NCLEX RN Practice Question # 881

NCLEX Examination.

Practice Question # 881.


NCLEX Examination.


Acute Respiratory Distress Syndrome


  • A form of acute respiratory failure that occurs as a complication caused by a diffuse lung injury or critical illness and leads to extravascular lung fluid.
  • The major site of injury is the alveolar capillary membrane.
  • The interstitial edema causes compression and obliteration of the terminal airways and leads to reduced lung volume and compliance.
  • The ABG levels identify respiratory acidosis and hypoxemia that do not respond to an increased percentage of oxygen.
  • The chest x-ray shows bilateral interstitial and alveolar infiltrates; interstitial edema may not be noted until there is a 30% increase in fluid content.
  • Causes include sepsis, fluid overload, shock, trauma, neurological injuries, burns, DIC, drug ingestion, aspiration, and inhalation of toxic substances.

Nursing Assessment

  • Tachypnea
  • Dyspnea
  • Decreased breath sounds
  • Deteriorating ABG levels
  • Hypoxemia despite high concentrations of delivered oxygen
  • Decreased pulmonary compliance
  • Pulmonary infiltrates

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