Question

A client with acute respiratory distress syndrome (ARDS) has fine crackles at lung bases, and the respirations are shallow at a rate of 28 breaths/min. The client is restless and anxious. In addition to monitoring the arterial blood gas results, what should the nurse do? Select all that apply.

A. Monitor serum creatinine and blood urea nitrogen levels.
B. Administer a sedative.
C. Keep the head of the bed flat.
D. Administer humidified oxygen.
E. Auscultate the lungs.

Answer 1

The nurse should monitor serum creatinine and blood urea nitrogen levels, administer humidified oxygen, and auscultate the lungs in a patient with ARDS. It's important not to keep the head of the bed flat and to be cautious with sedatives.

Step-by-step explanation:

A client with acute respiratory distress syndrome (ARDS) is experiencing several symptoms including fine crackles at lung bases, shallow respirations at a rate of 28 breaths/min, restlessness, and anxiety. In managing this patient, the nurse should pursue multiple interventions. In addition to monitoring arterial blood gas results, which provide essential information on the patient's respiratory status and gas exchange, the nurse should:

• Monitor serum creatinine and blood urea nitrogen levels to assess kidney function, as renal issues can complicate or result from severe ARDS.
• Administer humidified oxygen to improve oxygenation and help alleviate hypoxemia, the low level of oxygen found in the blood.
• Auscultate the lungs regularly to monitor for changes in the lung sounds, which can indicate improvement or worsening of the ARDS.

It is not advisable to keep the head of the bed flat since elevating the head of the bed can help improve lung expansion and reduce aspiration risk. The administration of a sedative should be considered carefully, as it could decrease the respiratory drive, and should only be done under careful monitoring or if the patient is mechanically ventilated.