Question

A client with acute respiratory distress syndrome (ARDS) is on a ventilator. The client's peak inspiratory pressures and spontaneous respiratory rate are increasing, and the PO2 is not improving. Using the SBAR (Situation-Background-Assessment-Recommendation) technique for communication, the nurse calls the health care provider (HCP) with the recommendation for:

A. Initiating IV sedation.
B. Starting a high-protein diet.
C. Providing pain medication.
D. Increasing the ventilator rate.

Answer 1

The most appropriate recommendation for a client with ARDS on a ventilator showing worsening respiratory parameters is to increase the ventilator rate to improve oxygen delivery and carbon dioxide removal.

Step-by-step explanation:

A client with acute respiratory distress syndrome (ARDS) who is on a ventilator and showing increasing peak inspiratory pressures, an increasing spontaneous respiratory rate, and non-improving PO2 likely indicates declining lung function and a need for augmentation of ventilatory support. In this SBAR report, the correct recommendation to the health care provider would be D. Increasing the ventilator rate. Increasing the rate can help ensure adequate oxygen delivery and carbon dioxide removal, whereas the other options might not directly address the primary issue of ventilation and gas exchange.

Initiating IV sedation might be important if the patient's agitation or non-compliance with the ventilator is contributing to the issue, but it is not indicated solely based on the information given regarding respiratory mechanics and gas exchange. A high-protein diet or providing pain medication might be important for overall patient care, but neither would be the immediate response to the changes observed in the patient's ventilatory status.