مريض فشل قلب جاء الساعة ٣ فجراً، يجلس على حافة السرير ويلهث، وسرعة تنفسه ٣٤، وتشبعه ٨٥٪، ويخرج بلغماً رغوياً وردياً. ضغطه ١٧٦/١٠٠. أي أوامر يتوقعها الممرض؟ (اختر كل ما ينطبق)

A heart-failure client arrives at 03:00 sitting on the bed edge gasping, RR 34, SpO2 85%, with pink frothy sputum. BP is 176/100. Which orders does the nurse expect? (Select all that apply)

1. IV furosemide
2. Non-invasive positive pressure ventilation (CPAP)
3. IV nitroglycerin with BP monitoring
4. A rapid 500 mL normal saline bolus
5. Lying flat with the legs raised

Answer: A) IV furosemide, B) Non-invasive positive pressure ventilation (CPAP), C) IV nitroglycerin with BP monitoring. This is acute pulmonary oedema with hypertension. Treatment: sit up with legs down, an IV diuretic, nitrates to reduce preload and afterload, and CPAP to improve oxygenation. Fluids and leg raising worsen congestion.