The nurse in intensive care is caring for a patient who is developing ARDS secondary to infection. When the patient develops hypoxemia, which intervention does the nurse anticipate?
A) Intubation with mechanical ventilation
B) Oxygen delivery via nasal cannula
C) Oxygen delivery via Venturi mask
D) Administration of surfactant
A) Intubation with mechanical ventilation
Explanation: A) Individuals with ARDS almost invariably require intubation and mechanical ventilation during their illness to manage the hypoxemia. Mechanical ventilation supports oxygenation by decreasing the work of breathing, providing increased levels of FIO2, recruiting atelectatic lung regions, and decreasing the venous return to the heart.
B) A nasal cannula cannot deliver the FIO2 that the patient with ARDS needs and will not reduce the work of breathing.
C) A Venturi mask delivers a specific oxygen concentration to patients on controlled oxygen therapy with adjustable levels of FIO2.
D) Surfactant administration will not improve hypoxemia. The combination of surfactant therapy and mechanical ventilation with continuous positive airway pressure (CPAP) to prevent alveoli from collapsing has been a mainstay of treatment of IRDS.
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