Purpose
To recognize risk factors for pulmonary edema/fluid overload.
Competency
Explain care for the client with lower respiratory disorders.
Instructions
Read the scenarios below and answer the questions. If you use sources, site them using APA format.
Case # 1
An elderly woman comes into the ER with severe dehydration after spending the day at the beach. The client is weak and feels like she is going to faint. An IV is started, and the RN hangs 0.9% Normal Saline. There are no IV pumps available. The client begins to feel better after 500 mL’s are infused, and the rest of the IV bag is infused. The client begins to have difficulty breathing. Auscultation of the lungs reveals crackles to ½ of the lower lung fields. The provider diagnoses pulmonary edema, and the client is treated with Lasix. She is stabilized but needs to be admitted to the ICU.
Question # 1: What nursing action could have prevented the client from having pulmonary edema? (5-10 sentences)
Question # 2: What makes this client at risk for pulmonary edema? (5-10 sentences)
Case # 2
A 22-year-old special-needs client comes to the ER with fever and difficulty breathing. The client weighs 66 LBS. The client is admitted with pneumonia and IV fluids, antibiotics, and respiratory treatments are started. The client is dehydrated, so she receives several bags of IV fluids over three days. On the third day, the client has worsening shortness of breath, and an X-ray is ordered which shows pulmonary edema. An echocardiogram is ordered. It shows normal cardiac function. The client is given Lasix, and the shortness of breath resolves.
Question # 3: How did the client’s size (body weight) put her at risk for pulmonary edema? (5-10 sentences)
Question # 4: How could pulmonary edema have been prevented in this client? (5-10 sentences)
Case # 3
A 32-year-old male with a history of cardiomyopathy is admitted to the medical-surgical floor with a diagnosis of flu. The client has a high fever and receives multiple bags of 0.9%NS. One day into the admission the client develops severe shortness of breath. An X-ray shows pulmonary edema.
Question # 5: What puts this client at risk for pulmonary edema? (5-10 sentences)
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