Pearson ARDS PP

Nursing: A Concept-Based Approach to Learning - Oxygenation

Module 15: Oxygenation Overview

  • Focus on Acute Respiratory Distress Syndrome (ARDS).

Exemplar Learning Outcomes 15.A

  • Analyze ARDS in relation to oxygenation.

  • Describe pathophysiology: non-cardiac pulmonary edema, lung inflammation, and injury.

  • Identify ARDS risk factors (direct & indirect insults) and prevention methods.

  • Recognize clinical manifestations and diagnostic tests for ARDS.

  • Differentiate care for diverse age groups.

  • Apply nursing process for culturally competent care.

Overview of ARDS

  • Characterized by rapid pulmonary edema, refractory hypoxemia, and multisystem organ failure.

Pathophysiology

  • Systemic inflammation causes capillary leakage, leading to alveolar fluid buildup and impaired gas exchange.

Etiology

  • Annual U.S. incidence: ~200,000, with mortality rates of 25%-45%.

Risk Factors

  • Direct: pulmonary infections, aspirations, inhalation injuries.

  • Indirect: sepsis, trauma, GI infections, drug overdose.

Prevention

  • Focus on reducing aspiration risk, smoking cessation, and addressing immunocompromised conditions.

Clinical Manifestations

  • Early signs: dyspnea, tachypnea; may have normal labs initially.

  • Progressive symptoms: increased respiratory rate, agitation, and confusion due to hypoxemia.

Team Care

  • Collaborative approach including nurses, respiratory therapists, and physicians for monitoring and care.

Diagnostic Tests

  • ABGs, imaging for lung fluid assessment, and laboratory tests for causes.

Ventilatory Support

  • Endotracheal intubation is critical.

  • Positive pressure ventilator types: CPAP, BiPAP, assist-control, etc.

  • Complications: VAP, barotrauma, pneumothorax.

Nutrition & Other Therapies

  • Monitor nutrition and use enteral/parenteral options during ventilation.

  • Prone positioning and prompt infection management with IV antibiotics.

Lifespan Considerations

  • Special needs for children, pregnant women, and older adults in ARDS management.

Nursing Process

  • Comprehensive patient assessment and continuous monitoring required.

  • Focus on measurable patient goals, interventions for comfort, and readiness for discharge evaluation.