This document discusses Acute Respiratory Distress Syndrome (ARDS), a clinical syndrome characterized by severe lung inflammation and injury leading to hypoxemia. It is most commonly caused by pneumonia, sepsis, aspiration, or trauma. The pathogenesis involves an initial exudative inflammatory phase, followed by a proliferative phase and possible fibrotic phase. Diagnostic tests include blood gases, chest X-rays, and CT scans. Treatment focuses on treating the underlying cause, administering oxygen, antibiotics, and corticosteroids. Nursing management centers around pulmonary toilet, monitoring fluid balance, improving breathing and nutrition, and mobilizing the patient.
Acute respiratory distress syndrome (ARDS) occurs when fluid builds up in the tiny, elastic air sacs (alveoli) in your lungs. The fluid keeps your lungs from filling with enough air, which means less oxygen reaches your bloodstream. This deprives your organs of the oxygen they need to function.
Acute respiratory distress syndrome nursing care plan & managementNursing Path
1. Acute respiratory distress syndrome is a form of acute respiratory failure that occurs as a complication of some other condition, is caused by a diffuse lung injury, and leads to extravascular lung fluid.
Acute respiratory distress syndrome (ARDS) occurs when fluid builds up in the tiny, elastic air sacs (alveoli) in your lungs. The fluid keeps your lungs from filling with enough air, which means less oxygen reaches your bloodstream. This deprives your organs of the oxygen they need to function.
Acute respiratory distress syndrome nursing care plan & managementNursing Path
1. Acute respiratory distress syndrome is a form of acute respiratory failure that occurs as a complication of some other condition, is caused by a diffuse lung injury, and leads to extravascular lung fluid.
Respiratory Disorders
Disease Condition Pneumothorax, Causes, Sign and Symptoms, Pathophysiology, Types, Assessment and Dignostic Test, Management
By HIREN GEHLOTH For Nursing Students Medical Surgical Nursing
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Respiratory Disorders
Disease Condition Pneumothorax, Causes, Sign and Symptoms, Pathophysiology, Types, Assessment and Dignostic Test, Management
By HIREN GEHLOTH For Nursing Students Medical Surgical Nursing
LAUGH A LOT IT CLEARS THE LUNGS
TEACHING IS ONE PROFESSION THAT CREATE ALL OTHER PROFESSION
Updates on Acute respiratory distress syndromeHamdi Turkey
These lecture notes were made by Dr. Hamdi Turkey (Pulmonologist at Taiz university)
** Contents:
- Historical view on ARDS
- New definition of ARDS
- Precipitating risk factors
- Pathophysiology of ARDS
- Clinical picture, Diagnosis, Management and Prognosis
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Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease characterized by persistent airflow limitation that is slowly progressive. It is also known as Chronic obstructive lung disease. “(COLD)”
It refers to Chronic Bronchitis and emphysema, a pair of two commonly coexisting disease of the lungs in which the airways become narrowed.
Community Acquired Pneumonia and other types of pneumonia
for medical students
Detailed information on pneumonia including the following
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Hospital acquired pneumonia and it’s treatment and management and prevention
Other types of pneumonia
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Acute respiratory Distress Syndrome - Medical and Nursing managementVarunMahajani
ARDS is an acute diffuse, inflammatory lung injury leading to pulmonary vascular permeability, increased lung weight, loss of aerated lung tissue with hypoxia, bilateral radiological opacities associated with increased venous admixture, increased physiological dead space, and decreased lung compliance.
this presentation provides in depth view of management of patient with ARDS
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MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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5. Pathophysiology
3 phases:
1) Exudative (inflamatory): damage to the
alveolar epithelium and vascular endothelium
→ leakage of water, protein, inflammatory
and red blood cells into the interstitium and
alveolar lumen.
Alveolar Type 1 cell → Hyaline membrane
Alveolar Type 2 cell → Alveolar collapse
6. Pathophysiology
2) Proliferative :
Type 2 cells proliferate with some epithelial
cell regeneration, fibroblastic reaction, and
remodeling.
