Acute Respiratory Distress Syndrome (ARDS)

The nurse is caring for a patient diagnosed with ARDS. On assessment, the nurse notes crackles in the lungs and peripheral edema. Which nursing assessments are appropriate for the nurse to obtain? (Select all that apply) a. Skin integrity b. I&O c. Oxygen saturation d. Blood glucose level e. Serum albumin level

a. Skin integrity b. I&O c. Oxygen saturation

The nurse is receiving a report on a patient diagnosed with ARDS. The patient is intubated and mechanically ventilated. On assessment, the nurse notes crackles in the lungs, poor skin turgor, and decreased capillary refill. The patient is receiving NPO with normal saline solution infusing at 100 mL/hr. Urine output was 100 mL over the last 4 hours. Which action should the nurse perform first? a. Administer dopamine as ordered b. Advance the patient to a regular diet c. Obtain an order for enteral nutrition d. Obtain an order to administer 5% dextrose in water with the normal saline solution

a. Administer dopamine as ordered

A patient is being evaluated for ARDS. On assessment of the patient, the nurse notes tachypnea, dyspnea, and confusion. For which test would the nurse expect to prepare the patient to confirm the diagnosis of ARDS? a. Chest x-ray b. Measurement of ABGs c. CBC with platelets d. MRI of the chest with contrast

a. Chest x-ray

A nurse is caring for a patient with severe ARDS. The patient had an arterial catheter placed in the morning. The nurse observed a decrease in cardiac output in blood pressure in the afternoon. What medication does the nurse anticipate administering? a. Dopamine b. Furosemide c. Antibiotics d. Epinephrine

a. Dopamine

A nurse is caring for a patient who is suspected of developing ARDS. The patient is receiving oxygen at 15 L/min through a nonrebreather mask while awaiting further evaluation. What should the nurse implement for this procedure to be most effective? a. Ensure the mask fits snuggly on the patient's face b. Encourage the patient to remove the mask when it becomes uncomfortable c. Obtain baseline vital signs before initiating oxygen supplementation therapy d. Encourage the patient to remove the mask periodically for deep breathing exercises

a. Ensure the mask fits snuggly on the patient's face

A nurse is assessing a patient with ARDS who is intubated and receiving mechanical ventilation. Arterial blood gases reveal a partial pressure of oxygen in arterial blood (PaO2) of 55 mm Hg. The nurse knows that the respiratory therapist may recommend which types of treatment? (select all that apply) a. Permissive hypercapnia b. Continuous positive airway pressure c. Airway pressure release ventilation d. Pressure-control inverse-ratio ventilation e. Extubation and use of nonrebreather mask

a. Permissive hypercapnia c. Airway pressure release ventilation d. Pressure-control inverse-ratio ventilation

The nurse knows that patients with which diagnoses are at risk of developing ARDS? (select all that apply) a. Septic shock b. Severe head injury c. Acute heart failure d. Amniotic fluid embolus e. Chronic kidney disease

a. Septic shock b. Severe head injury d. Amniotic fluid embolus

A patient with pneumonia reports increased sweating, persistent coughing, shortness of breath and palpitations. The nurse notes tachycardia and cyanosis. The patient is receiving oxygen via a nasal cannula at 2 L/min. which action would the nurse take next? (Select all that apply) a. Administer an antipyretic b. Notify the health care provider c. Inform the respiratory therapist d. Give a bolus of normal saline solution e. Increase oxygen concentration to 6 L/m

b. Notify the health care provider c. Inform the respiratory therapist

The nurse is caring for a patient with ARDS secondary to sepsis. The patient is receiving kinetic therapy. The nurse should ensure that the nursing assistant performs which intervention? a. Elevates the lower extremities b. Turns the patient every 2 hours c. Keeps the patient in a prone position d. Encourages the patient to ambulate each hour

b. Turns the patient every 2 hours

A patient with aspiration pneumonia presents with a heart rate of 128 bpm, respiratory rate of 32bpm, blood pressure of 148/92 mm Hg, and functional saturation of oxygen on 88% on room air. The patient reports shortness of breath and fatigue. Which blood test would the nurse anticipate first? a. Blood glucose b. Chemistry panel c. Measurement of ABGs d. PT/PTT/INR

c. Measurement of ABGs

The nurse is caring for a patient with ARDS who is having difficulty breathing and an oxygen saturation of 85%. The patient's spouse is at the bedside and asks why the patient is having difficulty breathing. What is the best response by the nurse? a. Your spouse has multiple organ dysfunction syndrome b. This is the normal course of ARDs and should resolve in a few days c. Your spouse has refractory hypoxemia, which is low blood oxygen that is not being resolved with the therapies we are trying d. Your spouse is probably feeling a little anxious, which can make it feel as if he/she is having difficulty breathing. The oxygen saturation level is normal

c. Your spouse has refractory hypoxemia, which is low blood oxygen that is not being resolved with the therapies we are trying

A nurse is caring for a patient with ARDS. At the start of the shift, the nurse finds that the patient has been placed in a prone position. Function saturation of oxygen if 93%. How does the nurse respond? a. Initiate aspiration precautions b. Notify the primary healthcare provider c. Turn the patient to the supine position d. Continue to monitor per hospital protocol

d. Continue to monitor per hospital protocol

A patient is diagnosed with ARDS two days after crushing chest injury during a motor vehicle collision. Which statement best explains the cause of the patient's worsening symptoms? a. Pulmonary vessels are dilated b. The immune system is inhibited c. Pulmonary compliance is increased d. Inflammatory mediators are released

d. Inflammatory mediators are released

A patient has developed ARDS after aspiration and is now arriving at the hospital by ambulance. The patient is hyperventilating and has been receiving oxygen at a rate of 15 L/min via a simple facemask. Which provider order would the nurse anticipate? a. Change to a nonrebreather mask b. Reduce oxygen concentration to 6 L/min c. Administer IV furosemide to reduce fluids d. Prepare for intubation and mechanical ventilation with positive end-expiratory pressure (PEEP)

d. Prepare for intubation and mechanical ventilation with positive end-expiratory pressure (PEEP)

A patient with ARDS secondary to a chest injury has crackles in the bilateral posterior lung fields. The nurse also notes tachycardia, delayed capillary refill, decreased urine output, and the following ABGs: pH 7.56, PaO2 51, PaCO2 28, HCO3 24, SaO2 76%. Which provider order would the nurse implement first? a. Measure urine output b. Administer furosemide c. Place the patient in a prone position d. Prepare the patient for mechanical ventilation

d. Prepare the patient for mechanical ventilation

A nurse is caring for a patient with ARDS and notes a hemoglobin of 7 g/dL. The nurse anticipates what order? a. Bolus of normal saline b. Administration of furosemide c. Administration of colloid solutions d. Transfusion of packed red blood cells

d. Transfusion of packed red blood cells