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Questions and Answers
What is pulmonary edema?
Abnormal accumulation of fluid in the alveoli and interstitial spaces in the lungs.
Which of the following is the most common cause of heart failure leading to pulmonary edema?
Which of the following can be causes of pulmonary edema? (Select all that apply)
What are common clinical manifestations of pulmonary edema?
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What is a significant diagnostic test for pulmonary embolism?
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Pulmonary embolism may lead to poor perfusion and right-sided heart failure.
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What treatment is typically used for pulmonary embolism?
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In the case of pulmonary hypertension, the vital signs may show a loud pulmonic ______ upon auscultation.
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What does an elevated BNP indicate in the context of pulmonary hypertension?
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Study Notes
Pulmonary Edema
- Abnormal fluid accumulation in the alveoli and interstitial spaces of the lungs
- A complication of various heart and lung diseases
- Most commonly caused by left-sided heart failure, secondary to coronary artery disease (CAD)
- Other causes include overhydration, low albumin levels (due to nephrotic syndrome or hepatic disease), respiratory distress syndrome
Clinical Manifestations of Pulmonary Edema
- Increased pulmonary venous pressures
- Increased respiratory rate, decreased oxygen saturation, increased heart rate, and blood pressure
- Anxious, pale, or dusky appearance
- Cold and clammy skin
- Severe dyspnea, use of accessory muscles
- Frothy, blood-tinged sputum
- Crackles, wheezes, or rhonchi
- Jugular venous distention
- Brain Natriuretic Peptide (BNP) greater than 500
- Dysrhythmias
Unilateral Pulmonary Edema
- This can occur in cases of a pulmonary embolism
- Look for a sudden onset of dyspnea and chest pain
Interventions for Pulmonary Edema
-
Critical Care
- BiPAP or mechanical ventilation
- Hemodynamic monitoring
- Morphine, Nitroglycerine, Inotropic support, anticoagulation (for atrial fibrillation)
- Ventricular assist device or intraaortic balloon pump
-
Medical-Surgical
- Diagnostic testing: ABG to assess for hypoxemia, Chest X-ray to reveal pulmonary veins, increased heart size, and opacities
- Management:
- ABCDE approach: Sit the patient up, administer oxygen by face mask, and provide reassurance
- IV Diuretic medications
- IV Opioid pain relievers
- IV Anti-emetics for nausea and vomiting
- Dialysis if needed
- CPAP/IPPV for respiratory support
- Fluid balance management
Pulmonary Embolism
- Causes: Deep vein thrombosis (DVT) in the legs
- Presentation: Dyspnea, sudden onset of chest pain
- Diagnostic testing:
- Ultrasound for blood clots in the legs
- CT scan for blood clots in the Lungs or legs
- Ventilation/Perfusion (VQ) Scan to assesses lung function
- Pulmonary angiography
- Lab Tests: D-dimer
- Treatments:
- Blood thinners (heparin)
- Thrombolytics
- Clot removal
- Inferior Vena Cava (IVC) filter
Pulmonary Hypertensions
- Pathophysiology: Vasoconstriction and increased vascular resistance in pulmonary blood vessels, leading to poor perfusion, hypoxemia, and right-sided heart failure
- Clinical Manifestations:
- Dyspnea, especially at rest
- Chest X-ray: Clear lung fields, enlarged central pulmonary arteries, and enlarged right ventricle
Diagnosis of Pulmonary Hypertension
- Vital signs: Loud pulmonic second heart sound, tachycardia
- Blood tests: BNP, Basic Metabolic Panel (BMP), Complete Metabolic Panel (CMP), Liver Function Tests (LFTs)
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Description
This quiz explores the causes, clinical manifestations, and interventions related to pulmonary edema. It highlights the significance of understanding this condition as a complication of heart and lung diseases. Test your knowledge on its symptoms and management strategies.
