23 - Adult - CHF/Pulmonary Edema

Question 1

T/F: All 3 doses (max) of NTG MUST be administered prior to a trial of CPAP?

Answer 1

False! If they require CPAP, perform the procedure.

Question 2

Oxygen in the CHF/Pulmonary Edema patient must be titrated to greater than ____.

A. 93%
B. 94%
C. 95%
D. 96%

Answer 2

B. 94%

Question 3

S/S of CHF/pulmonary edema.

Answer 3

• dyspnea
• wheezing
• orthopnea (difficulty in breathing with laying flat)
  
  • these patients may describe using pillows upon which to sleep or sleeping in a recliner
• palpitations
• tachycardia/tachypnea
• wet lung sounds
• pedal edema

Question 4

What cardiac intervention (in addition to cardiac monitoring) must be performed in the CHF/PE patient?

Answer 4

12-lead ECG. This will determine if the pt’s CHF/PE is due to ischemia/STEMI.

Question 5

T/F: CPAP may be applied if the patient is obtunded.

Answer 5

False!

Question 6

CPAP may be performed if the patient has a systolic blood pressure greater than ____ without medical control contact.

Answer 6

100 mmHg

Question 7

Medical control must be contact for CPAP use in the patient with what systolic blood pressure?

Answer 7

Between 90-100 mmHg.

Hypotensive patients receiving CPAP may develop further hypoTN as the intrathoracic pressure remains high.

Question 8

In the adult PE/CHF patient, EtCO2 must be used and should have a reading between _____.

Answer 8

35-45 mmHg

Question 9

NTG should be withheld if a patient with CHF/PE has what conditions/medication use?

Answer 9

• ED drug in previous 24 hours

- Inferior STEMI (contact MedCom for these patients)

Question 10

ALS may utilize what NTG in addition to the 0.4 mg SL NTG?

Answer 10

1” Nitro paste on anterior chest wall