Acute Respiratory Distress Syndrome Case Study

-Use of indiscriminate sedatives, benzos, and opioid’s, especially in post-op patient who retains Co2, may suppress the ventilator drive and lead to respiratory failure

The nurse found Mrs Smith to be tachypnoeic, her respirations were recorded as 24 breaths per minute it was observed as being fast and it appeared that her accessory muscles were being used. Mrs Smith’s pallor also appeared flushed and her saturations were documented as 93%. The nurse used the stethoscope to check for wheeze the patient’s lungs were clear and chest rise was symmetrical. Mrs Smith was commenced on 100% oxygen through a non-rebreathe mask, oxygen as an intervention is necessary as Creed & Spiers (2010) highlight ‘metabolic demand for oxygen throughout the body is hugely increased by sepsis and is essential to ensure the supply of oxygen is maximized’ .The nurse monitored the patient closely because in her confused state the patient may try to remove the oxygen mask.

Both rapid, shallow breathing patterns and hypoventilation effect gas exchange. Arterial blood gases will be monitored and changes discussed with provider. Alteration in PaCO2 and PaO2 levels are signs of respiratory failure. Patient’s body position will be properly aligned for optimum respiratory excursion, this promotes lung expansion and improved air exchange. Patient will be suctioned as needed to clear secretions and maintain patent airways. The expected outcome is that the patient’s airway and gas exchange will be maintained as evidence by normal arterial blood gases (Herdman,

1. A physician is called to the intensive care unit to provide care for a patient who received second- and third-degree burns over 50 percent of his body due to a chemical fire. The patient is in respiratory distress and is suffering from severe dehydration. The physician provides support for two hours. Later that day the physician returns and provides an additional hour of critical care support to the patient.

Shallow breathing and pain altered this patient’s comfort. Therefore, one of the nursing diagnoses can be stated as “Breathing Pattern, Ineffective r/t pain and anxiety, as evidenced by respiratory depth changes" (Ackley & Ladwig p. 175). We briefly discussed the specifics of incentive spirometry use before initiating the intervention. After return demonstration, the patient was ready to use his incentive spirometer.

The patient may experience dyspnea, caused by pulmonary congestion. They may report orthopnea as blood is redistributed from the legs to the central circulation when the patient lies down a night, paroxysmal nocturnal dyspnea due to reabsorption of interstitial fluid when lying down, and reduced sympathetic stimulation while sleeping. Pulmonary congestion may also cause a non-productive cough. Later clinical manifestations of left sided heart failure include crackles due to pulmonary congestion and hemoptysis resulting from bleeding veins in the bronchial system caused by venous distention. On physical exam the patient may have cool, pale skin resulting from peripheral vasoconstriction, and may be restless and confused due to reduced cardiac

There is a considerable controversy regarding the use of OBL in patients with respiratory failure and those on mechanical ventilation because of the potential high morbidity and mortality associated with its use in those patients (20, 21). While the role of OLB has become well established in the diagnosis of interstitial lung disease (18), its utility and safety are more controversial in critically ill patients. Proponents of OLB argue that solid diagnosis of underlying aetiology can be helpful in determination of the best course of treatment (22). Moreover, the risk of biopsy is fairly low if adequate precautions are taken (23). In contrast, opponents of OLB believe that defining the underlying mechanism of injury is largely academic and it will not add new to the treatment of those patients because of the lack of specific therapies for underlying aetiologies of ARDS and respiratory

Mr. Joseph is a 56-year-old has 30 smoking pack years. He was diagnosed 10 years ago with asthma/chronic bronchitis, arthritis of the knees, and congestive heart failure (CHF). Mr. Joseph weighs 350 pounds with a height of 6 feet, making his body mass index (BMI) of 47.5, much more than the recommended 25, and in fact his BMI places him in the morbid obesity classification. He takes medicines for his pulmonary conditions, along with a diuretic.

Acute respiratory distress syndrome (ARDS) occurs when fluid builds up in the tiny, elastic air sacs (alveoli) in your lungs. More fluid in your lungs means less oxygen can reach your bloodstream. This deprives your organs of the oxygen they need to function.

Progress inside the bronchi generally makes this affected individual experience less than breathing. They should find them selves breathing problems along with breathing problems, experiencing ache in stomach place or, using some circumstances, breathing problems along with paying blood. Others will present signs along with signs

I started my morning by reviewing his Kardex and noticed that chest pain had been noted and that he had an ECG and CT of his chest. I went into his room to find him wide-awake in bed. I performed my safety check and took his vitals. His resp rate was quite high at this time and his Sp02 was on the lower side. MK expressed through nodding that he was having chest pain during that time. I also did a respiratory assessment because I was concerned with his SpO2 and resp rate. I found decreased air entry to his bases, expiratory wheeze, and a visual use of accessory muscle to breath. His breathes where short and labored. When asked if he was experiencing SOB, he nodded and this directed my care for that morning. I reported to my instructor with my findings as this was the first time I had a client say yes to chest pain. I quickly addressed his SOB with his PRN bronchodilator using a spacer and put him on two liters of O2 via nasal prongs. I checked back in after 5 minutes and his resp rate had lowered and his SpO2 had risen to a more adequate level. I noticed he did not have audible wheeze any longer and was not using his accessory muscles. Overall he looked way more relaxed in his bed after addressing his respiratory distress. Unfortunately, he still was nodding yes to chest pain in that moment. The RN on my team left a doctors note about another CT and ECG and noted that the client was still

According to the American Lung Association, “Acute respiratory distress syndrome (ARDS) is a rapidly progressive disease occurring in critically ill patients.” ARDS is an extreme manifestation of a lung injury that can be associated with an acute medical problem. This occurs as a result of direct or indirect trauma to the lungs. With nearly 200,000 cases in the United States each year, ARDS is not extremely common (“Acute Respiratory Distress Syndrome”). Most people who acquire this disease are critically ill patients within the hospital. The most common predisposing medical problems of ARDS consist of: shock, trauma, pulmonary infections, sepsis, aspiration, and cardiopulmonary bypass (Ignatavicious, 2013). ARDS is a severe syndrome and even with prompt and aggressive medical treatment, almost fifty percent of those diagnosed do not survive. Those who survive have a longer hospital stay along with recurring hospital admissions throughout their lifetime (“Acute Respiratory Distress Syndrome”). Acute respiratory distress syndrome is a rapidly progressive disease which requires thorough assessment, rapid diagnosis, and emergency treatment measures in order to successfully respond to the disease process.

is Pneumonia. This is based on the patient’s subjective and objective data. The collaborative diagnosis to address this problem is Pneumonia r/t immobilization; r/t pleural effusion, and r/t debilitation (Carpenito, 2013, p. 859-860). The nursing goal for this patient on the day of care is to control and reduce the complication of pneumonia (Carpenito, 2012, p. 860). The nurse will monitor the patient’s respiratory status while assessing for sign and symptoms of infection, and inflammation (Carpenito, 2012, p.

On your physical exam, what is most concerning to you on Sarah’s presentation? My main concern would be that the patient Sarah is so short of breath she cannot finish a sentence. Her oxygen saturation is only 87%, she is tachypneic disoriented and has ashen skin. I would be concerned that she is hypoxic.

Chest tightness - this will sense like something is squeezing or sitting on the chest of the patient and suffocating them making it difficult to breathe.