ARDS NCLEX Quiz Questions And Answers

Conditions that trigger the high-pressure alarm include kinking of the ventilator tubing, bronchospasm or pulmonary embolism, mucus plugging, water in the tube, coughing or biting on the ET tube, and the client’s being out of breathing rhythm with the ventilator. A disconnected ventilator tube or an ET cuff leak would trigger the low-pressure alarm. Changing the oxygen concentration without resetting the oxygen level alarm would trigger the oxygen alarm.

During the Fibrotic Phase of ARDS, fibrous tissue forms, and the lungs don't expand well. This leads to a decrease in lung compliance, making it difficult for the patient to breathe. As a result, the effort required to breathe increases, leading to an increased demand for oxygen. This vicious cycle further exacerbates the breathing difficulties experienced by the patient.

The earliest detectable sign of acute respiratory distress syndrome is an increased respiratory rate, which can begin from 1 to 96 hours after the initial insult to the body. This is followed by increasing dyspnea, air hunger, retraction of accessory muscles, and cyanosis. Breath sounds may be clear or consist of fine inspiratory crackles or diffuse coarse crackles.

Skin color doesn’t affect the mucous membranes. The lips, nail beds, and earlobes are less reliable indicators of cyanosis because they’re affected by skin color.

The normal pulmonary capillary wedge pressure (PCWP) is 8 to 13 mm Hg, and the patient is considered to have high readings if they exceed 18 to 20 mm Hg. The client with acute respiratory distress syndrome has a normal PCWP, which is an expected finding because the edema is in the interstitium of the lung and is noncardiac.

The development of acute respiratory distress syndrome (ARDS) in a client with a fracture of the right femur may indicate the presence of a fat embolus. Fat embolism syndrome occurs when fat globules from the broken bone enter the bloodstream and travel to the lungs, causing respiratory distress. This can lead to symptoms such as shortness of breath, rapid breathing, low oxygen levels, and the need for mechanical ventilation. Therefore, the presence of ARDS in this scenario suggests that a fat embolus may be developing.

During the Proliferative Phase of ARDS, the lung starts to repair itself. This phase is crucial as it determines whether the patient will start to get better or if the condition will deteriorate further. The formation of fibrous tissue during this phase leads to decreased lung expansion and increased effort to breathe. This increased demand for oxygen further exacerbates the breathing difficulties. Therefore, the repair process during the Proliferative Phase plays a significant role in the patient's prognosis.

The explanation for the given correct answer is that management of ARDS (Acute Respiratory Distress Syndrome) is primarily focused on providing supportive care. This means that the treatment mainly involves measures such as providing supplemental oxygen, mechanical ventilation, and addressing the underlying cause of ARDS. Unfortunately, there are currently no specific medications or interventions that can completely reverse the process of ARDS. Therefore, the statement that "there is little we can do to reverse the process" is true.

ARDS is a condition characterized by non-cardiac pulmonary edema, which refers to the accumulation of fluid in the lungs, leading to impaired gas exchange. In ARDS, this pulmonary edema is accompanied by increasing hypoxemia, which is a low level of oxygen in the blood. Despite treatment with oxygen, the patient's condition continues to worsen, indicating a life-threatening deterioration of gas exchange. Therefore, the correct answer is "Non-cardiac pulmonary edema with increasing hypoxemia despite treatment with O2."

The 5 characteristics of ARDS are dyspnea, refractory hypoxemia, dense pulmonary infiltrates on CXR, decreased pulmonary compliance, and non-cardiac pulmonary edema. These symptoms and findings are commonly seen in patients with ARDS, indicating severe lung injury and respiratory distress. Myasthenia Gravis, cyanosis, and chest pain are not specific to ARDS and are not included in the list of characteristics.

The advanced signs and symptoms of ARDS include retraction of tissues between the ribs and above the sternum, the use of accessory muscles for breathing, pallor or cyanosis (bluish discoloration of the skin), significant changes in the chest X-ray showing pulmonary infiltrates, and respiratory acidosis (a decrease in blood pH due to increased carbon dioxide levels). These signs indicate the severity of ARDS and the compromised respiratory function in the patient.

The early signs and symptoms of ARDS include dyspnea (difficulty breathing), non-productive cough, restlessness, clear chest X-ray (CXR), and respiratory alkalosis (a decrease in blood carbon dioxide levels). These symptoms may indicate the onset of ARDS before significant changes are seen on a CXR or before respiratory acidosis (an increase in blood carbon dioxide levels) occurs. Retractions, accessory muscle use, pallor or cyanosis, and significant CXR changes are not always present in the early stages of ARDS.