ch 19 pulmonary edema

Question 1

what is cardiogenic pulmonary edema classified as

Answer 1

restrictive lung disease

Question 2

what is cardiogenic pulmonary edema also called

Answer 2

hydrostatic pulmonary edema

Question 3

what is it essentially caused by

Answer 3

left side heart failure or fluid overload

Question 4

what is pulmonary edema

Answer 4

excessive amount of fluid in the lung tissue or alveoli due to an increase in pulmonary capillary pressure resulting from abnormal left heart function

Question 5

what is the etiology of cardiogenic pulmonary edema

Answer 5

left heart failure (ex. coronary artery disease)
aortic stenosis
mitral valve stenosis
systemic hypertension
fluid overload
decrease in osmotic pressure (pressure in blood to keep blood in inter vascular space - protein - albumin level)

Question 6

what does the etiology result in

Answer 6

backup of fluid from the heart into the pulmonary capillaries which becomes engorged

Question 7

what happens when pulmonary capillaries become engorged

Answer 7

fluid leaks into interstitial space and then into the alveoli

Question 8

what is the swan ganz catheter

Answer 8

it measures the back pressure from the pulmonary veins - done from the carotid vein or subclavian vein and into right atrium, tricuspid, right ventricle

Question 9

is it possible to measure the pressure from the left heart

Answer 9

no

Question 10

is it possible to measure from the right heart

Answer 10

yes

Question 11

what carries the swan ganz

Answer 11

the right ventricle into the pulmonary artery

Question 12

where does the swan ganz measure pressure and it should be no more than what

Answer 12

5-8 and only in front of the catheter is where it is measured

Question 13

how do they measure the progress of the treatment of the pulmonary edema

Answer 13

swan ganz catheter

Question 14

how can you treat pulmonary edema

Answer 14

ionotropic - make left side work harder (digoxin)

lasics - get the excess fluid out of the body like a diuretic

Question 15

what is atrial fibrillation

Answer 15

atopic phoxi (spelling lol) 
350-600 / min

Question 16

what is atrial fibrillation caused by

Answer 16

congestive heart of the left ventrical, academia, alkalemia, electrical imbalances

Question 17

vital signs on admission

Answer 17

increased RR 22 
pH 7.56 
co2 28
hco3 20
pao2 51
spo2 70%
respiratory alkalemia - caused by hypoxemia

Question 18

patient inspection

Answer 18

distended neck veins
frequent cough - pink frothy sputum
distended abdomen
pitting edema 
blue lips

Question 19

xray

Answer 19

faint opacities in lower lobes bilaterally

heart was enlarged (left ventrical)

Question 20

treatment

Answer 20

oxygen
intravenous digitalis - dobutamine makes heart beat faster
furosemide - laxis takes liquid out of body to make you pee

Question 21

digitalis

Answer 21

• inotrophic
• increases myocardial force of contraction
• increases stroke volume
• antiarrhythmic used to treat atrail flutter and fibrillation

Question 22

dobutamine

Answer 22

increase myocardial contraction and stroke volume without increasing systemic vascular resistance (doesn’t increase blood pressure)
beta one

Question 23

how does furosemide work

Answer 23

causes diuresis by inhibiting reabsorption of sodium, also causes loss of chlorine, and potassium

Question 24

what abg can furosemide cause

Answer 24

metabolic alkalosis

Question 25

auscultation

Answer 25

inspiratory crackles expiratory wheezes over lower lobes

Question 26

example of shunt in this disease

Answer 26

alveoli filled with fluid

Question 27

venous admixture

Answer 27

good lung mixing with bad lung leaded to lower pao2

Question 28

pulmonary mechanics what happens to lung volumes

Answer 28

all lung volumes get smaller

Question 29

what needs to be resupplied for lung volumes to go back to normal

Answer 29

surfactant

Question 30

forced vital capacity

Answer 30

flow would unaffected but forced vital capacity would be smaller (middle line in picture)

Question 31

lung compliance?

Answer 31

decreased compliance

Question 32

WOB ?

Answer 32

increased work of breath

Question 33

what is the gold standard treatment for cardiogenic pulmonary edema

Answer 33

cpap mask