Acute Respiratory Distress Syndrome (ARDS) **Definition:** Acute respiratory failure due to fluid buildup in the lungs, leading to stiff lungs and impaired gas exchange. **Etiology:** Shock, sepsis, trauma, inhalation injury. **Risk Factors:** Severe infections, trauma, aspiration, pancreatitis. **Signs and Symptoms:** Hypoxemia, dyspnea, tachypnea, crackles, wheezing, cyanosis, restlessness. **Physical Examination:** Crackles, diminished breath sounds, accessory muscle use, cyanosis. **Lab Investigations:** ABG (low PaO₂, high PaCO₂), Chest X-ray (bilateral infiltrates), Pulse oximetry (<90%). **Medical Management:** Oxygen therapy, mechanical ventilation, diuretics, steroids, antibiotics. **Surgical Intervention:** Rare; ECMO in severe cases. **Nursing Interventions:** Monitor vitals, ABG, fluid balance, position in high Fowler’s. **Complications:** Respiratory failure, multi-organ failure, death. **Prevention:** Early treatment of infections, avoid lung injury.