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?

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?