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RESPIRATORY DISTRESS
SYNDROME
INTRODUCTION TO RESPIRATORY
SYSTEM
contd…………
2
Mr sanjay. M. Peerapur, Principal, KLES Institute of Nursing Sciences, Hubli
INTRODUCTION TO RESPIRATORY
SYSTEM
contd…………
Mr sanjay. M. Peerapur, Principal, KLES Institute of Nursing Sciences, Hubli 3
Definition:
• Hyaline membrane disease (HM) is a disease
manifesting within 6 hrs of birth being related to
deficiency of ...
4. Contributing factors are any factors that
decreases surfactant: such as
• Premature and immature alveolar lining cells
...
Pathophysiology Prematurity
( Immature lung with underdeveloped and un inflated alveoli  
Decreased surfactant
 
Increased...
      As the diseases progress
– Peripheral edema increases
– Muscle tone decreases
– Cyanosis increases
 -- Body tempera...
 Expiratory grunting
 Sternal , suprasternal , substernal and
intercostals retraction progressing to paradoxical
seesaw ...
Investigation
      Antenatal period
     Examination of the amniotic fluid
Lecithin sphingomyelin ratio ;
-         > ...
      Chest X- ray
      “ Ground glass appearance” or “ White
wash lung”
      Blood gas analysis
Low po2 < 50mmhg...
5. Antibiotic as needed to treat infection .
6. Constant observation of complication – Pneumothroax ,
DIC , PDA
7. Prevent...
• Treatment initiated after infant is stabilized in the
delivery room or within 30 minutes of life .
• Benefits of surfact...
Nursing Diagnosis
1.Impaired gas exchange related to diseases
process
2.Imbalanced nutritional less than body
requirement ...
Nursing Intervention
• Promote adequate gas exchange
  Administer supplemental oxygen .
  Measure oxygen concentration...
Promote adequate Nutrition and Hydration :
Administer IV fluids or enteral feeding as ordered
   Observe IV sites for i...
Encouraging parental attachment :
♦ Identify factors that may prohibit the parents visitation
and communication .
♦ Call t...
Respiratory distress syndrome
Respiratory distress syndrome
Respiratory distress syndrome
Respiratory distress syndrome
Respiratory distress syndrome
Respiratory distress syndrome
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Respiratory distress syndrome

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Respiratory distress syndrome

  1. 1. RESPIRATORY DISTRESS SYNDROME
  2. 2. INTRODUCTION TO RESPIRATORY SYSTEM contd………… 2 Mr sanjay. M. Peerapur, Principal, KLES Institute of Nursing Sciences, Hubli
  3. 3. INTRODUCTION TO RESPIRATORY SYSTEM contd………… Mr sanjay. M. Peerapur, Principal, KLES Institute of Nursing Sciences, Hubli 3
  4. 4. Definition: • Hyaline membrane disease (HM) is a disease manifesting within 6 hrs of birth being related to deficiency of surfactant in the alveoli, leading to acute respiratory distress with fatal termination if not treated promptly. Etiology: 1.Deficiency of surfactant in the pulmonary alveoli. 2.Small alveoli which are difficult to inflate and tend to collapse with expiration. 3.Weak and excessively complaint chest wall.
  5. 5. 4. Contributing factors are any factors that decreases surfactant: such as • Premature and immature alveolar lining cells • Acidosis • Hypothermia • Asphyxiated newborn • Infant with diabetic mother
  6. 6. Pathophysiology Prematurity ( Immature lung with underdeveloped and un inflated alveoli   Decreased surfactant   Increased alveoli surface tension   Atelectasis Hypoxaemia Co2 retension Acidosis   Pulmonary vasoconstriction and hypo profusion   Capillary damage Plasma leak   Firinogen Fibrin ( Hyalin membrane )
  7. 7.       As the diseases progress – Peripheral edema increases – Muscle tone decreases – Cyanosis increases  -- Body temperature drops  -- Bradycardia may occur  -- Diminished breath sounds  Secondary signs and symptoms ∀ •        Hypotension ∀ •        Edema of the hands and feet ∀ •        Absent bowel sounds ∀ •        Decreased urine out put
  8. 8.  Expiratory grunting  Sternal , suprasternal , substernal and intercostals retraction progressing to paradoxical seesaw respirations  Inspiratory nasal flaring  Tacypnea  Cyanosis  Decreased breath sounds and dry “ Sandpaper” breath sounds  Pulmonary edema
  9. 9. Investigation       Antenatal period      Examination of the amniotic fluid Lecithin sphingomyelin ratio ; -         > 2 full maturation -         1.5 – 1.99 borderline maturation -         < - associated with sever RDS       Laboratory tests : -  Paco2 elevated -  Partial pressure of arterial oxygen – low -  Blood PH – low due to metabolic acidosis -  Calcium – low -  Serum glucose – low
  10. 10.       Chest X- ray       “ Ground glass appearance” or “ White wash lung”       Blood gas analysis Low po2 < 50mmhg, Paco2 > 50 mmHg and acidosis indicates respiratory failure Management : Supportive 1. Maintain of oxygenation – Pao2 at 60 to 80 mmHg , t prevent hypoxia 2. Maintenance of normal body temperature . 3. Maintenance of fluid , electrolytes and acid base balance – Metabolic acidosis buffered with sodium bicarbonate 4. Maintenance of nutrition – Iv dextrose 10 % in water usually required
  11. 11. 5. Antibiotic as needed to treat infection . 6. Constant observation of complication – Pneumothroax , DIC , PDA 7. Prevent hypotension 8. Maintain a hematocrit of 40% to 45% . 9. Maintenance of respiration with ventilation support , if necessary Aggressive : 7. Administration of exogenous surfactant in to lungs early in the diseases 8. Especially beneficial in the very low birth weight infant 9. May be given preventively to VLBW infant at birth 10. Surfactant replacement therapy 11. Prophylactic surfactant therapy ; infants at increased risk of RDS , infant of less than 30 weeks gestational age , infants with a birth weight of less than 1,250g   
  12. 12. • Treatment initiated after infant is stabilized in the delivery room or within 30 minutes of life . • Benefits of surfactant ; increased oxygen requirement • Antibiotics – To prevent infection ; Ampicillin 200mg/ kg IV 12 hrly with Gentamicin 5mg/kg IV 12 hrly . Complication • Intra ventricular hemorrhage. • Bronchopulmonary. • Pulmonary hemorrhage • Pneumothroax • Retrolental fibroplasias • Neurological abnormalities
  13. 13. Nursing Diagnosis 1.Impaired gas exchange related to diseases process 2.Imbalanced nutritional less than body requirement related to prematurity and increased energy expenditure on breathing 3.Ineffective thermoregulation related to immaturity . 4.Impaired parenting related to separation from the neonate due to hospitalization .
  14. 14. Nursing Intervention • Promote adequate gas exchange   Administer supplemental oxygen .   Measure oxygen concentration every hour and recorded   Monitor ABG levels as appropriate . Observe the infants response to oxygen therapy .   Position the infant to allow for maximal lung expansion.   Suction as needed   Observe for complication
  15. 15. Promote adequate Nutrition and Hydration : Administer IV fluids or enteral feeding as ordered    Observe IV sites for infiltration or infection  Provide adequate caloric intake and output chart   Administer medication as per order .
  16. 16. Encouraging parental attachment : ♦ Identify factors that may prohibit the parents visitation and communication . ♦ Call the parents daily them an the infants condition . ♦ Demonstrate for the parents how they can touch and speak to the child ♦ Provide the parents with information concerning the disease process.

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