Exhibits

Which of the following is the most appropriate treatment strategy for this patient, who is likely experiencing allergic rhinitis?

A. Impaired carbon dioxide elimination due to shunting: Shunting in ARDS affects oxygenation rather than carbon dioxide elimination. ARDS primarily results in impaired gas exchange due to inflammation and fluid accumulation in the alveoli, affecting oxygen rather than CO2.

B. Decreased pulmonary arterial pressure due to ventilation-perfusion (V/Q) mismatch: ARDS typically leads to increased pulmonary arterial pressure due to inflammation and decreased lung compliance. The V/Q mismatch contributes to impaired gas exchange, often resulting in elevated pulmonary arterial pressure rather than decreased.

C. Hypoxemia due to dead space: In ARDS, hypoxemia is primarily due to impaired gas exchange from damaged alveoli, not due to dead space. Dead space refers to areas where ventilation occurs without adequate blood flow, which is not the main issue in ARDS.

D. Decreased pulmonary compliance due to stiffness: ARDS is characterized by decreased pulmonary compliance due to the stiffness of the lung tissue caused by inflammation and edema. This decreased compliance makes lung expansion more difficult, which is a central feature of ARDS.

A. Hyperventilate the client with 100% oxygen before suctioning the airway: Hyperventilation before suctioning is a method to prevent hypoxia, not to thin secretions. It does not affect the viscosity of secretions.

B. Provide humidified oxygen: Humidified oxygen helps to moisten the airways, which can thin secretions, making them easier to clear. This is an appropriate intervention for managing tenacious secretions in a client with a tracheostomy.

C. Perform chest physiotherapy prior to suctioning: Chest physiotherapy helps mobilize secretions but does not thin them. While useful in clearing airways, it is not a direct method for thinning secretions.

D. Prelubricate the suction catheter tip with sterile saline when suctioning the airway: Prelubricating the suction catheter is done to reduce friction and trauma during suctioning but does not impact the thickness of the secretions.