The nursing interventions for patients with acute respiratory distress syndrome?

KPSC Staff Nurse - 2017

Medical & Surgical Nursing

Hard

Appeared in: KPSC Staff Nurse - 2017

Explanation

ARDS management requires a comprehensive, multi-faceted nursing approach that addresses both physiological and psychosocial needs.
Maintaining a patent airway is the foremost priority to facilitate oxygen delivery to the compromised lungs. This includes positioning, suctioning, and mechanical ventilation.
Monitoring arterial blood gases (ABGs) is critical for assessing the severity of refractory hypoxemia and guiding therapeutic adjustments to ventilator settings and oxygen therapy.
Providing psychosocial support by explaining procedures and addressing patient/family concerns (removing misconceptions) is vital to reduce anxiety, which can decrease oxygen demand and improve cooperation.
Because maintaining the airway, monitoring gas exchange, and providing psychosocial support are all standard and essential nursing interventions for ARDS, the 'All the above' option is the most complete and correct answer.

Option A: This option is correct but incomplete. While maintaining a patent airway is a critical first step, it is only one part of the comprehensive care required for an ARDS patient. It neglects the essential roles of monitoring physiological parameters and providing psychosocial support.
Option B: This option is correct but incomplete. Monitoring ABGs is crucial for guiding therapy, but it is a surveillance action. It does not address the primary need to establish and maintain a patent airway or the patient's significant psychosocial distress.
Option C: This option is correct but incomplete. Psychosocial support is an important aspect of holistic nursing care, but it does not take precedence over life-sustaining physiological interventions like airway management and oxygenation monitoring.

Clinical Relevance

Nursing practice connection: Knowing Nursing management of Acute Respiratory Distress Syndrome (ARDS) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Managing a patient with ARDS is a core competency for critical care nurses, requiring the integration of advanced assessment skills, ventilator management, and compassionate communication.
Nurses must be vigilant for complications of ARDS and its treatment, including barotrauma from high ventilator pressures, ventilator-associated pneumonia (VAP), and skin breakdown from immobility and prone positioning.
What if? If a patient with ARDS develops sudden hypotension and tracheal deviation to one side, the nurse should immediately suspect a tension pneumothorax (a complication of PEEP) and prepare for emergency needle decompression and chest tube insertion.

How to Approach the Question

First, identify the core concept of the question, which is the nursing management of ARDS.
Evaluate each option individually to determine if it is a valid and appropriate intervention for a patient with ARDS.
Option A, maintaining a patent airway, is a fundamental principle of respiratory care and is absolutely essential in ARDS.
Option B, monitoring ABGs, is a critical assessment tool to guide therapy for the severe hypoxemia characteristic of ARDS.
Option C, removing misconceptions, addresses the significant psychosocial needs of a critically ill and anxious patient, which is a key component of holistic nursing.
Since all three options represent correct and necessary nursing interventions for ARDS, conclude that the 'All the above' option is the most comprehensive and correct choice.

Concept Tested & Keywords

Concept Tested: Nursing management of Acute Respiratory Distress Syndrome (ARDS).
Stem keywords: nursing interventions, acute respiratory distress syndrome, ARDS
Lead-in keywords: BEST, MOST RELEVANT CLUE
Negative lead-in flag: false

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E6 Nursing Brunner Adult Health 3SA Vol 1 Part 2 pp. 5-7, 6-8