In acute pulmonary edema, fluid accumulates in the alveoli, causing severe dyspnea and hypoxia. The High Fowler's position (sitting upright at 90°) with legs dangling off the side of the bed is the priority intervention because:

• Gravity pulls fluid away from the lungs (reduces venous return to the heart)
• Dependent legs act as venous pooling areas (reduces preload)
• Upright position maximizes diaphragmatic descent and lung expansion
• Improves ventilation-perfusion matching

Additional nursing interventions in pulmonary edema:

1. High-flow oxygen or CPAP/BiPAP
2. IV furosemide (diuretic) — reduces fluid overload
3. IV morphine — reduces anxiety and vasodilates
4. Stop IV fluids or drastically reduce rate
5. Cardiac monitoring