Often resulting from left-sided ventricular failure, pulmonary congestion results in pulmonary edema, leading to decreased perfusion.

  • Clinical Manifestations: cerebral hypoxia (LOC changes), systematic hypoxia (cyanosis, cool skin), weak pulses + tachycardia, incessant coughing with foamy/frothy (maybe pink/blood-tinged) sputum.
  • Diagnostics: LSHF, crackles/rales, CXR (increased interstitial markings), pulse oximetry (ABG)
  • Medical Management: reduce volume overload (diuresis), improve ventricular function (inotropes), and increase respiratory exchange (oxygenation, medication)
  • Pharmacologic Therapy: morphine (reduce anxiety, antidote is naloxone hydrochloride/Narcan), diuretics (reduce fluid volume), and vasodilators (nitroglycerin)
  • Nursing Interventions: Assist in oxygenation, intubation, and ventilation. Position patient upright with feet down to promote circulation. Regularly evaluate medication effects.