Chapter 30: Pulmonary Edema Flashcards
A nurse is educating a patient diagnosed with acute respiratory distress syndrome (ARDS). Which of the following is a primary cause of ARDS that can contribute to pulmonary edema?
A. Increased blood pressure
B. Altered capillary permeability in the lungs
C. Low levels of oxygen in the blood
D. Weak heart muscle function
B. Altered capillary permeability in the lungs
Rationale: ARDS results from altered capillary permeability in the lungs, leading to fluid accumulation in the alveoli and pulmonary edema. This is typically caused by factors such as aspiration, inhaled toxins, pneumonia, or severe hypoxia.
A nurse is caring for a patient with left ventricular failure. Which of the following is the most likely consequence that can lead to pulmonary edema in this patient?
A. Decreased pulmonary capillary pressure
B. Increased oncotic pressure in the lungs
C. Backward flow of blood into the lungs
D. Increased capillary permeability due to toxins
C. Backward flow of blood into the lungs
Rationale: Left ventricular failure can cause blood to back up into the lungs, leading to an increase in hydrostatic pressure in the pulmonary capillaries. This pressure forces fluid into the alveoli, resulting in pulmonary edema.
A nurse is monitoring a patient with nephrotic syndrome. Which of the following conditions increases the risk for pulmonary edema in this patient?
A. Decreased oncotic pressure due to hypoalbuminemia
B. Excessive albumin in the blood
C. High blood pressure from fluid retention
D. Decreased pulmonary capillary pressure
A. Decreased oncotic pressure due to hypoalbuminemia
Rationale: Nephrotic syndrome leads to hypoalbuminemia, which decreases the oncotic pressure that normally holds fluid in the blood vessels. This allows fluid to leak into the tissues, including the lungs, leading to pulmonary edema.
A patient develops pulmonary edema after an allergic reaction. Which of the following mechanisms is most likely responsible for the pulmonary edema in this patient?
A. Increased capillary permeability due to histamine release
B. Increased hydrostatic pressure from the heart’s inability to pump
C. Decreased oxygenation in the blood due to airway obstruction
D. Decreased lymphatic drainage from the lungs
A. Increased capillary permeability due to histamine release
Rationale: Anaphylactic reactions release histamines and other mediators that increase the permeability of blood vessels, allowing fluid to leak into the lungs and causing pulmonary edema.
A patient with pulmonary edema has been overhydrated with IV fluids. What is the most likely cause of the patient’s pulmonary edema in this situation?
A. Increased capillary permeability due to systemic inflammation
B. Excessive volume of IV fluids leading to increased hydrostatic pressure
C. Acute left-sided heart failure from fluid overload
D. Re-expansion of the lung after drainage of a pneumothorax
B. Excessive volume of IV fluids leading to increased hydrostatic pressure
Rationale: Overhydration with IV fluids can increase the volume of fluid in the vascular system, raising hydrostatic pressure in the pulmonary capillaries and resulting in fluid leakage into the alveoli, causing pulmonary edema.
A patient with a history of opioid overdose presents with respiratory distress. What is a potential cause of pulmonary edema in this patient?
A. Opioid-induced neurogenic pulmonary edema
B. Increased capillary permeability due to lung injury
C. Fluid overload from inappropriate IV fluid administration
D. Acute left ventricular failure due to opioid-induced hypotension
A. Opioid-induced neurogenic pulmonary edema
Rationale: Opioid overdose can lead to neurogenic pulmonary edema, a condition in which damage to the central nervous system results in increased pulmonary vascular permeability and fluid accumulation in the lungs.
A patient with pulmonary edema after a near-drowning incident is receiving treatment. Which of the following factors most likely caused the pulmonary edema in this patient?
A. Increased hydrostatic pressure from right-sided heart failure
B. Hypoxemia leading to constriction of the pulmonary vasculature
C. Fluid overload due to intravenous rehydration therapy
D. Aspiration of water leading to increased lung permeability
D. Aspiration of water leading to increased lung permeability
Rationale: Near-drowning incidents can cause aspiration of water into the lungs, which leads to increased capillary permeability, allowing fluid to leak into the alveoli and cause pulmonary edema.
