RDS - please correct me if I'm wrong

[NN2BVE]

Hi there,

I'm a second semester nursing student finishing up a care plan for a preemie. I have to write patophysiology of RDS, but not sure if i understand the process right. Please correct me if I'm wrong. Here it's goes:

The primary cause of RDS is inadequate amount of surfactant produced by the lungs that helps to reduce surface tension in the alveoli, reducing amount of effort infant has to make to get air in. When there is not enough of surfactant, alveoli collapse, atelectasis follows causing hypoximia and hypercarbia --> respiratory and metabolic acidosis,--> pulmonary vasoconstriction, --> endothelial and epithilial cell damage --> pulmonary inflammation and edema.

What i'm not sure is that i interpret the symptoms right:

In the beginning symptoms are tachycardia and tachypnea as a compensatory mechanism to get more oxygen in and carbon dioxide out. At this point things are not that bad still? Is that right? But as respiratory muscles fatigue, the respiratory rate slows down THAT is when things are going down hill leading to hypoximia, hypercarbia and everything else.

I guess the question is would maintaining a tachycardic rate be a reassuring sign that infant is coping. At least for some degree? And would bradycardic rate be more reason for concern?

I'm not sure if I'm making sense here. I'm totaly confused. PLease help! Thanks

[300g]

In the beginning symptoms are tachycardia and tachypnea as a compensatory mechanism to get more oxygen in and carbon dioxide out. At this point things are not that bad still? Is that right? But as respiratory muscles fatigue, the respiratory rate slows down THAT is when things are going down hill leading to hypoximia, hypercarbia and everything else.

I guess the question is would maintaining a tachycardic rate be a reassuring sign that infant is coping. At least for some degree? And would bradycardic rate be more reason for concern?

I'm not sure if I'm making sense here. I'm totaly confused. PLease help! Thanks

Good start, but not exactly... newborns (especially premies) have very little reserve and are not going to sustain tachypnea (or tachycardia r/t RDS) very long. They're probably not RDS (respiratory DISTRESS syndrome) and more likely TTN (Transient Tachypnea of the Newborn) of which the symptoms are initially similar.

You're also not going to see a sustained bradycardic rate (well, you better not!) You'll see a rapid drop in heart rate usually secondary to apnea which is most likely caused by hypercarbia/Respiratory fatigue. Intervention is necessary at this point because, as you know, apnea is not life sustaining.

Tachycardia is generally not a reassuring sign r/t RDS. You may see it initially as a compensatory response, but if it is prolonged, it's more likely a symptom of another problem (hyperthermia, low circulatory volume, etc.)

I'm on my way out the door to work... so this may not be an all inclusive complete answer. There's a lot more to RDS and it's symptoms... I'm sure others will chime in.

Hope this helps!

[littleneoRN]

Oops never mind! I re-read the original post and understood what the OP meant!

[NN2BVE]

Thanks 300g so much, that makes much more sense now.

[Valerie Salva, BSN, RN]

There are few misspellings in the care plan.