The nurse is caring for a patient with ARDS. Which of the following would indicate that the disease is progressing?
1. increased lung compliance
2. respiratory alkalosis
3. hypoxemia refractory to oxygen therapy
4. respiratory acidosis
3
Rationale: In progressive ARDS there is a pattern of increasing hypoxemia that is refractory to increasing concentrations of oxygen because of collapsed alveoli, decreased lung compliance, and significant shunting. In the early onset of ARDS, respiratory alkalosis, and not acidosis, predominates as a result of compensatory mechanisms. Pulmonary function tests indicate decreased lung compliance and functional residual capacity because of the restrictive component of the disease.
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