A nurse is caring for a patient suspected of having acute respiratory distress syndrome (ARDS). Which of the following assessment data would support the suspected diagnosis?

Confusion
Crackles
Decreased breath sounds
Hypoxemia despite high Fi02
Tachypnea

Explanation

•ARDS is a condition of diffuse alveolar injury that prevents diffusion of oxygen into the blood stream.

•The lower the patient's arterial oxygen level with high FiO2 levels, the worse the patient's condition. This is because pulmonary edema and decreased surfactant production increase the thickness of the alveolar capillary space, increasing the distance oxygen must travel to reach the blood. This results in hypoxemia and acidosis.

•Crackles on auscultation can occur secondary to pulmonary edema. 

•Confusion can occur after the onset of hypercapnia. 

•Tachypnea is often a symptom of ARDS, along with increased work of breathing and nasal flaring or use of accessory muscles. Decreased breath sounds may also be noted, depending on the degree of pulmonary edema. 

•ARDS is an acute syndrome with a rapid onset.

•You would not expect a slow onset with ARDS.

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