Republic of the Philippines

UNIVERSITY OF NORTHERN PHILIPPINES

Tamag, Vigan City
2700 Ilocos Sur
College of Nursing
Website: www.unp.edu.ph Mail: unp_nursingvc@yahoo.com
CP# 09177148749, 09175785986

NAME: Bea Flor Rapisura-Pegad YR&SEC: BSN IV DATE: 3-22-21

Critical Thinking Exercise No. 10

Nursing Management of the client with
ACUTE RESPIRATORY DISTRESS SYNDROME
(ARDS)
SITUATION: Mang Cardo, a 40 year-old in Acute Respiratory Distress has been admitted to
the Intensive Care Unit (ICU) following an automobile accident during which he suffered direct
lung trauma. The client has been placed on prone position and his VS and ABG values are
continuously monitored. The client initially received oxygen via face mask with a high flow
system, but he is now on a mechanical ventilator using Positive End-Expiratory Pressure
(PEEP). The client is extremely anxious and is also frustrated that he cannot speak due to the
ET tube.

Answer the following comprehensively.

1. What symptoms should alert the nurse that ARDS is progressing?

Most people with ARDS will be on a mechanical ventilator, also known as life support. The
main problem in ARDS is that fluid leaks into the lung. This makes it difficult to breathe,
and lungs cannot get oxygen into the blood. To improve the amount of oxygen in their
blood and reduce the work of breathing, many people are placed on a ventilator to
support them while their lung heals. If the inflammation and fluid in the lung grow, some
people develop scarring in the lung. This is known as the fibrotic stage of ARDS. During this
stage, the lung can “pop” and deflate, leading to a collapsed lung—known as a
pneumothorax.
Symptoms of pneumothorax a nurse should be alert of is shortness of breath and sudden
CHEST PAIN.

2. How does a mechanical ventilator using PEEP benefit the client with ARDS?

In PEEP, a pressure is applied by the ventilator at the end of each breath to ensure that the
alveoli are not so prone to collapse. This ‘recruits’ the closed alveoli in the sick lung and
improves oxygenation. It reduces trauma to the alveoli . It also Increases the functional
residual capacity- the reserve in the patients lungs between breaths which will also help
improve oxygenation.
3. Why is it necessary to monitor the client’s Arterial Blood Gas (ABG)?

An ABG is a blood test that measures the acidity, or pH, and the levels of oxygen (O2) and
carbon dioxide (CO2) from an artery. The test is used to check the function of the patient’s
lungs and how well they are able to move oxygen into the blood and remove carbon
dioxide.

4. What can the nurse do to allay the client’s anxiety, fear, and frustrations?

Explain well to the patient his condition and treatments to be done. Assuring him that the
health care team would be doing their best for his treatment. A nurse must talk to the
patient in a calm and non threatening matter to relieved patients fear making him relaxed
and comfortable. Teach the patient to perform some relaxation techniques such as deep
breathing exercises to promote relaxation and reduce stress levels.