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24 Cards in this Set
- Front
- Back
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Define ARDS
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non cardiac pulmonary edema, progressive refractory hypoxemia
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Explain refractory hypoxemia
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the pt becomes very short of breath quickly and even though you are giving them O2 their sats still don't improve
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What is the most common clinical disorders associated with ARDS?
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severe sepsis, shock, acute pancreatitis
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What signs might your patient begin to show if they have a decrease in their level of oxygen?
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change in personality, disorientation or/and anxiety
grunting respirations, cyanosis, pallor, retractions, use of accessory muscles, initial dyspnea w/ hyperventilation and tachypnea |
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What is the nurses main focus during phase 1 of ARDS?
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focus is on supporting the client and providing O2
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What what your pts vital signs look like if your pt. has ARDS?
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fever, hypotension, tachycardia (dysrhythmias)
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What is refractory hypoxia?
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high concentrations of O2 are given with no increase in O2 sats.
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How will your pts lungs sound during phase 1 of ARDS?
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initially clear but then wil develop crackles and rhonchi
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What might your ARDS pts CXR look like during either phase2 or phase 3?
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diffuse, bilateral infiltrates, fluid appears all white on the CXR
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When looking at your pts CXR, how can you tell the difference between ARDS and pneumonia?
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ARDS: will show both sides diffused
pneumonia: would show in a specific lobe usually |
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What are some interventions that may occur with your ARDS patient once they enter into phase 2?
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mechanical ventilation and prevention of complications
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Once your pt. is put on a ventilator, what level of O2 should you start them at?
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100%
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Why would you put your ventilator pt. on PEEP?
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because the pt. will be hypotensive and they need the max amt of surface area for gas exchange. PEEP can help accomplish this
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Why are some interventions that may occur with your ARDS patient once they enter into phase 3?
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focus on maintaining adequate O2 transport
preventing complications and supporting the failing lung until it has time to heal |
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What does a Swan Ganz catheter do?
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measures pulmonary artery pressure (fluid)
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What type of drugs would you have your ARDS pt. on?
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corticosteroids for inflammation
depends on the underlying cause: if caused by sepsis you would have them on antibiotics, etc |
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What is our goal when giving our ARDS pt fluid therapy?
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to maintain CO and tissue perfusion
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Why might you have to give your ARDS pt. a diuretic?
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to decrease lung edema but avoid hypotension and dehydration
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How would you be positioning your ARDS pt?
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HOB elevated
rotation: help to mobilize secretions prone: helps with gas exchange |
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As the nurse, what things would you likely be assessing in your ARDS pt?
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sputum production, oxygenation, heart and lung sounds, hemodynamic status (cardiac output, urinary output), cardiac rhythm
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If your ARDS pt. is hypotensive, what would you expect their urinary output to be?
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decreased
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What has usually occurred if your pt. goes to phase 4 of ARDS?
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multi system failure
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How can you best control acidosis in your ARDS pt?
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by ambuing the pt. and blowing of CO2
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What causes acidosis?
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lack of gas exchange
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