ARDS nursing lecture (acute respiratory distress syndrome) with free quiz to help nursing students prep for NCLEX. This lecture will cover ARDS pathophysiology, treatment, symptoms, nursing diagnosis, and more.

What is acute respiratory distress syndrome (ARDS)? It’s a type of respiratory failure that occurs when the capillary membrane that surrounds the alveoli sac becomes damaged, which causes fluid to leak into the alveoli sac.

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ARDS has a fast onset and tends to occurs in people who are already sick (hospitalized) and usually develops as a complication to a systemic inflammation process occurring in the body.

What can cause the capillary membrane to become more permeable and leak fluid?

This is usually triggered by an event that leads to major systemic inflammation, which can be indirectly damage the capillary membrane or directly damage the capillary membrane.

Indirect (source isn’t the lungs): capillary membrane is INDIRECTLY damaged due to a systemic inflammatory response system (SIRS) by the immune system:

*Sepsis (most common and very poor prognosis for patients who have gram-negative bacteria)
Burns
Blood transfusion (multiple)
Inflammation of the pancreas
Drug overdose

Direct (source is the lungs)….capillary membrane is DIRECTLY damaged

Pneumonia
Aspiration
Inhaling a toxic substance
Significant drowning event
Embolism

This pathophysiology of ARDS is discussed in-depth in this video and features the 3 phases of ARDS (Exudate, Proliferative, Fibrotic Phases)

Signs and Symptoms of ARDS (acute respiratory distress syndrome):
Tachypnea, refractory hypoxemia (hallmark sign and symptoms), cyanosis, mental status changes, abnormal lungs sounds like crackles in the late stages, tachycardia, respiratory alkalosis that can progress to respiratory acidosis, etc.

Nursing interventions for ARDS include: maintaining respiratory function with mechanical ventilation with PEEP (monitoring for complications of this therapy), pulmonary artery wedge pressure reading (helps to determine if this is pulmonary edema due to ARDS or a cardiac issue), prone positioning, administering medications (inotropics, fluids, corticosteroids, antibiotics, GI drugs to prevent stress ulcers etc.

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