Which of the following patients have the greatest risk of developing acute respiratory distress syndrome (ARDS) after traumatic injury?
a. A patient who has a closed head injury with a decreased level of consciousness
b. A patient who has a fractured femur and is currently in traction
c. A patient who has received large volumes of fluid and/or blood replacement
d. A patient who has underlying chronic obstructive pulmonary disease
C
During states of hypoperfusion and acidosis, inflammation occurs and vessels become more permeable to fluid and molecules. With aggressive fluid resuscitation, this change in permeability allows the movement of fluid from the intravascular space into the interstitial spaces (third spacing). As more IV fluids are given to support systemic circulation, fluids continue to migrate into the interstitial space, causing excessive edema and predisposing the patient to additional complications such as abdominal compartment syndrome, ARDS, acute kidney injury, and MODS. A patient with a closed head injury, a patient with a fractured femur stabilized by traction, and a patient with chronic obstructive pulmonary disease may develop ARDS, but it would be related to fluid resuscitation and excessive inflammation associated with traumatic injury.
You might also like to view...
The nursing process uses which of the following approaches to problem solving?
A) Trial-and-error B) Reflexive thinking C) Intuition D) Scientific method
A nurse manager is collecting staff views about a current unit problem to make a decision about actions to take. Which style of decision-making is this manager employ?
1. Unilateral 2. Individual 3. Authoritarian 4. Consensus
A hospital organization is working to improve a feeling of being valued and respected among all staff members. Which action by administration would reinforce the feeling of being valued?
a. Create professional pathways that require advanced education for any advancement of staff. b. Seek staff input when planning a remodeling project of patient rooms. c. Form committees that consist of upper management to plan organizational goals. d. Consistently schedule required staff meetings at the same time each month.
An additional bag of fluid used to give medications when the patient is receiving an intravenous infusion is called a
A) primary solution. B) piggyback. C) peripheral solution. D) None of the above