A 59-year-old male presents with complaints of chest tightne…

A 59-year-old male presents with complaints of chest tightness and shortness of breath. He has a medical history of CAD, hypertension, and hyperlipidemia. Family history is positive for CAD, hypertension, hyperlipidemia, and asthma. His vital signs are: heart rate 110, blood pressure 189/106, respiratory rate 28, and SpO2 96%. On exam the AG-ACNP appreciates bilateral expiratory wheezes, but no rubs, gallops, or murmurs. Capillary refill time is less than 3 seconds. Which medication should be avoided until asthma has been ruled out?

The AG-ACNP is seeing a patient who is initiating breaths on…

The AG-ACNP is seeing a patient who is initiating breaths on SIMV. The SpO2 is 98% on 40% fraction of inspired oxygen. The AG-ACNP notices that the patient’s spontaneous tidal volumes are 130 mL per breath, and the patient is getting mildly tachycardic and is complaining of fatigue. Respiratory muscle fatigue can best be reduced by:

A 65-year-old female is admitted with complaints of shortnes…

A 65-year-old female is admitted with complaints of shortness of breath. Shortly after, she requires emergency intubation secondary to hypoxia. Her initial blood pressure was 220/140 mmHg. Chest x-ray shows pulmonary edema. A bedside echocardiogram shows preserved left ventricular (LV) systolic function with hyperdynamic LV. You make a diagnosis of hypertensive emergency with flash pulmonary edema.  How do you treat the condition?

An NP is called to assess a 76-year-old female patient who h…

An NP is called to assess a 76-year-old female patient who has a known history of systolic heart failure. The patient is being admitted to the hospital with complaints of couch orthopnea and declining activity tolerance. Oxygen saturations are lower than her usual baseline and a chest x-ray demonstrates pulmonary venous hypertension.  Which is the initial intervention in the treatment of this patient?