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Fibrotic Phase (Nursing)

by Rhonda Lawes

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      Slides Nursing ARDS Acute Respiratory Distress Syndrome.pdf
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    00:01 For those that it doesn't stop and things keep progressing, now they enter the third phase.

    00:06 Not everybody goes through the third phase, but some people do.

    00:10 So, when we say it's not a universal outcome, that means it not everybody has to go through the fibrotic phase who has ARDS.

    00:18 Good thing, but those that do, it is bad news.

    00:23 Because it's an increased mortality, you know, that means deaf, and may also have prolonged.

    00:30 Prolonged, prolonged mechanical ventilation.

    00:37 Okay, so someone whose lungs become fibrotic, they're stiff, they're not compliant, their gunked up.

    00:43 They have an increased risk of dying and we know they're going to be on that mechanical ventilator for a long time because their lungs just can't do it on their own.

    00:53 They've got this significant interstitial and intra alveolar fibrosis.

    00:59 Now I want you to think back to those pictures, remember where the interstitial space is.

    01:05 Think about that alveolar wall.

    01:07 Yeah.

    01:07 So everything in there is stiff, that's what fibrosis means stiff, thick, dense.

    01:15 It's not compliant.

    01:17 It doesn't move well and you know, we're not going to have good gas exchange.

    01:21 We're not going to have tissue that can expand and contract.

    01:23 We've got major lifetime alteration here.

    01:28 So, they can also have some collagen deposits as if all this wasn't enough.

    01:31 They can also have collagen deposits in the alveoli.

    01:35 They can avascular and interstitial areas with microcysts.

    01:38 This is crazy change to the lungs.

    01:42 So we're glad not everyone goes through this but if they do, they are going to have lifetime risks and complications if they survive this phase.

    01:53 Keeping in mind, lung damage is progressive.

    01:56 I love I had someone help me with this because I really wanted to see these two things together.

    02:02 So you've got fraction of maximum right there, right? So we're talking one equals the maximum of what we usually see.

    02:10 Now look along the bottom, those are the number of days Now, we broke it up into phases.

    02:15 The exudative phase, the proliferative phase and the fibrotic phase.

    02:19 Remember not everybody goes through that, thank goodness.

    02:22 So, please just write that in the slide because we all need hope.

    02:25 Write down, not everyone goes through this.

    02:28 Increased mortality if they do enter this phase.

    02:32 But look at the edema, when is it peak? Yeah, early on we're talking about all that fluid and edema that and that interstitial space.

    02:39 Now, let's look at the next phase, we're talking about the hyaline membranes.

    02:43 You see where they peak.

    02:45 Yeah, still in that exudative phase but they peak, and then they kind of drop off because you're gonna have a lot of them built.

    02:53 Now, look at the proliferative phase, look at the interstitial inflammation.

    03:00 That's a later sign, good you're getting it, I love how you're reading this graph with me.

    03:05 Last look at interstitial fibrosis, kind of evens out till that proliferative phase.

    03:10 That's where both the interstitial fibrosis in the interstitial inflammation hit their peak is in the proliferative phase.

    03:19 So should you be able to recreate this for the exam? No, I just want you to see hey, here's a great snapshot.

    03:27 I'm expect my patient to be edematous more in the beginning.

    03:29 They were going to have the hyaline membrane is developing.

    03:32 Meanwhile that interstitial inflammation and interstitial fibrosis is starting to happen in that extra day to face, but it's going to hit its peak in the proliferative phase.


    About the Lecture

    The lecture Fibrotic Phase (Nursing) by Rhonda Lawes is from the course Acute Respiratory Distress Syndrome (ARDS) (Nursing) (quiz coming soon).


    Author of lecture Fibrotic Phase (Nursing)

     Rhonda Lawes

    Rhonda Lawes


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