Physiological Adaptation Q 18

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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. Symptoms may also include coughing up blood or bloody froth; difficulty breathing when lying down (orthopnea); feeling of “air hunger” or “drowning” (this feeling is called “paroxysmal nocturnal dyspnea” if it causes you to wake up 1 to 2 hours after falling asleep and struggle to catch your breath).

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Option A: Physical findings in patients with pulmonary edema are notable for tachypnea and tachycardia. Patients may be sitting upright, they may demonstrate air hunger, and they may become agitated and confused. Patients usually appear anxious and diaphoretic.

Option B: Auscultation of the lungs usually reveals fine, crepitant rales, but rhonchi or wheezes may also be present. Rales are usually heard at the bases first; as the condition worsens, they progress to the apices.

Option C: Cardiovascular findings are usually notable for S3, accentuation of the pulmonic component of S2, and jugular venous distention. Auscultation of murmurs can help in the diagnosis of acute valvular disorders manifesting with pulmonary edema.

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