RDS A2 (1) ٣

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Nunc viverra imperdiet enim. Fusce est. Vivamus a tellus.

Respiratory Distress Syndrome
Prepared By
G A2
1/Fatma Nasr 2/Fatma Hady
3/Farah Waly Eldeen 4/Farha Atef
5/Fareda Arafa 6/Fouad Aiman
7/Victor Hesham 7/Kamel Ebrahim
Under Supervision of
• Assist.prof.Dr :Bothaina nader sade
• Dr: Sohair morshedy ismael
• Dr :Sahar saleh kamal
• Dr :Nora mahmoud
• Assist.lect :Abdelaziz saied hendy
• Demonstrator : Hoda mohamed ibrahim
• Demonstrator: Hassan Hassanin Ahmed
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Definition

Respiratory distress Syndrome or
RDS: is disease occur when a
baby's lungs are not fully developed
and can't provide enough oxygen,
and causing breathing difficulties. It
.usually affects premature babies
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CONTENTS
Outlimes
1-Defimition
2-Etiology
3-Risk factors
4-Clinical Features
5-Medical Management
6-Nursing Management
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Etiology
-RDS is caused by a lack of surfactant in the
lungs. The lungs of a fetus start making
surfactant during the third trimester, which
starts after the 26th week of pregnancy . May
occurs in preterm delivery, diabetic mother.
-Also caused by meconium aspiration ,

congenital heart defect
Result in :
• Decrease lung compliance
• Unstable alveoli
• Increased work of breathing
• Atelectasis
• Hypoxia, through shunting of blood
• Decreased functional residual capacity
•
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Risk Factors
 The disease is mainly caused by a lack of a slippery substance in the

lungs called surfactant. This substance helps the lungs fill with air and
keeps the air sacs from deflating. Surfactant is present when the lungs
are fully developed.
 Neonatal RDS can also be due to genetic problems with lung

development.

 Most cases of RDS occur in babies born before 37 to 39 weeks. The
more premature the baby is, the higher the chance of RDS after birth.
The problem is uncommon in babies born full-term (after 39 weeks).

Factors that can increase the risk for RDS include:
 A brother or sister who had RDS
 Diabetes in the mother
 Cesarean delivery or induction of labor before the baby is full-term
 Problems with delivery that reduce blood flow to the baby
 Multiple pregnancy (twins or more)
 Rapid labor
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Clinical Features
-There are Five Gold of signs and symptoms of RDS :

 Retraction The chest appears to sink in just below the neck
and/or under the breastbone and/or in between the ribs with each
breath trying to bring more air into the lungs.
 Nasal flaring The openings of the nose spreading open
while breathing.
 Tachypnea Increased heart rate.
 Grunting sound can be heard each time the person
exhales the body's way of trying to keep air in the lungs.
 Cyanosis Bluish color of the skin and mucus
membranes around the mouth, on the inside of the lips,
or on the fingernails.
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Investigations
Clinical Screening
1-Baby’s appearance (Observations) color, and 1-Arterial blood gases (ABGs; hypoxemia
breathing efforts. These can point to a baby's and
need for help with breathing. hypercapnia)
2-Auscultate Breathing sounds / Measure Pulse 2-Chest x-ray shows ground glass appearance
3- Blood Culture , cerebrospinal fluid (CSF), and
tracheal aspirate cultures
4-Echocardiography.
This test is a type of ultrasound that looks at the
structure of the heart and how it is working. The
test is sometimes used to rule out heart problems
that might cause symptoms similar to RDS. It will
also show whether a PDA may be making the
problem worse.
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Medical Management
When an infant is born with RDS and symptoms are immediately apparent,
the infant is usually admitted to a neonatal intensive care unit (NICU).
 Giving oxygen through a mask.
 Surfactant replacement therapy.
 Mechanical Ventilator or nasal continuous positive airway pressure

(NCPAP) .
 Total Parentra Nutrition (TPN)
 Giving fluids through IV line.
 Giving medications (Antibiotics to prevent infections)

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Nursing Management
Risk for Impaired Gas Exchange
Nursing Diagnosis:
related to low lung function and cold
stress
Intervention
•Assessment
•Elevate the head of the bed
•Suction the airway as needed
•Administer oxygen
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Nunc viverra imperdiet enim. Fusce est. Vivamus a tellus. Nursing Management
Ineffective air way clearness related to
immature lungs as manifested by apnea
Nursing diadnosis and cyanosis and rapid and shallow
breathing.
Intervention
1.Assess airway patency.
2.Evaluate chest movement and auscultate for breath sounds.
3.Monitor ET tube placement.
4.Administer oxygen as ordered.
5.Note excessive coughing, increased dyspnea.
6.Suction as needed.
7.Provide chest physiotherapy as indicated, such as percussion.
8.Administer (iv) bronchodilators as indicated.
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Ineffective thermoregulation related to
immature temperature control as
Nursing Diagnosis:- manifested by rapid and shallow
breathing
Intervention the
: general condition of the baby is assessed i.e skin colour. -1
2- vital signs are checked.
3- Frequently take care of the baby.
.4-Administer diuretics, anticoagulants or corticosteroids as prescribed
Nursing Diagnosis:- Ineffective breathing pattern related to pulmonary and

neuromuscular immaturity, decreased energy and fatigue
as manifested by Changes in color of lips , fingers and
toes
Intervention :
vital signs are checked as:
- temperature - pulse 130b/min - respiration 40b/min
- proper position are given i.e side lying position given to the baby.
- observe the patient condition. Respiratory rate should be monitored and observe the baby skin colour.
- suctioning done properly every 2 hrly.
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Complications
1/Acute : 2/Chronic :
 pneumothorax  neurological impairment
 sepsis  chronic lung disease
‫ بصى احنا هنقول‬diagnosis ‫ و بعده هنقول ايه الحاجات اللى هنعملها عشان ن‬manage
 ducts can open ‫ المشكلة دى بمعنى مثال‬ hearing and visual impairment
3/Bleeding into the brain or lungs

4/Blood clots
5/Blood infection
6/Air buildup in the sac around the heart , or around the lung
7/Kidney failure
8/Bronchopulmonary dysplasia
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References
1/Copyright the regents of the university of California published in intensive care nursery house
staff manual
2/https://www.stanfordchildrens.org/en/topic/default?id=respiratory-distress-syndrome-90-
P02371
3/National Institute of Mental Health.
4/MentalHealth Public Inquiries, 5600 Fishers Lane
5/Room 15C-05, Rockville, MD 20857. (888) 8269438.
6/Arch Dis Child, 1976 Jun: 51(6): 454-458.
7/https://www.aafp.org/pubs/afp/issues/2007/1001/p987.html
8/https://www.msdmanuals.com/professional/pediatrics/respiratory-problems-in-neonates/
respiratory-distress-syndrome-in-neonates
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THANK YOU

RDS A2 (1) ٣

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互联网医疗

Nunc viverra imperdiet enim. Fusce est. Vivamus a tellus.

-Also caused by meconium aspiration ,

 The disease is mainly caused by a lack of a slippery substance in the

 Neonatal RDS can also be due to genetic problems with lung

-There are Five Gold of signs and symptoms of RDS :

 Giving oxygen through a mask.

 Surfactant replacement therapy.

 Mechanical Ventilator or nasal continuous positive airway pressure

 Total Parentra Nutrition (TPN)

 Giving fluids through IV line.

 Giving medications (Antibiotics to prevent infections)

•Elevate the head of the bed

•Suction the airway as needed

Nursing Diagnosis:- Ineffective breathing pattern related to pulmonary and

3/Bleeding into the brain or lungs

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