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Asked by waleomoakin
A 72-year-old man presents to the emergency department with congestive heart failure exacerbation. He is awake and alert but in distress. He is using accessory respiratory muscles and says it is hard to breathe. His vitals signs are: heart rate, 120 beats/min; blood pressure, 120/80 mm Hg; respiratory rate, 34 breaths/min; and oxygen saturation, 90% on 8 L of oxygen by simple face mask. Physical examination reveals bilateral lower extremity edema and crackles in the posterior lung fields. A chest radiograph demonstrates bilateral fluffy infiltrates consistent with pulmonary edema. Arterial blood gas analysis demonstrates: pH 7.30, PCO2 50 mm Hg, and PO2 64 mm Hg. In addition to diuresis, which of the following is the best next step in this patient’s management? A. Intubate and initiate invasive mechanical ventilation B. Initiate noninvasive positive pressure ventilation C. Switch to nonrebreather oxygen mask D. Switch to high-flow, high-humidity oxygen
SCIENCE
HEALTH SCIENCE
NURSING

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