscular blocking agents
EVALI
what is the syndrome known as e-cig/vaping-associated acute lung injury
saltwater
what is an example of a direct lung injury (near drowning)
findings on x-ray
what are bilateral infiltrates that quickly worsen
look at albumin level frequently
what is if parenteral nutrition is required & being given
dexmedetomidine
what is a sedative
causes the fluid build up
what is the body's inflammatory response ("affects both lungs most of the time, 99% of the time i should say")