Pulmonary Edema
Pulmonary edema
 It’s life threatening condition is defined as
abnormal accumulation of fluid in the lung
tissue and/or a...
Pathophysiology/ Etiology
The present of fluid in the alveolio impedes
gas exchange especially oxygen movement
into pulmon...
Pathophysiology/ Etiology
 Pulmonary edema most commonly occurs as a result of
increase micro vascular pressure from abno...
 If cause is lung injuries.
A) Flash pulmonary edema
e.g. Pt who has undergone pneumoectomy
Remove of one lung or partial...
Note
 This pulmonary edema still until pt’s
pulmonary vasculature attempt to
adapt.
Pathophysiology/ Etiology
B) Re-expansion pulmonary edema.
this caused by rapid reinflation of the lung after removal of
t...
 Other causes:
- Hypervolemia “circulatory overload”
- Infections pneumonia.
- Organophesphorous poisoning.
Clinical manifestation:
 Dyspnea, orthopnea.
Note: pt usually uses accessory muscle of respiration with
retraction of int...
Diagnostic Evaluation
 Auscultation reveals crackles.
 Chest x-ray show interstitial marking “edema”
 Pulse oximetry, A...
Management
1.The immediate objectives are:
a- improve oxygenation.
b- reduce pulmonary congestion.
2. Identify and correct...
Cont..
5- Morphine sulfate to:
a- Reduce anxiety.
b- Venous pooling of blood in the periphery.
c- Reduce resistance agains...
Cont..
8- Contractility enhancement “Digoxin, dopamin, aminophyllin
to improve heart muscle to pump
complete emptying of b...
Complication
 Dysrhythmias.
 Respiratory failure.
Nursing Intervention
 Improve oxygenation
 Decrease anxiety.
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Pulmonary edema egh nsg.forum-palestine.com

  1. 1. Pulmonary Edema
  2. 2. Pulmonary edema  It’s life threatening condition is defined as abnormal accumulation of fluid in the lung tissue and/or alveolar space.
  3. 3. Pathophysiology/ Etiology The present of fluid in the alveolio impedes gas exchange especially oxygen movement into pulmonary capilary.
  4. 4. Pathophysiology/ Etiology  Pulmonary edema most commonly occurs as a result of increase micro vascular pressure from abnormal cardiac function.  If cause is : Heart disease “ cardiovascular disease” e.g. Acute left ventricular failure, MI, aortic stenosis, sever mitral valve disease, hypertension, CHF. Inadequate left ventricular Function Fluid begins to leak to interstitial space and the alveoli  Hypervolemia “circulatory overload” lead to increase intravascular pressure in the lung.
  5. 5.  If cause is lung injuries. A) Flash pulmonary edema e.g. Pt who has undergone pneumoectomy Remove of one lung or partial of lung Cardiac output goes to remaining lung. If pt fluid is not montoring closly. Pulmonary edema
  6. 6. Note  This pulmonary edema still until pt’s pulmonary vasculature attempt to adapt.
  7. 7. Pathophysiology/ Etiology B) Re-expansion pulmonary edema. this caused by rapid reinflation of the lung after removal of the air from pneumothorax or evacuation of fluid from a large pleural effusion.
  8. 8.  Other causes: - Hypervolemia “circulatory overload” - Infections pneumonia. - Organophesphorous poisoning.
  9. 9. Clinical manifestation:  Dyspnea, orthopnea. Note: pt usually uses accessory muscle of respiration with retraction of intracostal space and supera-clavicular areas.  Cough with varying amount white-or-pink tinged frothy sputum.  Air hunger and central cyanosis.  Noisy breathing “inspiration and expiratory wheezing and bubbling sounds.  Distended neck veins.  Respiratory distress: 1- anxiety, ayitated 2- confusion or stuporous  Tachycardia, hypotension , shock
  10. 10. Diagnostic Evaluation  Auscultation reveals crackles.  Chest x-ray show interstitial marking “edema”  Pulse oximetry, ABG reveals hypoxemia.  measuring of pulmonary artery wedge pressure by Swan-Gam catheter.
  11. 11. Management 1.The immediate objectives are: a- improve oxygenation. b- reduce pulmonary congestion. 2. Identify and correct of precipitation factors to prevent recurrence. 3. Increase oxygen tension a- Reduce fluid volume by diuretics and vasodilators” b- Improving heart ability to pump “glycoside, beta agonists” c- Decease anxiety 4. Oxygen therapy a- Use high oxygen flow. b- Intubations and Mechanical ventilation
  12. 12. Cont.. 5- Morphine sulfate to: a- Reduce anxiety. b- Venous pooling of blood in the periphery. c- Reduce resistance against which the heart must pump. 6- Vasodilator therapy “Nitroglycerin” - to reduce amount of blood returning to the heart. - to reduce resistance against which the heart most pump. 7- Diuretic therapy “lasix” - to reduce blood volume and pulmonary congestion.
  13. 13. Cont.. 8- Contractility enhancement “Digoxin, dopamin, aminophyllin to improve heart muscle to pump complete emptying of blood from the ventricle. Decrease fluid backing up into the lungs.  Aminophylline to prevent bronchospasm.
  14. 14. Complication  Dysrhythmias.  Respiratory failure.
  15. 15. Nursing Intervention  Improve oxygenation  Decrease anxiety.

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