Podcast
Questions and Answers
A patient diagnosed with CHF presents with severe dyspnea. Which of the following positions is MOST appropriate to alleviate their respiratory distress?
A patient diagnosed with CHF presents with severe dyspnea. Which of the following positions is MOST appropriate to alleviate their respiratory distress?
- Fowler's (correct)
- Trendelenburg
- Supine
- Prone
Which of the following hemodynamic values is MOST consistent with a patient experiencing acute pulmonary edema secondary to CHF?
Which of the following hemodynamic values is MOST consistent with a patient experiencing acute pulmonary edema secondary to CHF?
- Increased PCWP, increased PAP (correct)
- Decreased PCWP, decreased PAP
- Decreased PCWP, increased PAP
- Increased PCWP, decreased PAP
A patient with pulmonary edema has pink, frothy secretions. This finding is MOST directly related to:
A patient with pulmonary edema has pink, frothy secretions. This finding is MOST directly related to:
- Atelectasis and alveolar collapse.
- Increased mucus production due to infection.
- Fluid transudation across the alveolar-capillary membrane. (correct)
- Bronchospasm and airway narrowing.
What is the PRIMARY goal of administering diuretics, such as furosemide (Lasix®), in the treatment of CHF and pulmonary edema?
What is the PRIMARY goal of administering diuretics, such as furosemide (Lasix®), in the treatment of CHF and pulmonary edema?
Which of the following arterial blood gas (ABG) results is MOST likely observed in a patient with early-stage pulmonary edema?
Which of the following arterial blood gas (ABG) results is MOST likely observed in a patient with early-stage pulmonary edema?
During the assessment of a patient with suspected pulmonary edema, you auscultate their chest. Which of the following breath sounds is MOST indicative of this condition?
During the assessment of a patient with suspected pulmonary edema, you auscultate their chest. Which of the following breath sounds is MOST indicative of this condition?
Which of the following chest X-ray findings is LEAST likely to be associated with CHF and pulmonary edema?
Which of the following chest X-ray findings is LEAST likely to be associated with CHF and pulmonary edema?
A patient with CHF develops bradycardia. Which of the following medications is MOST appropriate to administer?
A patient with CHF develops bradycardia. Which of the following medications is MOST appropriate to administer?
Flashcards
Congestive Heart Failure (CHF)
Congestive Heart Failure (CHF)
Impaired cardiac pumping leading to fluid overload.
Pulmonary Edema
Pulmonary Edema
Fluid accumulation in the lungs' interstitial and alveolar spaces.
Tachypnea
Tachypnea
Rapid breathing often seen with CHF/pulmonary edema patients.
Orthopnea
Orthopnea
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Paroxysmal Nocturnal Dyspnea (PND)
Paroxysmal Nocturnal Dyspnea (PND)
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Crackles
Crackles
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Diuretics
Diuretics
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Brain Natriuretic Peptide (BNP)
Brain Natriuretic Peptide (BNP)
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Study Notes
- Cardiac/Pulmonary Vascular Disease is related to Congestive Heart Failure/Pulmonary Edema
Definitions
- Congestive Heart Failure (CHF) is an abnormal condition reflecting impaired cardiac pumping
- CHF is caused by myocardial infarction, ischemic heart disease, or cardiomyopathy
- Pulmonary Edema occurs when excessive fluid moves from the pulmonary vascular system to the extravascular system (interstitial space) and air spaces of the lungs (alveoli)
- CHF is the most common cause of Pulmonary Edema
Patient Assessment
- General Appearance includes Peripheral/pedal edema, diaphoresis, and cyanosis
- Respiratory Pattern includes Tachypnea, orthopnea, and paroxysmal nocturnal dyspnea (PND)
- Breath Sounds include Crackles and wheezing
- Cough presents as Pink frothy secretions
- Diagnostic Chest Percussion presents as a flat or dull percussion note
- Other Chest Assessment Findings include Increased tactile and vocal fremitus
Diagnostic Testing
- Chest X-ray reveals bilateral fluffy opacities, dilated pulmonary arteries, left ventricular hypertrophy (cardiomegaly), butterfly or bat wing pattern, and Kerley A & B lines
- Arterial Blood Gas presents Respiratory alkalosis with hypoxemia
- Pulmonary Function shows Reduced volumes and capacities, but a normal FEV1/FVC ratio
- Hemodynamics increase PCWP, PAP
- Cardiac enzymes: Elevated brain natriuretic peptide (BNP)
Treatment/Management
- Administer High flow oxygen therapy via non-rebreather mask, HFNC
- Closely monitor vital signs and place patient in Fowler's position
- Administer Hyperinflation therapy (IPPB, IPV)
- Administer Diuretics to promote fluid excretion, such as furosemide [Lasix®]
- Administer Positive inotropic agents like digitalis, digoxin, dobutamine, dopamine
- Administer the Analgesic morphine
- Administer Preload reduction agents like nitroglycerin, nitroprusside, or morphine
- CPAP is indicated to support oxygenation
- Mechanical ventilation with PEEP is indicated for ventilatory failure
- Antidysrhythmic agents treat Bradycardia with atropine
- Antidysrhythmic agents treat Tachycardia with procainamide, metoprolol
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Description
Overview of cardiac/pulmonary vascular diseases, focusing on congestive heart failure (CHF) and pulmonary edema. Covers definitions, patient assessment techniques, diagnostic testing, and chest X-ray findings. CHF is the most common cause of Pulmonary Edema
