What are the most common early manifestations of acute respiratory distress syndrome that a nurse will assess in a patient?

Bradycardia and increased work of breathing.

Cyanosis and apprehension.

Dyspnea and tachypnea.

Respiratory distress and frothy sputum.

Answer and Explanation

The Correct Answer is C

A. Bradycardia and increased work of breathing: Bradycardia is not typically an early sign of ARDS; it may develop later due to hypoxia or cardiac compromise. Increased work of breathing can occur, but bradycardia is not a reliable early manifestation.

B. Cyanosis and apprehension: Cyanosis and anxiety may appear as ARDS progresses and hypoxemia worsens, but these are usually later signs after respiratory compromise has advanced. Early recognition relies on subtler, more common findings.

C. Dyspnea and tachypnea: Dyspnea (shortness of breath) and tachypnea (rapid breathing) are the most common early manifestations of ARDS. They reflect impaired gas exchange from alveolar-capillary membrane injury and pulmonary edema. Early recognition of these signs allows prompt intervention to prevent progression to severe hypoxemia.

D. Respiratory distress and frothy sputum: Frothy sputum is more characteristic of cardiogenic pulmonary edema rather than ARDS. While respiratory distress is present, frothy sputum is not a typical early finding in ARDS, which initially presents with subtle hypoxemia and increased respiratory effort.

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Correct Answer is C

Explanation

A. Obtain 24-hour dietary intake: While monitoring dietary intake is important for long-term management of diabetes insipidus, it does not address the acute and potentially life-threatening fluid and electrolyte imbalance caused by excessive water loss. This is not the immediate priority.

B. Administer corticosteroids: Corticosteroids may be used in cases of secondary DI due to adrenal insufficiency, but they are not first-line therapy for the majority of DI patients. Immediate management focuses on correcting dehydration and hypernatremia rather than starting steroids.

C. Administer IV fluids: Patients with DI excrete large volumes of dilute urine, leading to dehydration and hypernatremia. Rapid IV fluid replacement is critical to restore circulating volume, correct electrolyte imbalances, and prevent hypovolemic shock. This intervention addresses the most urgent physiologic threat.

D. Obtain blood cultures: Blood cultures are indicated if infection is suspected but are not part of the immediate management of DI. Delaying fluid resuscitation to obtain cultures could worsen dehydration and hemodynamic instability.

A. Teach about the importance of nutrition after treatment B. Offer dry crackers and carbonated fluids during the treatments C. Administer prescribed antiemetic 1 hour before the treatments D. Have the patient eat large meals when nausea is not present

Correct Answer is C

Explanation

A. Teach about the importance of nutrition after treatment: While nutrition education is important for long-term recovery and maintaining strength, it does not prevent or control acute chemotherapy-induced nausea and vomiting during or immediately after treatment. This intervention alone is insufficient to manage the patient’s severe symptoms.

B. Offer dry crackers and carbonated fluids during the treatments: Small, bland snacks may provide some comfort, but offering them during chemotherapy is unlikely to prevent severe vomiting and diarrhea. The patient’s ability to tolerate oral intake is limited during active emesis, so this is supportive rather than preventive care.

C. Administer prescribed antiemetic 1 hour before the treatments: Prophylactic administration of antiemetics is the most effective strategy for controlling chemotherapy-induced nausea and vomiting. Giving the medication before treatment allows peak drug levels to coincide with chemotherapy exposure, reducing the severity and frequency of emesis and improving patient comfort.

D. Have the patient eat large meals when nausea is not present: Large meals can be difficult to tolerate and may exacerbate nausea or vomiting. Smaller, frequent meals are generally recommended for patients with chemotherapy-induced gastrointestinal upset, making this approach less effective than timely antiemetic therapy.

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What are the most common early manifestations of acute respiratory distress syndrome that a nurse will assess in a patient?

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