Adrienne Benedetti

ADRS – Acute Respiratory Distress Syndrome

Sudden-progressive resp. failure. Direct / indirect
Impaired Gas Exchange
damage to alveoli causing fluid buildup and instability.
↓ surfactant production and alveoli collapse cause
↓ gas exchange.
Identify risk modifiers (obesity, alcohol abuse,
diabetes, hypoalbuminemia, acidosis, tachypnea,
and oxygen supplementation) **treat/manage
risk factors promptly**

Direct: Aspiration, Pneumonia, Chest trauma, Embolism (air,
fat, amniotic, thrombus), toxic substances, near drowning, O2
toxicity, radiation pneumonitis. Indirect: Sepsis,
Severe/massive trauma, Acute pancreatitis, Cardiopulmonary
bypass, Disseminated intravascular coagulation, Opioid OD,
Severe head injury, Schock, Transfusion related injuries.
Early: Restlessness, Dyspnea, HYPOtension, Confusion,
Fatigue, Mood swings, Disorientation, Altered LOC,
Cough/Fever caused by PNA
LATE: Rapid/shallow breathing, SOD, tachycardia, cyanosis,
thick/frothy sputum, Abnormal breath sounds
** Metabolic Acidosis - ↓ PaCO2 w/ resp alkalosis, ↓ PaO2

ABG, blood CX, Sputum CX History, Breath sounds, Chest X-ray,

Bronchoscopy, Chest CT, ECHO

VAS (vent-associated pneumonia)

Pulmonary interstitial
Resp. assessments, VS, monitor ABG’s, Steroids, sedatives, Take medications as directed. Follow-up as emphysema,
monitor SE of medications and diuretics, antibiotics, directed. When to call MD / ER / 911
Treatments, Humidified O2, Admin meds Pneumothorax, SQ
bronchodilators, pain Self care (Breathing exercises, Avoid the
as ordered. Positioning (prone to ↓ spread of germs, Do not smoke, Do not
emphysema, Renal
meds, Vasopressors,
pressure in lungs - ↑ HOB to open airway), drink alcohol, Get plenty of exercise) failure, Lung scaring,
IV fluids
Keep pt warm, ↓ anxiety Blood clots, Arrhythmias

Mechanical Ventilation Diagnostics, Resp. Therapy,

O2 Cardiology, Supportive Care, Drug
Positioning to promote oxygenation Therapy
Fluids and nutrition
Chest physiotherapy
**supportive care**