NUR 213 Exam 2
- A potentially fatal syndrome of lung inflammation and injury
Answer Acute Repiratory Distress Syndrome (ARDS)
- ARDS is caused by
Answer DIRECT injury to lungs or INDIRECTLY by severe illness
- Examples of direct injuries that cause ARDS
Answer Pneumonia/Sepsis** Gastric aspiration.Lung contusion.Fat emboli.Near Drowning.Inhalation injury.Reperfusion
Answer Lung transplant and/or Pulm embolectomy.
- Examples of indirect injuries that cause ARDS
Answer Sepsis** Severe trauma with shock & DIC.Cardiopulm. bypass. Overdose.Acute pancreatitis. TRALI.Burns.
- Gastric Aspirations and Near Drowning are examples of which type of lung injury?
Answer Direct
- Sepsis is caused by which type of lung injury?
Answer 1 / 3
Can be caused by both direct and indirect lung injuries.
- Severe Trauma, Overdose and Burns are examples of which type of lung injury?
Answer Indirect
- Acute Repiratory Distress Syndrome (ARDS) is acute respiratory *failure* with the
following features Answer ~ *hypoxemia* that persists even with 100% O2 ~ decreased lung (pulmonary) compliance ~ dyspnea ~*noncardiac* associated *bilateral pulmonary edema* ~ *dense pulmonary infiltrates* on x-ray (ground glass)
- Often ARDS occurs in people with no pulmonary disease after what?
Answer an *acute lung injury*
- Despite the different causes of acute lung injury - the trigger for ARDS is a
Answer systemic inflammatory response
11. ARDS
Answer The main site of injury in the lung is the
alveolar-capillary membrane
- The alveolar capillary membrane is normally permeable to only what?
Answer - small molecules
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- When injured, the alveolar capillary membrane becomes
Answer damaged and more permeable to intravascular fluid! The osmotic gradient "shifts" which the allows debris, proteins & H2O into the alveloi!
- The alveolar capillary membrane can be injured during what things?
Answer sepsis - both direct and indirect.pulmonary embolism - direct. shock - indirect.gastric aspiration - direct.Burns and inhalation injury - indirect.
- The course of ARDS and its management are divided into 3 phases
- Injury/exudative phase.
- Reparative/proliferative phase.
- Fibrotic/chronic phase.
Answer
- Injury/exudative Phase
Answer Can last up to a week. Damage to the alveolar / fluids flood in!Gas exchange compromised (what findings would you see?). Alveolar collapse.Fluid inactivates surfactant / worsens hypoxemia that does not respond to supplemental O2.
- Reparative/proliferative phase
Answer Can lasts up to 3 weeks.
Inflammatory response occurs/phase complete when the lung is dense with fibrous tissue.
Increased pulmonary vascular resistance & pulmonary hypertension may occur d/t the destroyed pulmonary vasculature.
If phase persists widespread fibrosis results.If arrested lesions resolve and pt. may recover fully.
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