Acute Respiratory Distress Syndrome ( ARDS )

DEFINITION
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.

DESCRIPTION
The major site of injury is the alveolar capillary membrane. The interstitial edema causes compression and obliteration of the terminal airways and leads to reduced lung volume and compliance. The ABG s identify respiratory acidosis and hypoxemia that does not respond to an increase percentage of oxygen. The chest X-ray film shows interstitial edema. Some of the causes includes sepsis, fluid overload, shock.

Causes & Risk Factors

ARDS can be caused by any major swelling (inflammation) or injury to the lung. Some common causes include:
- Breathing vomit into the lungs (aspiration) - Inhaling chemicals - Pneumonia - Septic shock - Trauma

Signs and Symptoms

Rapid breathing, and low oxygen levels in the blood. Other signs and symptoms depend on the cause of the ARDS. They may occur before ARDS develops. For example, if pneumonia is causing ARDS, you may have a cough and fever before you feel short of breath. Sometimes, people who have ARDS develop signs and symptoms such as low blood pressure, confusion, and extreme tiredness. This may mean that the body's organs, such as the kidneys and heart, aren't getting enough oxygen.

 Most people who develop ARDS are in the hospital for other serious health problems. Rarely, people who aren't hospitalized have health problems that lead to ARDS, such as severe pneumonia. If you have trouble breathing, call your doctor right away. If you have severe shortness of breath, call 9 1 1.

Assessment
Tachypnea Dyspnea Decrease breath sounds Deteriorating gas levels Hypoxemia despite high concentration of delivered oxygen Decreased pulmonary compliance Pulmonary infiltrates

Diagnostic Evaluation
Based on clinical criteria history of risk factors acute onset of respiratory distress bilateral pulmonary infiltrates absence of left heart failure and severe refractory hypoxemia. Chest X-ray shows bilateral infiltrates and pulmonary edema

Nursing diagnosis
Ineffective airway clearance Ineffective breathing pattern Activity intolerance Anxiety (specify level: mild, moderate, severe, panic) Risk for aspiration

Nursing Intervention
Identify and treat cause of the Acute respiratory distress syndrome Administer oxygen as prescribed. Position client in high fowler s position. Restrict fluid intake as prescribed. Provide respiratory treatment as prescribed. Administer diuretics, anticoagulants or corticosteroids as prescribed. Prepare the client for intubation and mechanical ventilation using PEEP