A nurse is assessing a patient who has developed pulmonary edema at high altitude. What is the most likely mechanism responsible for this condition in the patient?
A. Decreased oxygen levels leading to pulmonary vasoconstriction and fluid accumulation
B. Increased blood pressure from overexertion at high altitude
C. Decreased ventilation resulting in hypoxemia and fluid retention
D. Fluid overload due to excessive intravenous hydration at high altitude
A. Decreased oxygen levels leading to pulmonary vasoconstriction and fluid accumulation
Rationale: At high altitudes, decreased oxygen levels can lead to pulmonary vasoconstriction, which increases capillary pressure and can result in pulmonary edema. This is a known risk in high-altitude environments.
A nurse is educating a patient about potential causes of pulmonary edema. Which of the following conditions should the nurse emphasize as a common cause due to altered capillary permeability?
A. Liver cirrhosis
B. Left-sided heart failure
C. Pneumonia
D. Chronic kidney disease
C. Pneumonia
Rationale: Pneumonia is a common cause of pulmonary edema due to increased capillary permeability resulting from inflammation in the lungs. This leads to fluid leakage into the alveoli, causing pulmonary edema.
A nurse is assessing a patient with pulmonary edema caused by left-sided heart failure. Which of the following clinical manifestations is most commonly associated with this condition?
A. Decreased respiratory rate and shallow breathing
B. Frothy, blood-tinged sputum
C. Bradycardia and hypotension
D. Decreased jugular vein distention
B. Frothy, blood-tinged sputum
Rationale: Frothy, blood-tinged sputum is a hallmark sign of pulmonary edema, especially in patients with left-sided heart failure, due to fluid leakage into the alveoli.
A nurse is caring for a patient in severe pulmonary edema. Which position should the nurse place the patient in to reduce the severity of symptoms?
A. Supine position
B. Semi or high Fowler’s position
C. Trendelenburg position
D. Prone position
B. Semi or high Fowler’s position
Rationale: Placing the patient in semi or high Fowler’s position helps improve lung expansion, reduce venous return, and ease breathing in patients with pulmonary edema.
A nurse is administering diuretics to a patient with pulmonary edema. Which of the following is the primary purpose of this intervention?
A. To reduce preload by removing excess fluid
B. To increase fluid retention
C. To increase cardiac output
D. To reduce afterload by dilating blood vessels
A. To reduce preload by removing excess fluid
Rationale: Diuretics, such as furosemide, reduce preload by promoting fluid excretion, which decreases the volume of blood returning to the heart and reduces pulmonary congestion.
A patient with pulmonary edema is receiving IV morphine. What is the primary reason for administering this medication?
A. To increase cardiac output
B. To promote diuresis
C. To reduce the risk of infection
D. To reduce afterload and alleviate dyspnea
D. To reduce afterload and alleviate dyspnea
Rationale: Morphine is used to reduce afterload and alleviate dyspnea in patients with pulmonary edema by causing vasodilation, which lowers systemic vascular resistance and decreases the work of the heart.
A nurse is caring for a patient with pulmonary edema. Which of the following interventions would be most appropriate to improve oxygenation and ventilation in this patient?
A. Administer oxygen and place the patient in a high Fowler’s position
B. Place the patient flat and administer bronchodilators
C. Administer a sedative to reduce anxiety
D. Restrict fluids and elevate the legs
A. Administer oxygen and place the patient in a high Fowler’s position
Rationale: Administering oxygen and placing the patient in high Fowler’s position helps improve oxygenation, lung expansion, and ease of breathing in pulmonary edema.
A patient with pulmonary edema is being treated with IV Dobutamine. What is the primary goal of administering this medication?
A. To reduce preload
B. To improve oxygenation
C. To enhance cardiac output
D. To dilate the airways
C. To enhance cardiac output
Rationale: Dobutamine is a positive inotropic agent used to enhance cardiac output by increasing the contractility of the heart in patients with pulmonary edema and heart failure.
