ch 19 pulmonary edema Flashcards
(33 cards)
what is cardiogenic pulmonary edema classified as
restrictive lung disease
what is cardiogenic pulmonary edema also called
hydrostatic pulmonary edema
what is it essentially caused by
left side heart failure or fluid overload
what is pulmonary edema
excessive amount of fluid in the lung tissue or alveoli due to an increase in pulmonary capillary pressure resulting from abnormal left heart function
what is the etiology of cardiogenic pulmonary edema
left heart failure (ex. coronary artery disease)
aortic stenosis
mitral valve stenosis
systemic hypertension
fluid overload
decrease in osmotic pressure (pressure in blood to keep blood in inter vascular space - protein - albumin level)
what does the etiology result in
backup of fluid from the heart into the pulmonary capillaries which becomes engorged
what happens when pulmonary capillaries become engorged
fluid leaks into interstitial space and then into the alveoli
what is the swan ganz catheter
it measures the back pressure from the pulmonary veins - done from the carotid vein or subclavian vein and into right atrium, tricuspid, right ventricle
is it possible to measure the pressure from the left heart
no
is it possible to measure from the right heart
yes
what carries the swan ganz
the right ventricle into the pulmonary artery
where does the swan ganz measure pressure and it should be no more than what
5-8 and only in front of the catheter is where it is measured
how do they measure the progress of the treatment of the pulmonary edema
swan ganz catheter
how can you treat pulmonary edema
ionotropic - make left side work harder (digoxin)
lasics - get the excess fluid out of the body like a diuretic
what is atrial fibrillation
atopic phoxi (spelling lol) 350-600 / min
what is atrial fibrillation caused by
congestive heart of the left ventrical, academia, alkalemia, electrical imbalances
vital signs on admission
increased RR 22 pH 7.56 co2 28 hco3 20 pao2 51 spo2 70% respiratory alkalemia - caused by hypoxemia
patient inspection
distended neck veins frequent cough - pink frothy sputum distended abdomen pitting edema blue lips
xray
faint opacities in lower lobes bilaterally
heart was enlarged (left ventrical)
treatment
oxygen
intravenous digitalis - dobutamine makes heart beat faster
furosemide - laxis takes liquid out of body to make you pee
digitalis
- inotrophic
- increases myocardial force of contraction
- increases stroke volume
- antiarrhythmic used to treat atrail flutter and fibrillation
dobutamine
increase myocardial contraction and stroke volume without increasing systemic vascular resistance (doesn’t increase blood pressure)
beta one
how does furosemide work
causes diuresis by inhibiting reabsorption of sodium, also causes loss of chlorine, and potassium
what abg can furosemide cause
metabolic alkalosis
