Deck 27: Acute Respiratory Distress Syndrome

Question 1

Clinical manifestations of ARDS include:
1) low or normal pulmonary capillary wedge pressure (PCWP).
2) tachycardia.
3) intercostal retractions.
4) cyanosis.

A)1, 2
B)3, 4
C)2, 3, 4
D)1, 2, 3, 4

Answer 1

1, 2, 3, 4

Question 2

Which of the following can lead to ARDS?
1) Liver failure
2) Burns
3) Septicemia
4) Hemorrhagic pancreatitis

A)1, 4
B)2, 3
C)2, 3, 4
D)1, 2, 3, 4

Answer 2

2, 3, 4

Question 3

The physiologic abnormalities found in the lungs of the ARDS patient include:
1) abnormal surfactant.
2) interstitial edema.
3) decreased shunt.
4) narrowing of the alveolar-capillary membrane.

A)1, 2
B)3, 4
C)1, 3
D)1, 2, 3, 4

Answer 3

1, 2

Question 4

Your patient has acute respiratory distress syndrome (ARDS). All of the following materials will be found in her alveoli, EXCEPT:

A) leukocytes.
B)cellular debris.
C)fibrin.
D)hyaline membrane.

Question 5

Your adult male patient weighs 68 kg (150 pounds). Because he has developed ARDS, the physician wants to adjust the mechanical ventilator to minimize further lung injury. What tidal volume should be set for the patient?

A) 150 ml
B)400 ml
C)680 ml
D)800 ml

Question 6

Your patient has a prolonged case of ARDS. What will happen to his alveolar cells?

A) Multiplication of the type I cells
B)Influx of macrophages
C)Hyperplasia and swelling of the type II cells
D)Development of emphysema

Question 7

Commonly heard breath sounds in a patient with ARDS include:
1) vesicular.
2) bronchovesicular.
3) crackles.
4) bronchial.

A)4
B)1, 2
C)3, 4
D)2, 3, 4

Question 8

A patient with massive blood transfusion or disseminated intravascular coagulation (DIC) is at risk for developing ARDS because of:

A) shock (hypovolemia).
B)receiving the wrong blood type.
C)fat emboli.
D)blockages in pulmonary blood vessels.

Question 9

All of the following would be low tidal volume ventilation goals in a patient with ARDS, EXCEPT:

A) decrease barotraumas.
B)plateau pressure > 30 cm H₂O.
C)decrease high transpulmonary pressures.
D)reduce overdistension of the lungs.

Question 10

Your patient with ARDS has alveolar consolidation and atelectasis. Which of the following can be used to offset these problems?
1) aerosolized bronchodilator medications
2) continuous positive airway pressure (CPAP)
3) chest percussion and postural drainage
4) positive end-expiratory pressure (PEEP)

A)4
B)1, 2
C)1, 3
D)2, 4

Question 11

The ventilation strategy used with most patients with ARDS includes:
1) large tidal volume.
2) small tidal volume.
3) high respiratory rate.
4) low respiratory rate.

A)2
B)3
C)1, 4
D)2, 3

Question 12

The physician has decided to implement permissive hypercapnia with an ARDS patient receiving mechanical ventilation. What should be the pH goal with the patient?

A) <7.2
B)=7.2
C)7.35-7.45
D)>7.45

Question 13

The anatomic alterations found in the alveoli of a patient with ARDS are closest to those found with what other disease?

A) Bacterial pneumonia
B)Hyaline membrane disease
C)Congestive heart failure
D)Emphysema

Question 14

A chest radiograph finding indicative of ARDS is:

A) "ground-glass" appearance.
B)pleural effusion.
C)lung hyperinflation.
D)tracheal deviation.

Question 15

Inhalation of all of the following can lead to ARDS, EXCEPT:

A) greater than 60% oxygen for a long period.
B)nitrogen dioxide.
C)very dry air.
D)chlorine gas.