An adult patient with hypertension and chronic heart failure presents with shortness of breath and edema. Which nursing action is most appropriate initially?

An adult patient with hypertension and chronic heart failure presents with shortness of breath and edema. Which nursing action is most appropriate initially?

• A. Administer furosemide immediately
• B. Elevate the head of the bed
• C. Place patient in Trendelenburg position
• D. Initiate continuous IV saline infusion

Answer: (B)

Stabilizing breathing in acute heart failure with pulmonary edema is the immediate priority. Elevating the head of the bed to a high-Fowler position improves lung expansion and reduces venous return to the heart, which lowers pulmonary congestion and eases dyspnea. This simple position change can rapidly increase comfort and oxygenation while other treatments are organized. The other actions would not support immediate relief of respiratory distress. Placing the patient in a Trendelenburg position increases venous return and worsens pulmonary edema. Initiating a continuous IV saline infusion would worsen fluid overload and edema. Administering furosemide right away depends on prescribed orders and ongoing assessment; while it may be part of treatment, it isn’t the quickest intervention to relieve acute dyspnea.

Stabilizing breathing in acute heart failure with pulmonary edema is the immediate priority. Elevating the head of the bed to a high-Fowler position improves lung expansion and reduces venous return to the heart, which lowers pulmonary congestion and eases dyspnea. This simple position change can rapidly increase comfort and oxygenation while other treatments are organized.

The other actions would not support immediate relief of respiratory distress. Placing the patient in a Trendelenburg position increases venous return and worsens pulmonary edema. Initiating a continuous IV saline infusion would worsen fluid overload and edema. Administering furosemide right away depends on prescribed orders and ongoing assessment; while it may be part of treatment, it isn’t the quickest intervention to relieve acute dyspnea.