Module 15.A Acute Respiratory Distress Syndrome Question and answers correctly solved, Exams of Nursing

Download Module 15.A Acute Respiratory Distress Syndrome Question and answers correctly solved and more Exams Nursing in PDF only on Docsity! Module 15.A : Acute Respiratory Distress Syndrome (ARDS) acute respiratory distress syndrome (ARDS) a disorder with rapid onset characterized by noncardiac pulmonary edema resulting from inflammatory damage to alveolar and capillary walls, and progressive refractory hypoxemia (the decrease of arterial oxygen despite administration of oxygen at high flow rates) recognized as a severe form of acute respiratory failure FiO2 fraction (percentage) of inspired oxygen ARDS pathophysiology (basic) acute lung injury resulting from an unregulated systemic inflammatory response to acute injury or inflammation -inflammatory cellular responses and biochemical mediators damage the alveolar-capillary membrane -this damage develops rapidly, often within 90 min of the systemic inflammatory response and within 24 hours of the initial insult -damaged capillary membranes allow plasma and blood cells to escape into the interstitial space -this pressure and damage allows fluid to enter alveoli -within alveoli this fluid dilutes and inactivates surfactant which increases alveolar surface tension and alveolar collapse with atelectasis -hyaline membranes form -fibrotic changes occur in lungs ARDS risk factors Direct Lung Injury: Aspiration, Pneumonia, Chest Trauma, Embolism (fat,air, amniotic), Near Drowing , pulmonary infections Indirect Lung Injury: Sepsis, Massive trauma, Acute pancreatitis, anaphylaxis, DIC, multiple blood transufsions, Severe head injury, Shock states clinical manifestations and therapies Hypoxia -manifestations : dyspnea, tachypnea, intercostal retractions , tachycardia, cyanosis, atelectasis -therapies : brochodilators, beta-agonists, corticosterois, O2 administration, monitor pulmonary artery pressures and cardiac output, mechanical ventilation, CPAP, BiPAP, PEEP, prone positioning, surfactant therapy Nutritional imbalance -manifestations : confusion, fluid-electrolyte imbalance, weakness or fatigue -therapies : fluid replacement, total parental/enteral nutrition or enteral feedings, nutritional analysis, monitoring of serum electrolytes Activity intolerance -manifestations : irritability, fatigue, confusion, lethargy, inability to maintain ADLs push air into the lungs the amount of air delivered with each breath can be delivered in mL (volume ventilator) or until a specific pressure is reached (pressure ventilator) -invasive ventilation using an endotracheal tube or tracheostomy or noninvasive modalities can be used noninvasive positive pressure ventilation (NIPPV) -provides respiratory support by way of a tight-fitting full face mask, nasal mask, nasal shield, or nasal pillows modes of ventilation CPAP BiPAP assist-control mode ventilation synchronized intermittent mandatory ventilation PEEP pressure-support ventilation pressure-control ventilation complications of ventilatory support -ventilator-associated pneumonia (VAP) -barotrauma -pneumothorax -cardovascular effects (cardiac output) -GI effects (stress ulcers, gastric distention) artificial airways oropharyngeal and nasopharyngeal airways endotracheal tubs tracheostomies