ARDS Case Study: Nursing Interventions

ARDS Overview

• Acute Respiratory Distress Syndrome (ARDS) is a severe lung condition characterized by rapid onset of respiratory failure.
• Key indicators include significant dyspnea, hypoxia, and cyanosis.

Patient Profile

• Name: Mr. Garcia
• Age: 55 years
• Gender: Male
• Occupation: Construction Worker
• Chief complaint includes sudden difficulty breathing, chest tightness, fever, and fatigue.

Health Assessment

• General appearance indicates obvious respiratory distress, requiring accessory muscles for breathing.
• Vital signs:
  • Temperature: 39°C (102.2°F)
  • Heart rate: 125 bpm (tachycardia)
  • Respiratory rate: 32 breaths/min (tachypnea)
  • Blood pressure: 88/60 mmHg (hypotension)
  • Oxygen saturation: 78% on room air.

Respiratory Examination

• Bilateral crackles noted upon auscultation.
• Diminished breath sounds at lung bases, indicating possible fluid in lungs.
• No wheezing detected.

Cardiovascular and Neurological Findings

• Cardiovascular: Tachycardia present, no murmurs.
• Neurological: Patient lethargic but responds to verbal stimuli.

Medical History

• History of hypertension and Type 2 Diabetes Mellitus for 10 years.
• 20-year smoking history (1 pack/day).
• No known drug allergies.

Laboratory Findings

• Elevated WBC count (14,000/mm³) suggesting infection or inflammation.
• Abnormal ABG results:
  • pH: 7.30 (acidosis)
  • PaO2: 55 mmHg (hypoxemia)
  • PaCO2: 48 mmHg (hypercapnia)

Other Lab Results

• Hemoglobin: 12.5 g/dL (slightly low)
• Hematocrit: 37% (slightly low)
• Platelet count: 130,000/mm³ (below normal).
• Elevated liver enzymes (AST: 65 U/L, ALT: 70 U/L).
• Creatinine: 1.4 mg/dL (elevated, kidney function concern).
• Blood Urea Nitrogen: 32 mg/dL (high, indicating possible dehydration or renal impairment).
• C-reactive Protein: 150 mg/L, indicative of inflammatory process.

Risk Factors and Context

• Recent close contact with a coworker diagnosed with pneumonia may have contributed to illness.
• Rapid deterioration of symptoms requires immediate and ongoing nursing interventions.

Nursing Care Plan Focus

• Monitor vital signs closely, with particular attention to oxygen saturation and respiratory status.
• Administer supplemental oxygen and consider mechanical ventilation if necessary.
• Assess for signs of fluid overload and manage accordingly.
• Implement infection control measures given the elevated WBC and risk of ARDS progression.

This case study focuses on Acute Respiratory Distress Syndrome (ARDS), defining the condition and examining the patient profile of Mr. Garcia. It covers the signs, symptoms, lab results, and the disease's pathophysiology while providing a comprehensive nursing care plan. Ideal for nursing students and professionals looking to enhance their understanding of ARDS care.