Question

Your pt is hypotensive after you have administered nitroglycerin under the Acute Cardiogenic Pulmonary Edema Medical Directive, but has crackles. Can you use a fluid bolus?

Answer 1

Given the crackles in the lungs and the patient's hypotensive state after administering nitroglycerin, a fluid bolus may not be suitable as it can worsen fluid accumulation in the lungs. Consult with a healthcare professional for proper assessment and treatment.

Step-by-step explanation:

In this case, the patient has crackles, which are abnormal lung sounds and can indicate pulmonary congestion or fluid in the lungs. Given that the patient is already hypotensive after administering nitroglycerin, a fluid bolus may not be appropriate as it can further worsen fluid accumulation in the lungs and lead to respiratory distress.

Crackles in the lungs can be a sign of cardiogenic pulmonary edema, which is often caused by heart failure. In such cases, the focus of treatment is to reduce fluid accumulation and improve heart function. Fluid boluses are generally used in hypovolemic shock, where the patient has low blood volume, rather than in cardiogenic pulmonary edema.

It is important to consult with a healthcare professional in such situations for an accurate assessment and appropriate treatment plan.