Term
| Acute pulmonary edema patho |
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Definition
acute event-acute left sided heart failure
life threatening medical emergency
LV can't handle BV overload, inc pressure in pulmonary vasculature, fluid moves out of capilaries and into interstitial space of lungs and aveloi, prescence of fluid impedes gas exhange (esp movement of O2 into capillaries) |
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Term
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Definition
cardiac-AMI, valve disease, htn, chronic CHF exacerbation
lung trauma-PE, smoke inhalation, shock lung
CNS trauma-stroke, head trauma
infection-sepsis
drug overdose-opiates can lead to res failure and progressive PE |
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Term
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Definition
nAcute MI-already had
nFVO-fluid vol overload
nHTN
nValvular Disease
nChronic Heart Failure (Left- sided )
nAcute Respiratory Failure
nTrauma
nSepsis
nDrug Overdose
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Term
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Definition
PaO2 and SaO2 sig dec
ABG shows hypoxia and res failure
chest xray-shows fluid in lung spaces (interstitial edema) and enlarged heart
ECHO-valve disease demonstrated
blood cultures-done to r/o IE
cardiac markers show BNP likely elevated from stretching of ventricles and inc troponin |
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Term
| clinical manifestations APE |
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Definition
S and S due to hypoxia
restlessness
confusion progressing to stupor
use of accessory muscles
air hunger
cough-crackles, pink/white frothy sputum
tachycardia-weak rapid pulse, s3 sound
cool clammy skin-cyanosis-late stage
distended juglar veins (inc JVP)
extreme anxiety and panic |
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Term
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Definition
nImprove Oxygenation
nApply O2
nReduce Pulmonary Congestion
nDecrease fluid volume
nDiuretics, Vasodilators
nImprove Cardiac Contractility
nGlycosidesàincrease contractility
nBeta-blockersà decrease heart rate
nDecrease Anxiety-end goal since psychosocial
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Term
| medication management of PE |
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Definition
nMorphine: (Duramorph)
nReduce pre-loadà reduces resistance against which the heart must pump
nPromotes venous pooling in periphery
nReduces anxiety
nVasodilators: (Niprid, Tridil)
nReduces amt of blood returning to heart
nDecreases resistance against which heart must pump
nContractility Enhancement: (Digoxin, Dobutamine, Dopamine)
nImproves cardiac pumping ability/ Increases cardiac contractility
nCaution: Dig toxicity: S&S: anorexia, n/v, bradycardia
nDiuretics: (Lasix, Bumex, Zaroxolyn)
nReduces volume & pulmonary congestion
nCaution: monitor K+ level: supplements prn
nBreathing Agents: (Aminophylline, Bronchodilators)
nTreats bronchospasms
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Term
| APE nursing interventions |
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Definition
nPositioning:
nHigh Fowlers: legs dangling as tolerated
nOxygen Therapy
nAssessment
nBaseline VS, I&O, daily weights (gaining fluid)
nCardiac & Respiratory assessment
nMonitor Urinary Output/renal function
nAdminster medications
nEvaluation of Patient Response-what’s working, whats not?
nReport Evaluation Outcomes & Revise Plan-share with team members
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Term
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Definition
nImpaired gas Exchange**
nFluid Volume Excess**
nDecreased cardiac Output
nActivity Intolerance/Fatigue-tired and can’t do what they normally do
nAnxiety
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Term
| APE elderly considerations |
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Definition
nIncreased risk for Pulmonary Edema occurs related to:
n Decreased CO
n Chronic Heart Failure (CHF)
nIncreased risk for F&E imbalances due to diuretics
nIV fluids MUST be administered at SLOWER RATES to prevent circulatory overload
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