Acute Cardiogenic Pulmonary Edema

Question 1

Acute Cardiogenic Pulmonary Edema
Indications

Answer 1

Moderate to severe respiratory distress
AND
Suspected acute cardiogenic pulmonary edema

Question 2

Nitroglycerin
Conditions
Age?
HR?
SBP?

Answer 2

Age: ≥ 18 years
HR: 60 - 159
SBP: Normotension

Question 3

Nitroglycerin
Contraindications

Answer 3

1. Allergy or sensativity to nitrates
2. Phosphodiesterase inhibitor use within previous 48 hours
3. SBP drops 1/3 of initial value

Question 4

Nitroglycern
Route - SL
SBP ≥ 100 to < 140
IV or Hx
Dose?
Max. Single Dose?
Dosing Interval?
Max # of Doses?

Answer 4

Dose: 0.4mg
Max. Single Dose: 0.4mg
Dosing Interval: 5min
Max # of Doses: 6

Question 5

Nitroglycern
Route - SL
SBP ≥ 140
IV or Hx
Dose?
Max. Single Dose?
Dosing Interval?
Max # of Doses?

Answer 5

Dose: 0.8mg
Max. Single Dose: 0.8mg
Dosing Interval: 5min
Max # of Doses: 6

Question 6

Nitroglycern
Route - SL
SBP ≥ 140
NO - IV or Hx
Dose?
Max. Single Dose?
Dosing Interval?
Max # of Doses?

Answer 6

Dose: 0.4mg
Max. Single Dose: 0.4mg
Dosing Interval: 5min
Max # of Doses: 6

Question 7

When can you fluid bolus a patient with pulmonary edema?

Answer 7

when administration of nitroglycerin results in hypotension with pts who have pulmonary edema a fluid bolus is permitted

once pt is normotensive discontinue fluid bolus