Pulmonary Edema
Pulmonary edema is an abnormal build up of fluid in the lungs, which leads to swelling. Usually caused by heart failure, also caused by damaged lungs or kidney failure.
Symptoms - Shortness of breath esp. when lying down, difficulty breathing, wheezing, cough, excessive sweating, coughing up blood
History
Recent change in sleep patterns
More frequent trips to the bathroom
Need to sleep on more pillows at night
Recent move to the recliner at nights
New episodes of Paroxysmal Nocturnal Dyspnea
Sudden awakening with acute shortness of breath
Relieved after standing or sitting upright
for a period of time
History
Is more nitroglycerin needed to stop the
episodes of chest pain?
Have nitroglycerin or oxygen doses increased incrementally in the last few
days?
General impression/initial assessment
Lung sounds
Wheezing, crackles
Middle-to-upper lung fields
Diaphoresis, change in skin color
Severe anxiety or restlessness
Tachycardia or bradycardia
Severe hypertension may be present
Treatment
OMI
Oxygen, Monitor, IV
MONA - Morphine, Oxygen, Nitro, ASA (Not in that order)
Positive Pressure Ventilations if necessary Bipap or ET
Vasodilatory Therapy (Nitrates)
AMI reperfusion
Container expansion reduces preload
Morphine
Reduce Fluid Retention
Diuretics
Lasix
Bumex
Pneumonia -
4.5 million cases annually in US
Winter months/Colder climates
More men than women
20% require hospitalization
S/S
Productive cough
Sputum may be
Green
Rust-colored
Current jelly
Foul smelling
Rigor or shaking chills
Headache
Malaise
N/V/D
Exertional dypsnea
Pleuritic chest pain,
friction rub
Abdominal pain
Fever
Tachypnea
Tachycardia
Cyanosis
Wheezes, coarse &
fine crackles
Anorexia & weight
loss
Dullness to percussion
Altered mentation
Wheezes, Course & fine
crackles
Febrile, chills
Productive cough
Hx URI, OM,
Conjunctivitis
Tachypnea, tachycardia
Cyanosis
H/A
Malaise
Abdominal distention
N/V/D
Source - Medline Plus
Source