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Acute Respiratory Distress Syndrome Nursing Care Plan & Management

Notes

Description
  1. Acute respiratory affliction syndrome is a mould of sharp respiratory need that appears as a confusion of some other mood, is suitd by a prolix lung waste, and transfers to extravascular lung mellifluous.
  2. The ocean standing of waste is the excavated capillary membrane.
  3. The interstitial edema suits compression and oblivion of the ultimate airways and transfers to abject lung tome and ductility.
  4. The ABG’s fulfill respiratory acidosis and hypoxemia that does not retort to an extension percentage of oxygen.
  5. The chest X-ray film shows interstitial edema.
  6. Some of the suits encloses sepsis, mellifluous overload, dismay, trauma, neurological injuries, burns, disseminated intravascular coagulation, refuse ingestion and expiration of toxic substances.
Causes & Facilitate Factors
ARDS can be suitd by any ocean turgescence (inflammation) or waste to the lung. Some base suits enclose:
  • Breathing spew into the lungs (aspiration)
  • Inhaling chemicals
  • Pneumonia
  • Septic dismay
  • Trauma
ARDS transfers to a buildup of mellifluous in the air sacs. This mellifluous frustrates ample oxygen from perishing into the dignitystream. The mellifluous buildup besides makes the lungs depressed and formal, and subsides the lungs’ ability to spread. The smooth of oxygen in the dignity can come dangerously low, equable if the peculiar entertains oxygen from a b facilitate tool (spontaneous ventilator) through a b facilitate tube (endotracheal tube). ARDS repeatedly appears along succeeding a occasion the need of other organ systems, such as the liver or the kidneys. Cigarette smoking and depressed alcohol use may be facilitate factors.
Assessment
  1. Tachypnea
  2. Dyspnea
  3. Decrease exhalation sounds
  4. Deteriorating gas smooths
  5. Hypoxemia resisting exalted vigilance of delivered oxygen
  6. Decreased pulmonary ductility
  7. Pulmonary infiltrates
Diagnostic Evaluation
  1. Based on clinical criteria narrative of facilitate factors sharp onset of respiratory affliction bilateral pulmonary infiltrates scantiness of left disposition need and keen mutinous hypoxemia.
  2. Chest X-ray shows bilateral infiltrates and pulmonary edema.
Primary Nursing Diagnosis
  • Impaired gas modify allied to extensiond excavated-capillary permeability, interstitial edema and subsided lung ductility
Other Diagnoses that may appear in Nursing Prevention Plans For ARDS
  • Ineffective airway conspicuousance
  • Ineffective b facilitate pattern
  • Activity intolerance
  • Anxiety (indicate smooth: gentle, temperate, keen, frighten)
  • Risk for wish
Medical Management
  • Identify and handle the underlying mood warrant present detection; use obnoxious supportive handlement; frusttrounce contagion ( intubation and spontaneous balm).
  • As complaint growthes, use direct and expiratory influence PEEP ( neuromuscular blocking delegate such as pancuronium (pavulon and vecuronium) (norcuron) perchance used to deadend resigned for easier balm.
  • Monitor arterial dignity gas values , pulse harmony , and pulmonary office testing.
  • Provide circulatory support; handle hypovolemia preventionfully ; relinquish overload
  • Provide large mellifluous composition ; carry intravenous solutions
  • Provide nutritional support; (35 to 45 kilocalories per kilogram daily)
  • Pharmacologic therapy may encsource anthropological recombinant interleukin-1 receptor competitor, neutrophil inhibitors, pulmonary- particular vasodilators, surfactant re-establishment therapy, antisepsis delegates, antioxidant therapy, and corticosteroids (tardy in the track of ARDS).
Pharmacologic Intervention
  • General Comments: Use of genetically engineered surfactant has been elabotrounce in ARDS but has not demonstrated the consummation that has appearred in rash infants succeeding a occasion surfactant want. Corticosteroids enjoy been widely used in ARDS, yet studies enjoy not pleasantly demonstrated any amendment in resigned outcomes and sojourn controversial. Some appearance exists that prolonged handlement succeeding a occasion low-dose corticosteroids may boon resigneds succeeding a occasion unresolving ARDS, especially by reversing the arrangement of fibroproliferation. If the resigned is unmanageable to temper, she or he may entertain skeletal muscle relaxants such as vecuronium (Norcuron), which are neuromuscular-blocking delegates that deaden the resigned’s skeletal muscles. These medications are used simply when the resigned’s gas modify is so bald as to dishearten his or her existence. Neuromuscular-blocking delegates deaden the resigned succeeding a occasionout influenceing invisible foundation, so the resigned requires sedation to oppose the congenial terror and prevention that appear when the resigned is feeble to stir.
  • Nitric oxide Expiration track a pulmonary vascular vasodilator to subsides pulmonary vascular hindrance succeeding a occasion extensiond perfusion to temperd areas
Nursing Intervention
  1. Identify and handle suit of the Sharp respiratory affliction syndrome
  2. Administer oxygen as prescribed.
  3. Position client in exalted fowler’s position.
  4. Restrict mellifluous intake as prescribed.
  5. Provide respiratory handlement as prescribed.
  6. Administer diuretics, anticoagulants or corticosteroids as prescribed.
  7. Prepare the client for intubation and spontaneous balm using PEEP.
Documentation Guidelines
  • Respiratory foundation of the resigned: respiratory trounce, exhalation sounds, and the use of alder muscles; arterial dignity gas (ABG) smooths; pulse oximeter and chest x-ray results
  • Response to handlement, spontaneous balm, imperturbability, and bedrest
  • Presence of any confusions (depends on the precipitating mood indispensable to ARDS)
Discharge and Home Healthprevention Guidelines
  • PREVENTION. Prompt vigilance for any contagions may subsource the stroke of sepsis,which can transfer to ARDS.
  • COMPLICATIONS. If resigneds outlast ARDS, few residual effects are seen. Complications are directed to any other moods the resigned may enjoy.

Sources: ADAM for images Marilyn Sawyer Sommers, RN, PhD, FAAN , Susan A. Johnson, RN, PhD, Theresa A. Beery, PhD, RN , DISEASES AND DISORDERS A Nursing Therapeutics Manual, 2007 3rd ed Nursing rob.com Handbook for Brunner & Suddarth’s, Textbook of Medical-SurgicalNursing, 11th ed

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Nursing Prevention Plan

Nursing Diagnosis
  1. Ineffective Airway Clearance
  2. Ineffective B facilitate Pattern
  3. Impaired Gas Exchange
  4. Decreased Cardiac Output
  5. Risk for Injury
  6. Excess Mellifluous Volume
  7. Impaired Physical Mobility
  8. Impaired Bark Integrity
  9. Impaired Verbal Communication
  10. Ineffective Coping
  11. Sleep Pattern Disturbance

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