Pulmonary Oedema Case Study Answers

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Question 1

According to Mrs Brown’s clinical manifestations it can be diagnosed that she has pulmonary oedema. Congestive heart failure happens when the heart is unable to pump blood productively causing the backup of blood, which increases the blood pressure and causes fluids to collect in the alveoli in the lungs which leads to pulmonary oedema. According to the clinical manifestations Mrs Brown had an increased heart rate of 120 beats/minute, the increased heart rate is the heart beating faster to make up for the loss of the pumping capacity. Due to having the heart pumping too fast for a while can damage heart muscle and hinder with the hearts normal electrical signals which can cause a dangerous heart rhythm, hence Mrs Brown’s ECG monitor
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Since acute pulmonary oedema is the cause of the heart failure it should be focused on relieving the pulmonary effects of the disorder. It is often instrumental to recognise early manifestations of pulmonary oedema and its treatment. As with many critical conditions, the care is directed towards the ABC’s: airway, breathing and circulation. Promoting effective gas exchange and restoring an effective cardiac output are the main concerns for a patient with pulmonary oedema. Impaired gas exchange is due to the accumulation of fluid in the alveoli, which interferes with ventilation of the lungs. Due to this the alveolar levels fall and carbon dioxide level rises. Reduced level of oxygen decreases the diffusion of gas into the pulmonary capillaries. To manage breathing in patients, the airway has to be unobstructed as a clear airway is important for pulmonary functions and for ventilation and gas exchange. The effectiveness of respiratory efforts has to be assessed as pulmonary oedema increases the work of breathing, hence an increase in effort can often lead to fatigue and decreased respiratory effort. Respiratory status has to be assessed frequently, such as rate, effort, the use of accessory muscle, sputum characteristics, lung sounds and skin colour. Patients should be placed in a high-Flowler’s position with legs …show more content…
So when the arteries are dilated, the peripheral resistance that the ventricles must overcome to eject blood onto the circulation is diminished. Sublingual glyceryl trinitrate are absorbed organic nitrates that are absorbed by the endothelial cells of the blood vessel wall. These medications are converted into nitric oxide in the vascular muscle through a sulfhydryl- dependent catalyst. The nitrates are nitric oxide donors which increases the intracellular levels of a second messenger called cyclic guanosine monophosphate, this alters the availability of calcium ions in the muscle cell and the activity of the contractile protein, myosin, making the blood vessels to dilate. The vasodilating effect of the organic nitrate is more marked in venous capacitance vessels than in arterial vessels. When there is a indirect reduction in the preload, it leads to a beneficial redistribution of coronary blood flow towards the endocardium. These medications are also involved in dilating the collateral coronary blood vessel, which often leads to an increased blood flow to ischaemic areas of the

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