Pulmonary Edema

Question 1

Who is at risk?

Answer 1

Any person:

• Getting IV fluids too fast (burn, DKA)
• Very young, very old
• Hx of heart or kid disease

Question 2

Fluid is backing up into the ____. Heart is unable to move it forward

Answer 2

Lungs

Question 3

Pulm. edema usually occurs at ___

Answer 3

Night, when client goes to bed

Question 4

Short or fast onset?

Answer 4

Sudden

Question 5

Breath

Answer 5

Breathless

Productive cough of pink, frothy sputum

Question 6

Appearance

Answer 6

Restless/anxious

Question 7

O2

Answer 7

Severe hypoxia

Question 8

Treatment?

Answer 8

O2! high flow oxygen and keep above 90%

Question 9

Diuretics-Furosemide

Cause diuresis and vasodilation which traps more blood out in the arms and legs and reduces ___

Answer 9

Preload

Question 10

Diuretics-Furosemide

40 mg IV push SLOWLY over 1-2 min to prevent ____

Answer 10

Hypotension and ototoxicity

Question 11

Diuretics-Bumetanide

How to administer?

Answer 11

IV push or continuous IV infusion to provide rapid fluid removal

1-2 mg IV push given over 1-2 min

Question 12

Nitroglycerin

Vasodilation: Decreases ___

Answer 12

Afterload

Question 13

Nitro

Decrease after load = ?

Answer 13

Increased CO bc heart is pumping against less pressure, and more blood can be moved forward

Question 14

Morphine

How to give?

Answer 14

2 mg IV push for vasodilation to decrease PREload and AFTERload

Question 15

Nesiritde

Push or IV infusion?
Short or long term?
Max time?
Does what?

Answer 15

IV infusion
Short term therapy
Don’t give more than 48 hours
Vasodilates veins and arteries; has diuretic effect

Question 16

Remember to turn the ____ off 2 hours before drawing a BNP level

Answer 16

Nesiritide

Question 17

Position?

Why?

Answer 17

Upright position
Legs down

Improves CO; promotes pooling of blood in lower extremities

Question 18

Prevention when possible. How?

Answer 18

Check lung sounds

Avoid fluid volume excess