Critical Care HESI Latest Version 100% Pass
Acute Respiratory Distress Syndrome (ARDS) ✔✔the exchange of oxygen for carbon dioxide in the lungs is inadequate for oxygen consumption and carbon dioxide production within the body's cells
ARDS Characterized by: ✔✔1. Hypoxemia that persists even when 100% oxygen is given. 2.Decreased pulmonary compliance. 3. Dyspnea. 4. Non-cardiac-associated bilateral pulmonary edema. 5. Dense pulmonary infiltrates on radiography. No abnormal lung sounds are present on auscultation because the edema of ARDS occurs first in the interstitial spaces, not in the airways.
HESI Hint #1 ✔✔ARDS is an unexpected, catastrophic pulmonary complication occurring in a person with no previous pulmonary problems. Clients are critically ill and are managed in an ICU setting. Mortality rate is high (50%)
HESI Hint #2: Interventions to prevent complications on mechanical ventilation with ARDS ✔✔Elevate HOB to at least 30 degrees. Assist with daily awakening ("sedation vacation").Implement a comprehensive oral hygiene program. Implement a comprehensive mobilization program.
- / 2
Common causes of respiratory failure ✔✔1. Exacerbation of COPD. 2. Pneumonia. 3. TB. 4.Contusion. 5. Aspiration. 6. Inhaled toxins. 7. Emboli. 8. Drug overdose. 9. Fluid overload. 10.DIC. 11. Shock
Nursing Assessment ARDS ✔✔A. dyspnea, hyperpnea, crackles (or rales). B. Intercostal retractions. C. cyanosis, pallor D. Hypoxemia: PO <50 mmHg with FiO2 >60%. E. Diffuse pulmonary infiltrates seen on chest radiograph as "white-out" appearance. F. Verbalized anxiety, restlessness.
Nursing Plans and Interventions ARDS ✔✔A. Position client for maximal lung expansion. B.Monitor client for signs of hypoxemia and oxygen toxicity. C. Monitor breath sounds for pneumothorax. D. Provide emotional support to decrease anxiety and allow ventilatory to "work" the lungs. E. Monitor client hemodynamically with essential vital signs and cardiac monitor. F.Monitor arterial blood gases (ABGs) routinely. G. Monitor vital organ status: CNS, LOC, renal system output, and myocardium [apical pulse, BP]). H. Monitor fluid and electrolyte balance. I.Monitor metabolic status through routine lab work.
HESI Hint #3 ✔✔Suction only when secretions are present
- / 2