A client develops ARDS. The nurse assesses signs of pulmonary edema and atelectasis. The findings correspond to which phase of ARDS?

• A. Fibrotic
• B. Exudative
• C. Reparative
• D. Proliferative

Answer: (B)

The situation reflects the exudative stage of ARDS. In this early phase, injury to the alveolar–capillary barrier makes vessels leaky, so protein-rich fluid floods the alveoli. That edema impairs surfactant function and causes alveolar collapse, or atelectasis. The combination of pulmonary edema and collapsed airspaces produces the diffuse breathing problems and hypoxemia seen early in ARDS.

As ARDS progresses, the proliferative phase brings fibroblast activity and attempted repair, with thickening of the interstitium, rather than the edema-based alveolar flooding seen initially. The fibrotic phase later features scarring and fibrous tissue replacing normal lung architecture.