7/15/2018 Acute Respiratory Distress Syndrome Nursing Management and Interventions - Nurseslabs

Acute Respiratory Distress Syndrome (ARDS)

By Matt Vera - March 19, 2012

De nition
Acute respiratory distress syndrome (ARDS) is a life-threatening lung condition. It is a
form of breathing failure that can occur in very ill or severely injured people.
It is not a specific disease.
It starts with swelling of tissue in the lungs and build up of fluid in the tiny air sacs that transfer
oxygen to the bloodstream. This leads to low blood oxygen levels.
ARDS is similar infant respiratory distress syndrome, but the causes and treatments are
different. ARDS can develop in anyone over the age of one year old.
Also known as Adult Respiratory Distress Syndrome, Respiratory Distress Syndrome,

Causes
Direct injury to the lungs:

Chest trauma, such as a heavy blow

Breathing vomit
Breathing smoke, chemicals, or salt water
Burns

Indirect injury to the lungs:

Severe infection
Massive blood transfusion
Pneumonia
Severe inflammation of the pancreas (pancreatitis)
Overdoses of alcohol or certain drugs (eg, aspirin, cocaine, opioids, phenothiazines, and
tricyclic antidepressants)
Lung and bone marrow transplantation–within few days of a lung transplant, the recipient is
prone to development of ARDS.

Risk Factors

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7/15/2018 Acute Respiratory Distress Syndrome Nursing Management and Interventions - Nurseslabs

ARDS usually develops in people who are already in the hospital and are being treated for an
injury listed above.
However, only a small number of people who have these injuries actually develop ARDS.
While none can predict who will get ARDS, cigarette smokers, those with chronic lung disease,
or those who are over age 65 are more at risk of developing ARDS.

Symptoms
Shortness of breath
Fast, labored breathing
Bluish skin or fingernail color
Rapid pulse

Diagnosis
A person suffering from severe infection or injury develops breathing problems
A chest x-ray shows fluid in the air sacs of both lungs
Blood tests show a low level of oxygen in the blood
Other conditions that could cause breathing problems have been ruled out
Blood pressure check
Blood tests for oxygen levels and signs of infection as well as levels of BNP (brain natriuretic
peptide) a marker of heart failure
Chest x-ray
Analysis of coughed-up matter
Occasionally, an echocardiogram (heart ultrasound), to rule out congestive heart failure
Pulmonary artery catheterization taid in diagnostic work-up
Bronchoscopy to analyze airways. A laboratory examination may indicate presence of certain
viruses, cancer cells etc.
Open lung biopsy is reserved for cases when diagnosis is difficult to establish.

Nursing Diagnoses
Ineffective Airway Clearance
Ineffective Breathing Pattern
Impaired Gas Exchange
Anxiety

Treatment
Treating the underlying cause or injury
Providing support until the lungs heal:
Mechanical ventilation (a breathing machine) through a tube placed in the mouth or nose, or
through an opening created in the neck
Monitoring blood chemistry and fluid levels
Often, ARDS patients are sedated to tolerate these treatments.

See Also
8 Pneumonia Nursing Care Plans
5 Pneumonia Nursing Care Plans

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