RESPIRATORY
DISTRESS
John Tyler Community College
School Of Nursing

RESPIRATORY DISTRESS
SYNDROME
(RDS or Hyaline membrane disease-HMD) causes babies to need extra oxygen and help breathing ETIOLOGY
Lack of surfactant of immature lung
• aids in elasticity of lungs
• stabilizes air passages and gas exchange
• helps lung remain partially aerated after each exhalation

Immature lungs of infant cannot retain air

GENETIC RDS
This manifestation of
Respiratory Distress
Syndrome is less common, and it can occur in full term infants!!! INCIDENCE
• High incidence with premature babies • Incidence increases with age of prematurity • Typically worsens 48-72 hours after delivery
• Improves with treatment

INCIDENCE
The Good
News!!!

Greater than
90% survival rate RISK FACTORS

 Gestational Age/Preterm infants • Previous preterm
• Periodontal disease
• Diabetes
• Low maternal body mass
• No or poor prenatal care
• Poverty
• Uninsured
• Minorities

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Low Birth weight
Multiple Birth
Cesarean Section Delivery
Cold Stress
Asphyxia
Precipitous Delivery
Previously Affected Delivery
Male

SIGNS & SYMPTOMS

 Tachypnea - respirations >
60
 Retractions
• Xiphoid (substernal) retractions • Intercostal retractions
• Supraclavicular retractions

 Flaring of the nares

 Cyanosis
• Central cyanosis involves the lips, tongue, mucous membranes and trunk which indicates true hypoxia
 Grunting
• Increases the pressure within the alveoli, which keeps the alveoli open and enhances the exchange of gases in the lungs
 Seesaw respirations
 Asymmetry

N U R S I N G C O N S I D E R AT I O N S

 Few disturbances
 Gentle handling
 Use a radiant warmer or incubator to keep infants warm and reduce risk of infection  Ongoing monitor of B/P, heart rate, breathing and temperature
 Use sensors on fingers and toes to check the amount of oxygen in infant’s blood  Giving fluids and nutrients
 Checking fluid intake to make sure it doesn’t build up in the baby’s lungs

QUESTIONS

Ready?

Which infant has the greatest risk for
Respiratory Distress Syndrome?
A.Full-term male infant delivered vagionally B.36-week male infant delivered by Csection
C. 39-week female infant delivered by Csection

Answer B.
A pre-mature male infant delivered by C-section has the greatest risk for
Respiratory Distress Syndrome.

Ms. Jones is a 19 year old woman who delivered her baby boy two days ago via C-section at 29 weeks gestation. The nurse comes in and tells her that her baby was transferred to the NICU because he was diagnosed with Respiratory Distress Syndrome or
RDS. When Ms. Jones asks the nurse to explain what that means, the best response is
A. Your baby needs extra attention because he was not breathing well.
B. RDS is a condition that hurts the baby’s lungs.
C. RDS is a medical condition where the baby has an insufficient amount of a lipoprotein called surfactant which inhibits the lungs from completely collapsing after exhaling.
D. RDS makes the baby breath harder because he lacks an important substance called surfactant which helps the lungs stay opened after he exhales.

Answer D:
This is the definition of RDS. Answers
A and B do not fully explain the meaning. They describe possible symptoms. C has too much medical jargon which may further confuse the young mother. D explains RDS very simply but complete.

The nurse is giving Ms. Jones more information on RDS. Ms. Jones asks the nurse, “Why did this happen to