Comprehensive Respiratory System Disorders Q 47

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A nurse is caring for a male client with acute respiratory distress syndrome. Which of the following would the nurse expect to note in the client?

  

     A. Pallor

     B. Low arterial PaO2

     C. Elevated arterial PaO2

     D. Decreased respiratory rate

    

    

Correct Answer: B. Low arterial PaO2

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The earliest clinical sign of acute respiratory distress syndrome is an increased respiratory rate. Breathing becomes labored, and the client may exhibit air hunger, retractions, and cyanosis. Arterial blood gas analysis reveals increasing hypoxemia, with a PaO2 lower than 60 mm Hg. Despite 100% oxygen, patients have low oxygen saturation.

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Option A: Systemic signs may also be evident depending on the severity of illness, such as central or peripheral cyanosis resulting from hypoxemia, tachycardia, and altered mental status. Chest auscultation usually reveals rales, especially bibasilar, but are often auscultated throughout the chest.

Option C: ARDS is defined by the patient’s oxygen in arterial blood (PaO2) to the fraction of the oxygen in the inspired air (FiO2). These patients have a PaO2/FiO2 ratio of less than 300. When interviewing patients that are able to communicate, they often start to complain of mild dyspnea initially, but within 12 to 24 hours, the respiratory distress escalates, becoming severe and requiring mechanical ventilation to prevent hypoxia.

Option D: The syndrome is characterized by the development of dyspnea and hypoxemia, which progressively worsens within hours to days, frequently requiring mechanical ventilation and intensive care unit-level care. The physical examination will include findings associated with the respiratory system, such as tachypnea and increased effort to breathe.

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