Pulmonary Edema

Question 2

What is Acute Pulmonary Edema?

Answer 2

Abnormal accumulation of fluid in the interstitial spaces and alveoli of the lungs.

Life-threatening condition often associated with Acute decompensated heart failure (ADHF).

Question 3

What are common causes of Acute Pulmonary Edema?

Answer 3

1. Left ventricular failure (most common)
2. Acute MI (AMI)
3. Acute CHF exacerbation
4. Renal failure (non-cardiac cause)

Question 4

What is the pathophysiology of Acute Pulmonary Edema?

Answer 4

LV fails → blood backs up into LA → ↑ LA pressure → ↑ pulmonary venous pressure → interstitial and alveolar edema.

Question 5

What is ‘Flash pulmonary edema’?

Answer 5

Sudden onset of pulmonary edema.

Resulting fluid in alveoli blocks gas exchange leading to hypoxemia.

Question 6

What are early signs of Acute Pulmonary Edema?

Answer 6

↓ cerebral oxygen leading to confusion, anxiety, restlessness, progressing to stupor.

Question 7

What are classic symptoms of Acute Pulmonary Edema?

Answer 7

1. Sudden dyspnea
2. Feeling of suffocation
3. Cold, moist, pale skin
4. Weak, rapid pulse
5. Cyanosis/ashen appearance of skin or nails
6. Neck vein distention
7. Cough

Question 8

What are respiratory changes associated with Acute Pulmonary Edema?

Answer 8

Rapid, noisy breathing described as ‘drowning in secretions’ with decreased oxygen saturation.

Question 9

What is a key sign of Acute Pulmonary Edema?

Answer 9

Pink, frothy sputum resulting from alveolar fluid mixing with air.

Question 10

What are the primary components of physical assessment for Acute Pulmonary Edema?

Answer 10

Airway, Breathing, Circulation (ABC), vital signs, cardiac monitoring, and establishing IV access.

Question 11

What diagnostics are used for Acute Pulmonary Edema?

Answer 11

1. Electrolytes
2. BUN/Creatinine (renal function)
3. CBC
4. Chest X-ray (CXR) to differentiate Right vs. Left sided failure.

Question 12

What are early warning signs for prevention of Acute Pulmonary Edema?

Answer 12

Dyspnea, orthopnea, fatigue.

Question 13

What are early interventions for prevention of Acute Pulmonary Edema?

Answer 13

1. Upright positioning
2. Legs in dependent position
3. Avoid overexertion
4. Minimize stress
5. Educate patients on symptoms and when to seek help.

Question 14

What are the primary goals of medical management for Acute Pulmonary Edema?

Answer 14

1. Treat the underlying disorder (e.g., CHF, AMI, renal failure)
2. Reduce fluid volume overload
3. Improve ventricular function
4. Enhance gas exchange.

Question 15

What is the initial oxygen therapy for Acute Pulmonary Edema?

Answer 15

Start with Non-Rebreather Mask (NRB) and progress to Non-invasive Positive Pressure Ventilation (NIPPV) if needed.

Question 16

What diuretics are used in the management of Acute Pulmonary Edema?

Answer 16

Loop diuretics (IV), e.g., furosemide.

Monitor blood pressure, urine output, I&O, daily weights, and electrolytes.

Question 17

What vasodilators are used in the medical management of Acute Pulmonary Edema?

Answer 17

IV nitroglycerin and IV nitroprusside.

Monitor BP closely.

Question 18

What nursing responsibilities are involved in managing Acute Pulmonary Edema?

Answer 18

**1. **Position upright with legs dangling **
2. Provide psychological support
3. Monitor response to medications.

Question 19

What should nurses monitor and document in patients with Acute Pulmonary Edema?

Answer 19

1. Vital signs
2. Neurological status
3. EKG changes
4. I/O
5. Electrolytes.