Care of the Client with Acute
Respiratory Distress
Syndrome (ARDS)

1
Acute Respiratory
Distress Syndrome
_____________________________________
Is a sudden, progressive disorder
characterized ...
Cause Of ARDS
___________________________
A. Insult (Bacteria)
B. Medical Condition (Multiple Trauma,
CABG, Burns)
C. Noxi...
Conditions Causing ARDS
___________________________
1. Direct Pulmonary Trauma
2. Indirect Pulmonary Trauma

4
Early Signs &
Symptoms of ARDS
_____________________________________
Rapid, Shallow Breathing
Air Hunger
Cough
Restlessnes...
ARDS -Later Signs & Symptoms
___________________________
Decreased Lung Compliance
Diffuse Bilateral Crackles & Rhonchi
Di...
Clinical Progression of ARDS
___________________________________
Hyperventilation
|
Respiratory Alkalosis
|
Dyspnea & Hypo...
Treatment Goals for Clients with
ARDS
_____________________________
1. Respiratory Support
2. Treat Cause
3. Prevent Compl...
Treatment for the Client with ARDS
_____________________________
1. Mechanical Ventilation with PEEP
2. Sedation
3. Neurom...
Treatment for the Client with ARDS
_____________________________
4. Sedative/Anesthetic Agent
a. Diprivan
1. Dose: 5-50 mc...
ARDS Complications
___________________________
Cardiac Dysrhythmias
O2 Toxicity
Renal Failure
Thrombocytopenia
GI Bleed
Se...
Mechanical Ventilation
_____________________________
1. Intubation
a. Endotracheal Tube
1. Laryngoscope
2. E.T. Cuff
b. Tr...
Complications of Positive
Pressure Ventilation
___________________________________
1. Decreased Cardiac Output
2. Decrease...
Nursing Care of the Client on a
Ventilator
________________________________
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Ards

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Ards Acute respiratory distress syndrome

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Ards

  1. 1. Care of the Client with Acute Respiratory Distress Syndrome (ARDS) 1
  2. 2. Acute Respiratory Distress Syndrome _____________________________________ Is a sudden, progressive disorder characterized by: 1. Acute Lung Inflammation 2. Diffuse Alveolocapillary Injury 2
  3. 3. Cause Of ARDS ___________________________ A. Insult (Bacteria) B. Medical Condition (Multiple Trauma, CABG, Burns) C. Noxious Event ( Smoke Inhalation, Radiation) 3
  4. 4. Conditions Causing ARDS ___________________________ 1. Direct Pulmonary Trauma 2. Indirect Pulmonary Trauma 4
  5. 5. Early Signs & Symptoms of ARDS _____________________________________ Rapid, Shallow Breathing Air Hunger Cough Restlessness Respiratory Alkalosis Marked Dyspnea Hypoxemia Lung Sounds Clear to Fine Crackles 5
  6. 6. ARDS -Later Signs & Symptoms ___________________________ Decreased Lung Compliance Diffuse Bilateral Crackles & Rhonchi Diffuse Bilateral Infiltrates Metabolic or Respiratory Acidosis Intercostal & Suprasternal Retractions Tachycardia & AMS Low PaO2 & High PaCO2 Cyanosis & Pallor Extensive Interstial & Alveolar Infiltrates (White Lung) 6
  7. 7. Clinical Progression of ARDS ___________________________________ Hyperventilation | Respiratory Alkalosis | Dyspnea & Hypoxemia | Metabolic Acidosis | Respiratory Acidosis | Further Hypoxemia | Hypotension & Decreased Cardiac Output | Death 7
  8. 8. Treatment Goals for Clients with ARDS _____________________________ 1. Respiratory Support 2. Treat Cause 3. Prevent Complications 8
  9. 9. Treatment for the Client with ARDS _____________________________ 1. Mechanical Ventilation with PEEP 2. Sedation 3. Neuromuscular Blocking Agents a. Pavulon (Pancuronium) b. Vecuronium c. Atracuronium 9
  10. 10. Treatment for the Client with ARDS _____________________________ 4. Sedative/Anesthetic Agent a. Diprivan 1. Dose: 5-50 mcg per kg per minute 5. Treat Cause – Shock or Infection 6. Monitor for Complications 10
  11. 11. ARDS Complications ___________________________ Cardiac Dysrhythmias O2 Toxicity Renal Failure Thrombocytopenia GI Bleed Sepsis DIC 11
  12. 12. Mechanical Ventilation _____________________________ 1. Intubation a. Endotracheal Tube 1. Laryngoscope 2. E.T. Cuff b. Tracheostomy Tube 1. Keep at bedside: 2nd trach. tube, obturator, trach. dilator 2. Suctioning a. Wall pressure adult – 80 –120 mmHg b. Suctioning distance – 20 – 24 cm 12
  13. 13. Complications of Positive Pressure Ventilation ___________________________________ 1. Decreased Cardiac Output 2. Decreased Blood Flow to the Splanchnic Area a. Ischemic Gastric Mucosa b. Decreased Renal Blood Flow 3. Respiratory Alkalosis 4. Barotrauma 5. Volu-pressure Trauma 6. Alveolar Hypoventilation 7. Alveolar Hyperventilation 8. Ventilator Associated Pneumonia 13
  14. 14. Nursing Care of the Client on a Ventilator ________________________________ 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. Respiratory Assessment Suctioning Oral Care ABG &/or continuous O2 sats. Supplementary Respiratory Treatments Providing for hydration Maintaining Nutrition ROM Exercises Rest & Sleep Anxiety Communication 14

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