2.4 Pulmonary oedema Listen

Pulmonary oedema can be caused by fluid overload following an acute myocardial infarction or in a patient with chronic heart failure. Patients describe feeling extremely short of breath and may fear that they are about to die.

Nursing Care of the patient with pulmonary oedema

  • The patient should be positioned upright supported by pillows or if necessary they may need to be nursed sitting in a chair.
  • 60% humidified oxygen should be prescribed and administered according to local policy.
  • If necessary Continuous Positive Airway Pressure (CPAP)  should be administered as prescribed by the medical team. CPAP treatment is a continuous positive pressure in the airways which provides resistance and displaces fluid in the lungs. Treatment should be initiated as early as possible and effectiveness of the treatment documented in the nursing records.
  • IV diamorphine and IV furosemide should be administered by the medical team. The patient may require an IV infusion of Furosemide.
  • Complications of pulmonary oedema are cardiac arrhythmias. If the patient experiences life threatening arrhythmias they will be prescribed antiarrhythmic medication or may require cardio version.
  • The patient will be cared for in a specialist cardiac unit with continuous monitoring of the patient’s condition by specialist nurses until their condition stabilises.

(Johnson and Rawlings-Anderson,2007)

Click here to see film (youtube): Acute cardiogenic pulmonary oedema nurse training courtesy of HealthPartners Clinical Simulation

 

A CPAP ventilator in use on a patient.

A CPAP ventilator in use on a patient.