Physiological Adaptation Q 105

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A patient admitted to the hospital with myocardial infarction develops severe pulmonary edema. Which of the following symptoms should the nurse expect the patient to exhibit?

  

     A. Slow, deep respirations

     B. Stridor

     C. Bradycardia

     D. Air hunger

    

    

Correct Answer: D. Air hunger

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Patients with pulmonary edema experience air hunger, anxiety, and agitation. Patients usually present with shortness of breath, which may be acute in onset (from minutes to hours) or gradual in onset occurring over hours to days, depending upon the etiology of pulmonary edema.

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Option A: Tachypnea is usually present, with the patient gasping for breath. Dyspnea and tachypnea are usually present, and may be associated with the use of accessory muscles of respiration. After initial airway clearance, oxygenation assessment, and maintenance, management mainly depends upon presentation and should be tailored from patient to patient. Supplemental oxygen is a requirement if the patient is at risk of hypoxemia (SPO2 less than 90% ).

Option C: Respiration is fast and shallow and heart rate increases. Tachycardia and hypotension may be present along with jugular venous distention. Auscultation of the heart helps to differentiate between the various causes of valvular lesions causing pulmonary edema.

Option B: Stridor is noisy breathing caused by laryngeal swelling or spasm and is not associated with pulmonary edema. Fine crackles are usually heard at the bases of lungs bilaterally, and progress apically as the edema worsens. Ronchi and wheeze may also be presenting signs.

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