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Pulmonary edema is an abnormal buildup of fluid in the air sacs of the lungs, which leads to shortness of breath.

Early symptoms of pulmonary edema include:

• shortness of breath upon exertion
• sudden respiratory distress after sleep
• difficulty breathing, except when sitting upright
• coughing

In cases of severe pulmonary edema, these symptoms will worsen to:

• labored and rapid breathing
• frothy, bloody fluid containing pus coughed from the lungs (sputum)
• a fast pulse and possibly serious disturbances in the heart's rhythm (atrial fibrillation, for example)
• cold, clammy, sweaty, and bluish skin
• a drop in blood pressure resulting in a thready pulse

The health care provider will perform a physical exam and use a stethoscope to listen to your lungs and heart. The following may be detected:

• Abnormal heart sounds
• Crackles in your lungs, called rales
• Increased heart rate (tachycardia)
• Pale or blue skin color (pallor or cyanosis)
• Rapid breathing (tachypnea)

Nursing Diagnosis : Anxiety related to Threat / Change in Health Status

Goal: Anxiety can be overcome

Expected outcomes:

• Reported fear / anxiety disappear or decrease to the level that can be handled, looks relaxed and resting / sleeping properly.

Nursing Intervention :

1) Record the degree of anxiety and fear. Inform the patient / person close to the patient, the normal feelings and push expressing feelings.
Rational:
Understanding that feelings (which are based plus oxygen imbalances that threaten) normal can help patients improve some sense of emotional control.

2) Explain the disease process and procedures in the level of the patient's ability to understand and handle information. Assess the current situation and the measures taken to address the problem.
Rational:
Eliminate anxiety as insecurity and reduce fear about personal safety. In the early phase of explanation needs to be repeated with frequent and short because the patient has decreased the scope of attention.

3) Provide comfort measures, ie, back massage, change of positions.
Rational:
Tool to reduce stress and indirect care to enhance relaxation and coping skills.

4) Help patients to identify behavioral help, eg a comfortable position, focus on breathing, relaxation techniques.
Rational:
Giving patients control measures to reduce anxiety and muscle tension.

5) Support the patient / significant other in accepting the reality of the situation, especially the plan for a long period of recuperation. Involve patients in planning and participation in care.
Rational:
Coping mechanisms and participation in treatment programs may improve learning patients to receive the expected result of the disease and improve some sense of control.

6) Watch out for out of control behavior or increased cardiopulmonary dysfunction, eg worsening dyspnea and tachycardia.
Rational:
Developing the capacity of anxiety requires further evaluation and possible intervention with anti-anxiety medication.