Test 4 Ch. 20 Pulmonary Edema

Question 1

Pulmonary edema results from movement of

Answer 1

fluid from the pulmonary vascular to the extravascular system and air spaces of the lungs

Question 2

Most of the fluid that accumulates in tb tree is churned into

Answer 2

frothy white (sometimes blood-tinged or pink) sputum as a result of air moving in and out of the lungs

Question 3

Pathologic or structural changes of the lungs associated with pulmonary edema are:

Answer 3

• Interstitial edema, including fluid enforcement of the perivascular and peribronchial spaces and the alveolar wall interstitium
• Alveolar flooding
• Increased surface tension of the alveolar fluids
• Alveolar shrinkage and atelectasis
• Frothy white (or pink) secretions throughout the TB tree

Question 4

The causes of pulmonary edema can be divided into two groups:

Answer 4

• Cardiogenic
• Noncardiogenic

Question 5

Heart disease is the #__ of death in the U.S

Answer 5

1

Question 6

Cardiac pulmonary edema occurs when the

Answer 6

left ventricle is unable to pump out a sufficient amount of the blood during each ventricular contraction

Question 7

What is Starling equation

Answer 7

J=K(Pc- Pi)- (pie[c]-pie[I])

Question 8

Common causes of Cadiogenic (🫀) Pulmonary Edema

Answer 8

• Arrhythmias
• Systemic hypertension
• Congenital heart defect
• Excessive fluid accumulation
• Myocardial Infarction
• Cardiac tamponade
• Renal failure

Question 9

Risks Factors for Coronary Heart Disease (CHD)

Answer 9

• Age
• Males order than 45
• Females older than 55
• Family history of CHD
• Obesity
• Cigarette smoker

Question 10

Noncardiogenic Pulmonary Edema is less

Answer 10

common and develops as a result of damage to the lungs

Question 11

The lung tissues becomes inflamed and swollen and fluid can readily

Answer 11

leak from the pulmonary capillaries into the the alveoli

Question 12

The more common causes of noncardiogenic pulmonary edema are

Answer 12

• Increased capillary permeability
• Lymphatic Insufficiency
• Decreased Intrapleural pressure
• High-Altitude Pulmonary Edema
• Decreased Oncotic Pressure

Question 13

Causes of increased capillary permeability

Answer 13

• Alveolar hypoxia (e.g high altitude)
• ARDS
• Inhalation of toxic agents such as chlorine, sulfur dioxide, nitrogen dioxides, ammonia, and phosgene
• Pulmonary infections
• Therapeutic radiation
• Acute head injury (also known as cephalogenic pulmonary edema)

Question 14

High-altitude pulmonary edema (HAPE) can occur in people who

Answer 14

exercise at altitudes above 8000 feet

Question 15

Cardiogenic is

Answer 15

CHF left side heart failure

Question 16

Other causes of noncardiogenic pulmonary edema

Answer 16

• Allergic reaction to drugs
• Excessive sodium consumption
• Drug overdose
• Aspiration (near drowning)
• Transfusion-related acute lung injury
• Pulmonary embolism

Question 17

Clinical manifestation for Pulmonary edema

Answer 17

• atelectasis
• increased alveolar- capillary membrane
• in severe cases, excessive bronchial secretions

Question 18

Vital signs
Increased RR
Increased HR

Question 19

Cheyenne- Stokes Respirations is associated w/

Answer 19

CHF and pulmonary edema

Question 20

Chest assessment findings

Answer 20

• Increased and vocal fremitus
• Crackles and wheezing

Question 21

Abnormal Lab Test

Answer 21

• Serum potassium: Low
• Serum sodium: Low
• Serum chloride: Low
• Brain natriuretic peptide (BNP): Elevated

Question 22

BNP levels below 100 pg/mL indicate

Answer 22

no heart failure

Question 23

BNP level of 100 to 300 pg/mL suggest

Answer 23

heart failure may be present

Question 24

BNP levels above 300 pg/mL indicates

Answer 24

mild heart failure

Question 25

BNP levels above 600 pg/mL indicates

Answer 25

moderate heart failure

Question 26

BNP levels above 900 pg/mL indicates

Answer 26

severe heart failure

Question 27

Radiologic Findings

Answer 27

• Bilateral fluffy opacities
• Kerly B lines
• Bat wings or butterfly pattern
• cardiomegaly

Question 28

Questions from the back
Which of the following is an after load reducer
a. Procainamide
b. Dopamine
c. Furisemide
d. Nitroprusside

Answer 28

d. Nitroprusside

Question 29

What is the normal hydrostatic pressure in the pulmonary capillaries?
a. 5 to 10 mm Hg
b. 10 to 15 mm Hg
c. 15 to 20 mm Hg
d. 20 to 25 mm Hg

Answer 29

b. 10 to 15 mm Hg

Question 30

Which of the following are causes of cariogenic pulmonary edema
1. Excessive fluid administration
2. Right ventricular failure
3. Mitral valve disease
4. Pulmonary embolus

Answer 30

• Excessive fluid administration
• Mitral valve disease
• Pulmonary embolus

Question 31

As a result of pulmonary edema, the patient’s
1. RV is decreased
2. FRC is increased
3. VC is increased
4. TLC is increased

Answer 31

1. RV is decreased

Question 32

The left ventricular ejection fraction
1. Normally is greater than 75%
2. Is a good measure of alveolar ventilation
3. Correlates well w/ the brain natriuretic peptide values
4. Provides a noninvasive measurement of cardiac contractility

Answer 32

3. Correlates well w/ the brain natriuretic peptide values
4. Provides a noninvasive measurement of cardiac contractility

Question 33

What is the normal oncotic pressure of the blood
a. 10 to 15 mm Hg
b. 15 to 20 mm Hg
c. 20 to 25 mm Hg
d. 25 to 30 mm Hg

Answer 33

d. 25 to 30 mm Hg

Question 34

Normal LVEF

Answer 34

55-70%

Question 35

LVEF less than 40%

Answer 35

May confirm heart failure

Question 36

LVEF less than 35

Answer 36

Severe