Assignment

Learning Objectives Covered:

Explain permissive hypercapnia and its clinical indication

Explain inverse I:E ratio ventilation and its clinical use

Background

ventilator.jpgManagement strategies for ARDS include correcting hypoxemia and acid-base disturbance, restoring cardiac function, and treating the underlying disease or precipitating factors. This is generally accomplished with mechanical ventilation at 6-8 ml/kg ideal body weight and the application of PEEP to correct refractory hypoxemia.

Prompt

Case Study: Adult Respiratory Distress Syndrome History:

Ms. Y is a 23 year-old woman who was feeling fine until the morning of admission when she began having severe chills, vomiting, diarrhea, headache, and fever of 40*C. The symptoms persisted throughout the day and caused her to seek medical attention at the local ED. Ms. Y had an intrauterine device (IUD) inserted at a local family planning clinic 3 days before admission. At the time of admission, she denied shortness of breath, wheezing, sputum production, cough hemoptysis, orthopnea, chest pain, illicit drug use, or exposure to TB.

Part 1

Question #1

Does the patient appear to have a pulmonary problem at this time? Why or why not?

Question #2

Does the patient's medical problem predispose her to the development of ARDS?

Part 2

Question #1

What is the pt's acid-base & oxygenation status? Interpret the blood gas and explain your answer.

Question #2

What pathophysiology accounts for the adventitious lungs sounds (fine, inspiratory crackles)?

Part 3

Question #1

Interpret the ABG.

Question #2

What initial settings would you place the patient on? Include mode of ventilation and indicate Why?

Attachment:- Management-strategies-for-ARDS.rar