Hi. I'm Cathy with Level Up RN. In
this video, we are going to talk about acute respiratory distress syndrome, which is
ARDS, and acute respiratory failure, or ARF. So ARDS is respiratory failure that occurs due
to non-cardiac pulmonary edema. So you may be familiar with the fact that left-sided
heart failure can result in pulmonary edema. That is not what's happening here with ARDS. With
ARDS, we have either direct injury to the lungs or indirect injury to the lungs that
results in systemic inflammation, which increases the permeability of the alveoli
and lets fluid enter the alveoli and collect in the lungs. So risk factors associated
with ARDS include sepsis, shock, trauma, pneumonia, pancreatitis, inhalation of chemicals
or water, such as a near-drowning event. So one of these things will trigger that systemic
inflammation, which in turn will allow for that accumulation of fluid in the alveoli. So signs
and symptoms of ARDS includes dyspnea, rapid and shallow breathing, substernal retractions,
tachycardia, cyanosis or pallor, and then when you listen to your patient's lungs, you will
hear crackles because of that fluid collection. In terms of diagnosis, we can use ABGs as well
as a chest X-ray to help diagnose ARDS. With that chest X-ray, we will see bilateral infiltrates.
And then treatment includes correcting the underlying cause as well as the administration
of oxygen, and then mechanical ventilation may be necessary as well. In terms of nursing care,
we're going to want to maintain a patent airway for the patient. We're going to closely monitor
their cardiac status, and we're going to provide mechanical ventilation care, which we will
talk more about in the following video. All right. Let's now talk about acute respiratory
failure, or ARF. So ARF is the inability of the lungs to maintain arterial oxygenation or
to eliminate carbon dioxide from the body such that we end up with tissue hypoxia. So
our tissues are not getting sufficient oxygen. Risk factors associated with ARF
include atelectasis, as well as COPD, cystic fibrosis, heart failure, pneumonia,
a pneumothorax, and a pulmonary embolism. So signs and symptoms, you could probably guess it,
respiratory distress is definitely going to be a key symptom as well as tachycardia, dysrhythmia,
and then signs of hypoxia. So like we talked about in one of the first videos in the respiratory
system, with early signs of hypoxia, the patient may exhibit things like restlessness. Late signs
can include decreased level of consciousness. In terms of treatment for ARF, oxygen therapy is
definitely going to be one treatment. Mechanical ventilation may be necessary as well. Chest
physiotherapy is an option, as well as BiPAP and CPAP. So medications that may also be
helpful include bronchodilators, corticosteroids, antibiotics, inotropic agents such as
digoxin, and vasopressors and diuretics. So in terms of nursing care, you always want to
maintain the patient's airway. So we want a patent airway; that's your number one priority. You want
to really promote effective positioning of the patient as well. So when the patient is on their
back, you want to make sure the head of the bed is up at least 30 degrees. However, we may need
to position the patient so that their good lung is down. So with the COVID-19 pandemic, you likely
saw a lot of patients being in the prone position, so face down. It actually allows for more
effective oxygenation. For non-intubated patients, we can encourage coughing and deep
breathing, as well as increased fluid intake. And then we want to closely monitor our
patient's ABGs, their eyes and nose, their fluid and electrolytes,
and their cardiac status as well. Okay. In my next video, we are going
to talk about mechanical ventilation, which, as I mentioned in this video, is a
treatment that we can use for both ARDS as well as ARF. So definitely listen to that video. And if
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