Acute Respiratory Distress Syndrome (ARDS) is a life-threatening condition characterized by severe respiratory failure resulting from diffuse lung injury. As nursing students, it is essential to comprehend the significance of critical thinking and accurate nursing care in ARDS management.
Understanding how to assess ARDS is crucial for nursing students to provide comprehensive care to clients suffering from this complex condition.
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By recognizing the primary nursing diagnoses such as impaired gas exchange, ineffective airway clearance, anxiety and fear, and risk for impaired skin integrity, nursing students can effectively assess, plan, and implement appropriate interventions to improve client outcomes and contribute to a multidisciplinary team approach in ARDS management.
Before going into details on how to efficiently recognize acute respiratory distress syndrome (ARDS), we’ll have a quick overview and some signs and symptoms.
ARDS Nursing Assessment Overview
Acute respiratory distress syndrome (ARDS) develops due to the building up of fluids inside the alveoli or the microscopic, elastic air sacs inside the lungs. This build-up of fluid will prevent or make it difficult for the lungs to be filled in with air, resulting in limited oxygen reaching the bloodstream. Decreased oxygen in the body compromises the entire system from working properly.
ARDS Risk Factors
ARDS usually happens to people who are severely ill or those who have experienced critical injuries. As for those who already have ARDS, most of them do not survive, and the risk of mortality increases with the illness’ severity and age. As for those who do survive, they either have irreversible lung damage or will recover completely.
The manifestations of ARDS change with intensity, and will significantly depend on the illness’ severity and cause, not to mention the presence of an underlying lung or heart disease. Some of the common signs and symptoms of ARDS are:
- Shortness of breath (SOB)
- Decreased blood pressure
- Extreme fatigue
- Rapid and labored breathing
ARDS Criteria for Emergent Care
How do we assess the client may be experiencing ARDS? What critical thinking skills are employed in deciding the outcome of the client? Let’s look at criteria for emergent care:
- Erroneous breathing
One of the main criteria for diagnosing ARDS is inconsistency in breathing patterns since the lungs are primarily affected.
- Oxygen saturation (SaO2)
If a postoperative client’s oxygen saturation has been steadily below 90% Sa02, it is one of the main indicators for ARDS.
- Partial pressure of oxygen (PaO2)
The health care provider (HCP) will also prescribe ABGs (Arterial blood gas) to see how much PaO2 or oxygen is going back to the pulmonary artery. If the result is anything less than 60%, that’s another criterion for ARDS.
- Power of hydrogen (pH)
If the pH result is less than 7.30, this means that the blood’s acidity is high and will immediately affect the lungs.
To summarize, here are critical diagnostic findings that HCPs should consider when assessing ARDS:
- SaO2 – less than 90%
- PaO2 – less than 60%
- pH – less than 7.3
Aside from distressed breathing, if the results show the indicators mentioned above, all it means is that the lungs are filling up with carbon di-acid or carbon dioxide, which makes it hard for the client to breathe.
While oxygen is not going inside the lungs and to the rest of the body, carbon dioxide is building up. Therefore, carbon dioxide is expected to go as high as 50mEq/L. This will cause the blood to become very acidic.
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