ARDS + PNEUMOTHROAX

ARDS S/S

tachypnea (high RR), tachycardia, respiratory alkalosis, cardiac output increases, pulmonary edema (crackles).

ARDS major treatments

mechanical ventilation with PEEP - positive end expiratory pressure (normal =5), high flow NC, ECMO (pumps blood out of the body), prone position.

Medications- antibiotics, neuromuscular blockade, hydration, nutrition.

ARDS potential risks to treat

refractory hypoxemia: when you give pt more oxygen but levels of oxygen don't change (Fio2 inc. without Pa02 response) BAROTRAUMA

pneumothroax cause

air enters pleural cavity - positive pressure causes lung to collapse

pneumothroax S/S small pneumothroax

Mild tachycardia, Dyspnea

pneumothroax S/S large pneumothroax

Rapid, shallow respirations, Severe dyspnea, Air hunger, ↓ O₂ saturation, Absent breath sounds on affected side

pneumothroax treatment

may resolve spontaneously, put in chest tube, pleurodesis, thoracentesis, URGENT NEEDLE DEPCROMPRESSION FOR TENSION PNEUMO

chest tube management by RN

Keep BELOW chest, Do NOT CLAMP, Do not strip or milk tube, If break in system - place end in sterile water to maintain seal

chest tube 3 chambers

collection, water seal, suction control

air leak in chest tube causes

bubbling in water-seal chamber

tidaling means

reflects changes in pressure = normal!!!!!!