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ARDS stands for acute respiratory distress syndrome – these are just some fancy words for a condition that’s causing severe alveoli inflammation leading to structural collapse and instability.
For those who are unaware what alveoli are, they are those small sacs located at the end portion of the respiratory tract. You can think of them as apples attached to the branches of your trees (lungs).
It is in the alveoli that oxygen and carbon dioxide exchange happens. When people inhale oxygen, it is exchanged with carbon dioxide (CO2) that is breathed out by the body. In acute respiratory distress syndrome, this process is compromised due to the mass of fluid pooling inside, causing lung collapse.
Nursing Intervention for ARDS
Fluid rushing into the respiratory tract and reaching the alveoli is the primary cause for ARDS. So, how does one manage and intervene? How do you make sure that you’re decompressing and minimizing inflammation to the respiratory tract? What are the important nursing interventions that you need to do?
Some common corticosteroids are Solu-Medrol and Prednisone. Clients are given corticosteroids to decrease inflammation in the respiratory tract. Take note; if you provide corticosteroids to your client with ARDS, you are also decreasing the movement of WBCs, thereby decreasing the immune response.
Since ARDS is a condition wherein there’s a pooling of liquid inside the lungs, the water becomes stagnant and is prone to becoming grounds for bacterial growth. Therefore, the client is likely to developing pneumonia. For this reason, antibiotics are necessary to protect the respiratory tract from developing complications and get rid of inflammation.
Remember that the primary goal why antibiotics are given is to alleviate inflammation and bring the client’s breathing back to normal.
Turn the Client
Put the client in a 45-degree or 90-degree sitting position, and turn your client every hour to make sure that the fluid inside the lungs is not stagnant in one place. This will give parts of the lungs to breathe. Moving the client will also facilitate drainage as steroids are provided.
Here’s a critical thinking question:
As a nurse caring for a client with the late phase of acute respiratory distress syndrome, between diuretics and IV fluids, which one would you give to your client and why?
First, this is a trick question. Second, the answer is neither because you should not give IV fluids nor diuretics to your ARDS client due to fluid considerations.
Intravenous fluids are not given because the lungs are already filled with fluid and, as the nurse in charge, you do not want to introduce further fluids that will add up to the ones that are already pooling inside the lungs.
On the other hand, diuretics are not given due to perfusion issues. Diuretics can cause concentrated blood, making it harder for hemoglobin and oxygen to move around the body. You have to make the most of the oxygen that’s left inside the body to be properly distributed to different parts and systems.
Remember, antibiotics and corticosteroids are essential in preventing infection and decreasing inflammation so that the fluid will not progress into multiple complications like pulmonary fibrosis or multi-organ dysfunction syndrome (MODS). Hopefully, this nursing intervention will reverse the condition, and the client will regain normal breathing.
That’s ARDS in a nutshell. For more relevant nursing topics, visit SimpleNursing.com.