3) Irreversible fibrotic phase : occasionally,
collagen deposition in alveolar, vascular
and interstitial beds with development of
microcysts.
8. NORMAL ALVEOLUS
Type I cell
Endothelial
Cell
RBC’s
Capillary
Alveolar
macrophage
Type II
cell
9. ACUTE PHASE OF ARDS
Type I cell
Endothelial
Cell
RBC’s
Capillary
Alveolar
macrophage
Type II
cell
Neutrophils
10. Most common causes ARDS
Pneumonia (34%)
Sepsis (27%)
Aspiration (15%)
Trauma (11%)
Pulmonary contusion
Multiple fractures
ARDSnet NEJM 2000:342:1301-8.
11.
12.
13. Diagnostic Tests
An arterial blood gas test. This blood test shows the oxygen
level in your blood. A low level of oxygen in the blood may be a
sign of ARDS.
Chest x ray. This test is used to take a picture of your lungs. It
can show whether you have extra fluid in your lungs.
Blood tests, such as a complete blood count, blood chemistries,
and blood cultures. These tests help find the cause of ARDS,
such as an infection.
Sputum cultures. This test looks at the spit you've coughed up
from your lungs. It can help find the cause of an infection.
Computed tomography or CT, scan. This test uses a computer
to take detailed pictures of your lungs. It may show lung
problems, such as fluid in the lungs, signs of pneumonia, or a
lung tumor.
14.
15. TREATMENT
Antiinflammatory therapies : Corticosteroids,
Neutrophil elastase inhibitors, Arachidonic acid
Inhibitors.
Surfactant.
Nowaday, the new points are based on
clinical evidences, we should give
corticosteroid in the fibroproliferative phase
of ARDS, 7-14 days, without evidence of
infection.
15
16. Nursing Management:
1. Administer prescribed medications, such as antibiotics, cardiac
medications, bronchodilators,mucolytics, corticosteroids and
diuretics as ordered.
2. Monitor fluid balance by intake and output measurement, daily
weight.
3. Perform chest physiotherapy and suctioning to remove mucus. Teach
slow, pursed lip breathing to reduce airway obstruction.
4. If the patient becomes increasingly lethargic, can not cough or
expectorate secretions, can not cooperate with therapy, or if PH falls
below 7.30, despite use of the above therapy, report and prepare to
assist with intubation and initiation of mechanical ventilation.
17.
18. 5. Improving breathing pattern
a. Encourage breathing, coughing exercises.
b. Use pursed- lip breathing at intervals and during periods of
dyspnea
6. Improving gas exchange
a. Check ABG’s.
b. Administer oxygen.
c. Inspiratory muscle training.
7. Improving nutrition.
a. Encourage frequent small meals if pt. is dyspneic.
b. Avoid foods producing gas and abdominal discomfort.
c. Monitor body weight.
Nursing Management:
19. Nursing Management:
8. Increasing activity tolerance.
a. Encourage pt. to carry out regular exercise program.
b. Encourage use of portable oxygen system for
ambulation for patient’s with hypoxemia.
9. Instruct the pt. do not do activities that increase venous
stasis such as crossing legs, sitting or standing for long
periods. Instruct pt. to elevate the legs above the level
of heart.
22. Summary
ARDS is a clinical syndrome characterized by
severe, acute lung injury, inflammation and
scarring.
Significant cause of ICU admissions, mortality
and morbidity
Caused by either direct or indirect lung injury
Mechanical ventilation with low tidal volumes and
plateau pressures improves outcomes
So far, no pharmacologic therapies have
demonstrated mortality benefit.
There is no really specific therapy for ARDS.
23. REFERENCES:
1. Potter PA, Perry AG. Fundamentals of
nursing. 6th ed. St.Louis: Elsevier
Mosby; 2006.
2. New Management strategies in ARDS.
Editor Levy MM. Critical Care Clinics,
January 2002
3. www.worldhealth.org.
4. ww.Answers.com.