Disease information
Name of disease:
ARDS-Acute respiratory distress syndrome
General description:
characterized by noncardiac pulmonary edema and progressive refactory hypoxemia.
Also known as wet lung, shock lung, Vietnam lung, or a sever form of acute respiratory
failure
Pathology/ Causes:
The cause is not clear but follows a number of diverse conditions producing direct or
indirect lung injury. Conditions associated with the development of ARDS: shock,
inhalation injuries, infections, drug overdose, and trauma
Signs and symptoms:
Dyspnea, tachypnea, and anxiety are early symptoms. Afterwards, increasing respiratory
rate, intercostals retractions, use of accessory muscles of respirations, cyanosis. Breath
sounds are clear at first but turn to crakles, rhonchi, agitation, confusion, and lethargy.
DX:
-
Arterial blood gases- show hypoxemia at Po2 of less than 60mmHG and
respiratory alkalosis due to tachypnea 80-100 normal
Chest X-ray
Pulmonary function testing
Pulmonary artery pressure monitoring
TX:
Commonly used drugs:
- inhaled nitric oxide- reduces intrapulmonary shunting and improves oxygenation
by dilating blood vessels in better ventilated areas of the lung
- surfactant therapy
- Corticosteroids- late stages- block the inflammatory response
- Endotracheal intubation and mechanical ventilation- meant to be set at the lowest
setting, if it can not be maintained with less than 50% inspired oxygen, there is a
better risk of oxygen toxicity will accentuate ARDS.
- CPAP- continuous positive airway pressure
- PEEP- positive end expiratory pressure
- Both to maintain blood and tissue oxygenation
Nursing interventions
- prone positioning while on a mechanical ventilation
Diet
- fluid replacement
- enteral or parental feeding
Major Complications:
Atelectasis
Acute respiratory failure
Potential problems of weaning ventilatory support
Nursing Diagnosis:
Impaired gas exchange
Decreased cardiac output
Ineffective airway clearance
Anxiety