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She was hospitalised for 4 weeks and needed the tracheostomy tube to be in place for 9-weeks following discharge. In general it is found that collaborations between the intensive care nurse and the intensive care specialist is vital for evaluating and managing the patient and to ensure that the outcomes are fruitful. In general, the mortalities for ARDS are high (40 to 50%), mainly due to the ineffective traditional methods of managing such patients that have been utilised in the past. However, with use of several evidence-based protocols, the outcomes can be improved. Some of the measures that were provided to Rita included include mechanical ventilation, tracheostomy, prone positioning (HOB elevation), antibiotic administration (as she had sepsis), ECMO (due to sudden drop in the partial pressure of oxygen), sedation protocols, supportive therapy, RBC packed cell and platelet transfusion and a conservative fluid strategy. Rita developed renal complications and aspiration pneumonia, which were effectively managed. A careful nursing plan requires to be chalked out to cater to the individual needs of the patient. Ideal treatment would ensure speedy recovery and early resumption of normal activities by the patient. Case Study of a Patient Suffering from ARDS and requiring Mechanical Ventilation and Nursing Care Introduction This case study is of a 38-year old female, by name Rita, who was suffering from acute distress respiratory syndrome (ARDS), due to sepsis and requiring mechanical ventilation and a nursing care plan. ARDS is a condition in which the lungs are unable to perform their usual function of absorbing oxygen (Ensure Care Plan 2011). ARDS usually may follow critical illnesses, serious injuries or developed after major surgeries. The condition is a form of pulmonary oedema not from a proper cardiac cause, which occurs due to a drop in pressure in the pulmonary arteries (ARDS Training 2010). In ARDS, there is leakage of fluids and proteins into the air sacs and the interstitial lung tissues leading to pulmonary oedema (caused from damage to the alveoli-capillary mechanism) (Austin CC 2012). There may be several mediators involved in the damage of the alveoli-capillary mechanism including microorganisms, toxins, allergens, neutrophils, TNF, etc. After injury, the symptoms can develop within en 24 to 72 hours, and the respiratory functions tend to deteriorate leading to decreased lung volumes and compliance (Ensure Nursing Plan 2011). Due to the damage to the pneumocytes type 2, the lungs collapse and there is a decrease in the volume of the lungs. Fibrocytes convert the intra-alveolar fluid to a fibrous tissue and leads to poor ventilation (causing hypoxemia). When ARDS progresses, the patient can develop respiratory failure and can lead to arrest of the cardiopulmonary functions (Ensure Nursing Plan 2011). Usually ARDS develops from an underlying cause or a lung disorder and may vary depending upon the geographical location, age group, etc. Some of the causes of ARDS include direct injuries (may be trauma, chemical, oxygen toxicity, damage from free radicals, thermal or burns, drug overdose, or sepsis), drowning (or near drowning) or hemorrhagic shock (ARDS Training 2010). The incidence of ARDS is about 140,000 to 150,000 cases each year, and about 40 to 50% of the affected cases develop mortalities (Ensure Care Plans 2011). This is a case
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(A Patient Requiring Mechanical Ventilation Essay)
It can either be non-invasive positive pressure ventilation, abbreviated NPPV, which refers to ventilation with positive airway pressure and without tracheal tube; or negative pressure ventilation, referring to ventilation in which negative pressure is applied to the thorax (Jones, 2009).
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