With acute respiratory distress syndrome (ARDS), a client progressively increases his work of breathing. The physiological principle behind this respiratory distress is related to:
A) Increases in left atrial pressure causing thickening of the lining of the pulmonary arteries
B) The elevation of pulmonary venous pressure
C) Structural abnormalities of pulmonary vessels with proliferation of the vessel intima
D) The stiffening of the lung, making it more difficult to inflate
Ans: D
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As the disease (ARDS) progresses, the work of breathing becomes greatly increased as the lung stiffens and becomes more difficult to inflate. There is increased intrapulmonary shunting of blood, impaired gas exchange, and hypoxemia despite high supplemental oxygen therapy. With pulmonary hypertension, there are continued increases in left atrial pressure, which can lead to medial hypertrophy and intimal thickening of the small pulmonary arteries, causing sustained hypertension. Pulmonary hypertension also causes an elevation of pulmonary venous pressure.
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