Nursing Assessment for Respiratory Distress Syndrome (RDS)

Nursing Assessment for Respiratory Distress Syndrome (RDS)

Respiratory distress syndrome (RDS), also called hyaline membrane disease, is the most common respiratory disorder of premature infants and affects, with different degrees of severity, many babies born before 28 weeks gestation. Babies with RDS experience difficulty in breathing due to the immaturity of the lung development and to insufficient production of surfactant.

Surfactant is a lubricating liquid lining the lungs, made of lipids (fats) and proteins that work together to enable the lungs to expand easily. If there is a lack of surfactant the baby will have difficulty breathing and therefore sufficient oxygen may not circulate properly in the body.

The resulting clinical signs and symptoms of RDS are:
  • Blue-coloured skin caused by hypoxia (inadequate oxygen supply to the body tissues)
  • Rapid breathing
  • Difficulty in breathing
  • Grunting noise when breathing out
  • Nasal flaring (nostrils seem to widen)
  • Straining of chest and neck muscles by the effort of breathing
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Nursing Assessment for Respiratory Distress Syndrome (RDS)


Nursing Assessment for Respiratory Distress Syndrome

Maternal History
  • Suffering from diseases such as diabetes mellitus
  • Conditions such as bleeding placenta
  • The type and duration of the process of giving birth
  • Stress fetal or intrapartus

Status of infant at birth
  • Premature, gestational age
  • Apgar score, if there asphyxia
  • Premature babies born by caesarean section

Cardiovascular
  • bradycardia (below 100 x per minute) with severe hypoxemia
  • systolic murmur
  • heart rate within normal limits

Integumentary
  • Pallor caused by peripheral vasoconstriction
  • Pitting edema on the hands and feet
  • Mottling

Neurological
  • Immobilitas, weakness, flaciditas
  • Decrease in body temperature

Pulmonary
  • Tachypnoea (breathing more than 60 x per minute, maybe 80-100 x)
  • Breath grunting
  • Nasal flaring
  • intercostal retraction, suprasternal, or Substernal
  • CNS (central followed sirkumoral) related to the percentage of hemoglobin desaturasi
  • Decreased breath sounds, crakles, episodes of apnea
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