Question

The nurse is assessing a patient with acute respiratory distress syndrome. An expected assessment is?

1) cardiac output of 10 L/min and low systemic vascular resistance.
2) PAOP of 10 mm Hg and PaO₂ of 55.
3) PAOP of 20 mm Hg and cardiac output of 3 L/min.
4) PAOP of 5 mm Hg and high systemic vascular resistance.

Answer 1

An expected finding when assessing a patient with acute respiratory distress syndrome is a PAOP of around 18-20 mm Hg and low PaO₂ (e.g., 55 mm Hg), indicating impaired gas exchange, although PAOP can be variable in ARDS.

Step-by-step explanation:

The nurse is assessing a patient with acute respiratory distress syndrome (ARDS). An expected assessment finding in a patient with ARDS is a pulmonary artery occlusion pressure (PAOP) of approximately 18-20 mm Hg and a partial pressure of arterial oxygen (PaO₂) that is lower than normal, such as 55 mm Hg due to impaired gas exchange. This reflects option 2) PAOP of 10 mm Hg and PaO₂ of 55, keeping in mind that a typical normal PAOP is 8-12 mm Hg. However, in ARDS, increased pulmonary capillary permeability and subsequent fluid accumulation within the alveolar spaces can lead to an increased PAOP. Therefore, the provided options may not perfectly align with expected ARDS values, as PAOP can be variable and PaO₂ is typically reduced. Increased work of breathing and diminished lung compliance are hallmarks, and patients may often have crackles on auscultation, similar to the findings in the provided patient scenario with pneumonia, though ARDS is a more severe pathology and may be secondary to severe pneumonia or other causes.