A client with acute respiratory distress syndrome (ARDS) shows no improvement despite increases in concentration in oxygen administered. What intervention should the nurse attempt which may improve ventilation-perfusion matching?

A. Prone positioning involves turning the patient onto their abdomen to improve ventilation-perfusion matching by redistributing ventilation to the dorsal lung regions, where perfusion is typically better in ARDS patients.

B. Semi-recumbent positioning may be used to prevent aspiration and reduce the risk of VAP but is not as effective as prone positioning for improving V/Q matching.

C. Albumin infusion is not specific interventions for improving ventilation-perfusion matching in ARDS and should be considered based on other clinical indications.

D. Transfusion of packed red blood cells (PRBC) may be indicated in cases of severe anemia or hypoxemia due to inadequate oxygen-carrying capacity. However, it is not a primary intervention for improving ventilation-perfusion matching in ARDS

C Atrial fibrillation (AF) is characterized by rapid, irregular electrical activity in the atria, leading to an irregularly irregular ventricular response. AF often results in palpitations, fatigue, and dizziness due to the irregular heart rhythm and inefficient cardiac output. A significant pulse deficit may also be present due to the irregularity of the ventricular response compared to the atrial activity. Given the sudden onset of irregular palpitations, fatigue, dizziness, and a significant pulse deficit, atrial fibrillation is a likely dysrhythmia in this scenario.

A First-degree AV block is characterized by a prolonged PR interval on the electrocardiogram (ECG), indicating delayed conduction between the atria and ventricles. While it can indicate conduction system abnormalities, it typically does not result in rapid or irregular palpitations, fatigue, or dizziness.

Therefore, it is less likely to be the cause of the client's symptoms.

B Sinus tachycardia is characterized by a rapid heart rate originating from the sinus node, typically with a regular rhythm. While sinus tachycardia can cause palpitations and fatigue, it is less likely to result in an irregular heart rate with a significant pulse deficit. Therefore, it is less likely to be the cause of the client's symptoms.

D Sinus bradycardia is characterized by a slow heart rate originating from the sinus node. While sinus bradycardia can cause fatigue and dizziness, it typically does not result in a rapid or irregular heart rate. Therefore, it is less likely to be the cause of the client's symptoms.