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1. Question
The nurse is assessing a client with multiple trauma who is at risk for developing acute respiratory distress syndrome. The nurse should assess for which earliest sign of acute respiratory distress
Correct
Answer: Option 4 is the correct answer.
Rationale: The earliest detectable sign of acute respiratory distress syndrome is an increased respiratory rate, which can begin from 1 to 96 hours after the initial insult to the body. This is followed by increasing dyspnea, air hunger, retraction of accessory muscles, and cyanosis. Breath sounds may be clear or consist of fine inspiratory crackles or diffuse coarse crackles. Test-Taking Strategy: Note the strategic word, earliest. Eliminate option 3 first because intercostal retraction is a later sign of respiratory distress. Of the remaining options, recall that adventitious breath sounds (options 1 and 2) would occur later than an increased respiratory rate.
Incorrect
Answer: Option 4 is the correct answer.
Rationale: The earliest detectable sign of acute respiratory distress syndrome is an increased respiratory rate, which can begin from 1 to 96 hours after the initial insult to the body. This is followed by increasing dyspnea, air hunger, retraction of accessory muscles, and cyanosis. Breath sounds may be clear or consist of fine inspiratory crackles or diffuse coarse crackles. Test-Taking Strategy: Note the strategic word, earliest. Eliminate option 3 first because intercostal retraction is a later sign of respiratory distress. Of the remaining options, recall that adventitious breath sounds (options 1 and 2) would occur later than an increased respiratory rate.
Acute respiratory distress syndrome
A form of pulmonary edema that leads to ARF, acute respiratory distress syndrome (ARDS) results from increased permeability of the alveolocapillary membrane. Although severe ARDS may be fatal, recovering patients may have little or no permanent lung damage.
What causes it?
ARDS may result from:
• Aspiration of gastric contents
• Sepsis (primarily gram-negative)
• Trauma (such as lung contusion, head injury, and long-bone
fracture with fat emboli)
• Oxygen toxicity
• Viral, bacterial, or fungal pneumonia
• Microemboli (fat or air emboli or disseminated
intravascular coagulation)
• Drug overdose (such as barbiturates and opioids)
• Blood transfusion
• Smoke or chemical inhalation (such as nitrous oxide, chlorine,
ammonia, and organophosphate)
