The Procedural Work For Cardiac Diseases

Pulmonary edema is the congestion of the lungs due to the accumulation of excess blood in the blood vessels of the respiratory system. This results in significant difficulty in breathing. Pulmonary edema commonly occurs as a result of left-sided heart failure, which causes difficulty in the return of blood from the lungs to the heart. This leads to blood accumulation in the lungs, causing pulmonary edema. If left untreated, pulmonary edema can lead to suffocation and be fatal.

Symptoms:

1. Severe difficulty in breathing, especially in the horizontal position.
2. Paleness of the face.
3. Increased heart rate.
4. Expectoration of large amounts of bloody sputum.
5. Cyanosis (blue discoloration of the skin and mucous membranes due to lack of oxygen).

The Primary Goal of Nursing Care for Pulmonary Edema:

The main objective of nursing care for these patients is to ensure that the patient receives the necessary amount of oxygen for proper respiratory function and to alleviate symptoms.

Role of Nursing Staff Towards the Patient:

1.  Positioning the Patient:

• Place the patient in a 90-degree or 45-degree angle (sitting upright) or allow them to sit on a chair. This position aids the patient in breathing more easily by reducing the workload on the heart and improving lung expansion.

2.  Oxygen Therapy:

• Administer 8 liters of humidified oxygen per minute, as this helps maintain adequate oxygen saturation in the blood and reduces breathing difficulty.

3.  Medication Administration:

• Digoxin: Give as prescribed to help strengthen the heart's contraction and improve its pumping efficiency.
• Diuretics: Administer Furosemide (Lasix) in doses ranging from 40 mg to 120 mg intravenously (slow infusion) to help remove excess fluid from the body.
• Aminophylline: Administer 250 mg to 500 mg IV to dilate the airways, facilitating easier breathing by relieving bronchospasm.

4.  Mechanical Ventilation (If Needed):

• In severe cases of respiratory failure, the patient may need mechanical ventilation to assist with breathing and support life. This is especially critical if the patient's oxygen levels are critically low.

General Care Considerations:

• Monitor vital signs closely, especially respiratory rate, heart rate, and oxygen saturation levels.
• Regularly assess the patient’s lung sounds for crackles or wheezes, indicating fluid accumulation.
• Provide psychological support to alleviate anxiety, as patients with pulmonary edema often feel panic due to their inability to breathe.
• Ensure fluid balance monitoring (input/output), as diuretic therapy can lead to dehydration or electrolyte imbalances.

By following these interventions and closely monitoring the patient's condition, nurses can play a vital role in improving the patient's oxygenation and preventing further complications associated with pulmonary edema.