السبت، 23 يونيو 2018

47-Pulmonary Edema (see Cardiac CHF)

About
Accumulation of fluid in the lungs, usually as a result of fluid overload or Congestive Heart Failure.
Assess
Lung sounds, history of cardiac problems, recent fluid overload, respirations, pulse oximetry, vital signs.
Complications
Respiratory or cardiac arrest- start CPR.
End stage congestive heart failure
Diagnosis
  • Fluid volume excess related to retention of sodium and water
  • Decreased cardiac output related to impaired heart function
  • Impaired gas exchange related to excessive fluid in the lungs and alveoli
  • Activity intolerance related to dyspnea and chronic disease state

Goals
  • The client will have adequate oxygenation.
  • The client will identify symptoms that may necessitate a change in treatment protocol.
  • The client will have clear breath sounds upon auscultation.

Interventions
  • Assess lung sounds, vital signs, and pulse oximetry.
  • Monitor intake and output, monitor daily weights ( a 2.2 pound weight gain = 1 liter of fluid gain).
  • Implement fluid restrictions as ordered.
  • Administer diuretics, as ordered.
  • Administer other cardiac drugs to manage cardiac disease ( cardiac glycosides, antihypertensives, nitrates, etc).
  • Teach client to monitor for signs of worsening; increase in daily weights, increase in shortness of breath, orthopnea, nocturia, etc).
  • Teach the client to maintain a low sodium diet.
  • Monitor for signs/ symptoms of complications.

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