slide notes
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
|---|---|---|---|---|---|
| ARDS/ARF definition | Pathologic acute injury to the lung (direct or indirect). Inflammatory syndrome marked by disruption of alveolar-capillary membrane
🗑
|
||||
| Mortality rate of ARDS | Very deadly, 50%
🗑
|
||||
| What are the symptoms of ARDS? | Decreased lung compliance
-Resulting in falling PO2 despite increase FiO2*******
Decreased surfactant
-Resulting in atelectasis
Increase in # of neutrophils and macrophages (“Phil and Mac attack”)
-Resulting in PROTEIN-RICH pulmonary edema
🗑
|
||||
| What are the causes of ARDS/ALI? | Direct Lung Injury: IN the lung
--aspiration, trauma, pneumonia
Indirect Lung injury: from the blood
--Sepsis, cardiopulmonary bypass, pancreatitis, transfusions
🗑
|
||||
| What is capnometry? | Measuring the amount of CO2 within/given off by the patient
🗑
|
||||
| PETCO2 | partial pressure of end tidal CO2. i) Measured by the ventilator and is 1-5mm < PaC02 in the STABLE patient.
ii) An extremely abnormal value indicates CO2 retention and could be an ominous sign of a change in condition. However……
🗑
|
||||
| Permissive hypercapnia | Maintaining lower tidal volumes to cause a rise in PaCO2 keeping pH above 7.25. This helps to prevent Barotrauma/Volutrauma. Keep in mind this is risky business, CO2 very strong vasodilator.GOAL: Maintain PaCO2 less than or equal to 60 mmHg and peak airw
🗑
|
||||
| What position should patient be in for when caring ALI/ARDS? | a) PRONE POSITIONING
i) Strongly supported by EBP
ii) Shifts edema and recruits aveoli
iii) Change in position= Improved oxygenation!
🗑
|
||||
| Supportive care for ARDS means | you treat UNDERLYING CONDITION
i) Interrupt inflammatory cascade
(1) Monitor Protein C as it is a marker for SYSTEMIC INFLAMMATION.
ii) Decrease Oxygen demand and promote sleep and rest
(1) Cluster your care to allow maximal rest for the patient
🗑
|
||||
| Make sure that ARDS patient has : | Maintain SaO2 >90% using LOWEST FiO2 (decreased chance of O2 toxicity),Head of bed > 30 degrees,GOOD ORAL CARE TO PREVENT PNEUMONIA,Mobility, ROM, Q2 Turns
🗑
|
||||
| Medications typically used with ARDS patients | i) Inhaled Nitric Oxide (Pulmonary vasodilation),Steroids (still controversial),Anti-inflammatory agents
🗑
|
||||
| Confusion/restlessness are early signs of | CO2 retention
🗑
|
||||
| Pa02/ Fi02 ratio | 80 / 20% (room air) = 400
🗑
|
||||
| Hypoxemia is ---- oxygen therapy | refractory
"A falling P02 in the face of a rising Fi02"
🗑
|
||||
| BOOP | Bronchiolitis Obliterans Organizing Pneumonia
🗑
|
||||
| CARS | Compensatory Anti-inflammatory Response Syndrome (more susceptible to infection)
🗑
|
||||
| COP | Cryptogenic Organizing Pneumonitis
🗑
|
||||
| DAD | Diffuse Alveolar Damage
🗑
|
||||
| Type I alveolar epithelial cells | 90% total alveolar surface within lungs
Highly susceptible to injury inflammation
🗑
|
||||
| Type II alveolar epithelial cells | Produce, store, secrete pulmonary surfactant
10% total alveolar surface within lungs
disruption of synthesis/storage of surfactant collapse of alveoli, impairment of pulmonary gas exchange, development of fibrosis and loss of compliance “stiff lungs”
🗑
|
||||
| In 2002 Severe Acute Respiratory Syndrome, or SARS killed | 15% of those infected
🗑
|
||||
| Of the H1N1 influenza A (swine flu) 2009/2010 18,000 deaths | 14 – 46% mortality rate primarily from ARDS
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
UARN85
Popular Nursing sets