Congestive Heart Failure and Pulmonary Edema Flashcards

1
Q

What kind of pt hx should you get?

A
  • OPQRST/SAMPLE
  • Medications (Beta blocks, nitroglycerin, Lasix, Digoxin, erectile dysfunction)
  • Hx of MI, CHF, COPD, PE Hx of DM, HTN
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2
Q

What are some signs and symptoms?

A
  • Chest pain
  • SOB
  • Orthopnea
  • JVD
  • Paroxysmal nocturnal dyspnea
  • Accessory muscle use, inability to speak in full sentences
  • Rales/Rhonchi
  • Pink /frothy sputum
  • Peripheral edema, apprehension
  • Hypotension, shock
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3
Q

What are the guidelines for SL1?

A
  • General patient care
  • Airway Management
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4
Q

What are guidelines for SL2?

A
  • Chest pain protocol
  • Cardiac monitoring and 12-lead EKG
  • EtCO2
  • Consider CPAP
  • Consider PEEP Valve
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5
Q

When do you consider CPAP?

A

If SPO2 remains <90% after increasing O2 to 10cmH2O

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6
Q

When do you consider PEEP Valve?

A

When using a BVM

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7
Q

What are the guidelines or Sl3?

A

vascular access

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8
Q

What do you do if a pts EKG shows ST elevation in the inferior leads?

A

Complete a Right Side EKG

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9
Q

What is a contraindication for nitroglycerin?

A

If ST elevation is present in the right-side leads

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10
Q

How is norepinephrine administered?

A

In a large vein with an infusion pump or 60gtt tubing

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11
Q

What kind of equipment do you need for a nitroglycerin drip?

A
  • At least one functioning IV
  • Infusion pump and proper vented (NTG) tubing
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12
Q

What do you need for patient monitoring?

A
  • If pain resolve completely, maintain drip at current rate of administration
  • If pain continues, increase the drip rate by 5mcg/min q 5 until pain resolves or SBP falls below 100mmHg
  • If SBP falls below 110mmHg during titration, temporarily stop the NGT drip
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