A 61-year-old female was admitted last night with shortness of breath.She currently is alert and oriented,but very anxious.Her latest arterial blood gas values,on a nasal cannula at 3L/min,show: pH = 7.39;PaCO₂= 41 mm Hg;PaO₂ = 40 mm Hg;SaO₂ = 74%;HCO₃^- = 24 mEq/L.Breath sounds are decreased throughout with fine late crackles on inspiration.The current chest x-ray shows an enlarged heart with bilateral vascular congestion.The most appropriate therapy for this patient is _________.

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The arterial blood gas values for this patient show refractory hypoxemia,as evidenced by the PaO₂ of 40 mm Hg while receiving supplemental oxygen.The breath sounds indicate pulmonary edema.This finding is supported by the chest x-ray,which shows bilateral vascular congestion and an enlarged heart.These findings are consistent with acute cardiogenic pulmonary edema.The most appropriate therapy is mask CPAP.

A 61-Year-Old Female Was Admitted Last Night with Shortness of Breath.She