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ARDS and Respiratory FailureMedical-Surgical Nursing-7th edition

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Question Answer
The most common initial indicator of respiratory failure is?
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Changes in mental status, for example, restlessness, confusion, agitation, combativeness.
How do drugs like norepinephrine and dopamine increases perfusion in patients with ARDS?
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They are vasopressors. They cause systemic vasoconstriction, increased blood pressure and perfusion.
Cyanosis is a late sign of respiratory failure and doesn't occur until the PaO2 drops to _________ or less.
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45
What can cause hypoxemic respiratory failure? (7)
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Pneumonia, pulmonary edema, pulmonary embolism, smoke inhalation, ventilator induced injury, heart failure, or shock. Essentially, anything that causes an oxygenation failure.
Which type of respiratory failure (Hypoxemic or Hypercapnic)? Results from an interruption of O2 transfer into the bloodstream.
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Hypoxemic (common caused by respiratory failure)
What type of respiratory failure can occur even when the patient has perfectly normal lungs?
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Hypercapnic. Can be caused by obesity, brain injury, respiratory muscle fatigue, neuromuscular disease, etc.
A patient who is lateral or side-lying should be placed with the good or bad lung down?
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Good
What should be done if a patient develops dysrhythmias during suctioning?
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Stop suctioning
What brain structure is the first to detect oxygenation problems?
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The cerebral cortex, this is what causes the mental status changes associated with poor oxygenation.
What positional therapy can be used to position patients at angles up to 60 degrees in order to improve lung ventilation?
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Kinetic (bilateral turning)
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How does prone positioning benefit a patient with ARDS?
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It improves the V/Q mismatch, increases aeration by decreasing the compression of the posterior areas of the left lung by the heart, clears out debris, decreases inflammation and increase oxygenation and perfusion.
When placing someone prone, how should their arms be positioned?
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In the swimmer's pose, one arm at their side, and one arm extended above the head.
In a 24-hour period, an ARDS patient should be placed in the prone position for at least ________ hours.
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18 hours
What are the disadvantages of prone positioning?
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Tube dislodgement, patient desaturation, skin breakdown, and/or facial edema.
How does mechanical ventilation positively impact the alveoli in patients with ARDS?
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It opens them up
_______ is the name for the condition that occurs when the alveolar-capillary membrane becomes damaged and more permeable to intravascular fluid.
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ARDS
How does Primacor/milrinone lactate increase perfusion in ARDS patients?
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It is a positive inotrope that vasodilates the pulmonary bed.
What lung sound is associated with pulmonary edema?
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Crackles
What lung sound is associated with COPD?
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Rhonchi
What lung sounds are associated with atelectasis?
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Diminished or absent lung sounds
What lung sounds are associated with pleural effusion?
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Diminished or absent lung sounds
  
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