Respiratory Distress Syndrome often found in premature infants. The incidence is inversely related to gestational age and weight. This means that the younger the gestational age of the mother, the higher the incidence of Respiratory Distress Syndrome in the baby. In contrast, the older the gestational age, the lower the incidence of RDS. Percentage of events according to gestational age is 60-80% occurs in infants born with a gestational age less than 28 weeks, 15-30% of infants between 32-36 weeks and are rarely found in term infants (mature). Besides the increase in frequency was also found in infants born to women who suffer from uterine perfusion during pregnancy, for example, maternal diabetes, hypertension, hypotension, section and antepartum haemorrhage.
At first the baby will show rapid and shallow breaths in an effort to meet the oxygen demand is high, so that the blood gas analysis initially occurs because carbon dioxide respiratory alkalosis wasted. However, the baby will soon be exhausted because of difficulties developing alveoli and could not sustain his effort and respirasinya. If this is the case, then business slowed breathing and blood gases showed respiratory acidosis and respiratory failure commencement.
Caused by direct injury to the lung capillaries or alveoli. However, because the capillaries and alveoli are closely related to the extensive destruction of one item to another usually causes the destruction that occurs as a result of spending by the lytic enzymes the cells were dead, as well as the inflammatory reaction that occurs after injury and cell death. examples of conditions which affect the alveolar capillaries and are presented below:
Capillary destruction
There will be a movement of plasma and red blood cell spatial interstitium. This increases the distance that must be traveled to diffuse oxygen and carbon dioxide, thus declining to how fast gas exchange. The fluid that accumulates in the interstitial fluid moves into the alveoli, dilute surfactant and increase surface tension. This then leads to a decrease in ventilation and hypoxia. Causes of pulmonary capillary damage include septicemia, pancreatitis and uremia. Pneumonia, smoke inhalation, trauma and drowning can also damage capillaries.
Alveolar destruction
Causes damage to the alveolar include pneumonia, aspiration and inhalation of smoke. Oxygen toxicity arising after 24-36 hours of high oxygen therapy, can also cause damage to the alveolar membrane through the formation of oxygen free radicals.
Clinical Manifestations
- Severe dyspnoea.
- Decreased Lung Compliance.
- And rapid shallow breathing at first that causes respiratory alkalosis due to (CO2) carbon dioxide lot of flying.
- Increased respiratory rate.
- Short breath and exhale when the sound of snoring.
- Blackish skin due to hypoxia.
- Retraction antargia breathing or chest every time.
- Nasal flaring.
- Many babies survived IRDs, where the symptoms subside and disappear usually within 3 days.
- Tachypnea (more than 60x/mnt)
Nursing Diagnosis for Respiratory Distress Syndrome
1. Impaired gas exchange related to decreased volumes and lung compliance, pulmonary perfusion and alveolar ventilation.
2. Risk for Fluid Volume Deficit related to loss of fluids due to risk of aspiration and choking.
3. Imbalanced Nutrition: Less Than Body Requirements related to the inability to suck, decreased intestinal motility.
4. Ineffective family coping related to anxiety, guilt, and parting with the baby as a result of a crisis situation.
