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Pulmonary Edema - Coggle Diagram
Pulmonary Edema
Interventions
administer supplemental oxygen per doctors orders
immediately descending to a lower elevation
limiting intense physical activity
taking prescribed medications
keep blood pressure low
manage underlying health conditions
avoiding cause of condition
cessation of smoking
limit sodium intake
managing a healthy diet/weight
getting regular exercise
monitoring I&Os
assessing urine output
elevating affected extremities
place patient in semi-fowlers/high-fowlers position
Pathophysiology
common cause: congestive heart failure
condition that involves an excess fluid in the lungs
fluid collects in alveoli, causes difficult breathing
other causes: pneumonia, exposure to toxins/medications, chest trauma, exercising at high elevations, kidney disease, chronic health conditions
types of pulmonary edema: acute (sudden), chronic, high-altitude pulmonary edema (HAPE)
acute pulmonary edema requires emergency medical care
cardiogenic pulmonary edema: due to heart condition (coronary heart disease, cardiomyopathy, heart valve problems, hypertension)
air prevented from being absorbed into bloodstream
other causes: acute respiratory distress syndrome, pulmonary embolism, high altitudes, near drowming, negative pressure pulmonary edema, nervous system conditions/procedures, smoke inhalation, transfusion-related lung injury, viral infections
risk factors: arrhythmias, alcohol use, congenital heart disease, coronary artery disease, diabetes, heart valve disease, high blood pressure, sleep apnea, blood clots, traveling at high-altitude locations above 8,000 feet
Patient Education
If patient is on fluid restrictions, they may receive education on why and the importance of restricting fluids
limiting sodium intake to decrease edema
taking medication as prescribed
fluid volume excess and causes
rationale of treatment program
the need to use antiembolic stockings
importance of proper nutrition, hydration, diet modification
Medications
diuretics
furosemide (Lasix) to
morphine (MS Contin, Oramorph) for shortness of breath and anxiety
antianginals
nitroglycerin (Nitromist, Nitrostat), nitroprusside (nitropress)
for HAPE: acetazolamide, nifedipine (Adalat CC, Procardia)
Pertinent Assessment Findings
acute pulmonary edema s/s: dyspnea, extreme shortness of breath (worsens with activity or lying down), feeling suffocated that worsens when laying down, coughing with frothy sputum (can be tinged with blood), wheezing, cold/clammy skin, anxiety, restlessness, apprehension, bluish lips, rapid/irregular heartbeat
chronic pulmonary edema s/s: difficulty breathing during activity/laying flat, coughing that wakens the person during the night, feeling breathless, shortness of breath, wheezing, rapid weight gain, swelling in lower extremities, fatigue, new/worsening cough
HAPE s/s: headache, shortness of breath with activity/worsens with rest, decreased ability to exercise, dry cough (initially), cough that produces froth/pink sputum, tachycardia, weakness, chest pain, low-grade fever, symptoms worsen at night
diagnostic tools: chest x-ray, chest CT, pulse oximetry, arterial blood gas test, BNP blood test, other blood tests, ECG, EKG, echocardiogram, cardiac catherization, coronary angiogram, lung ultrasound