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