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تم تحميل هذا الملف من
منتديات تمريض مستشفى غزة الاوروبي
http://egh-nsg.forumpalestine.com/
لتحميل اجمل واروع المحاضرات فقط قم بزيارتنا وسوف تكون من الاوائل
مع تحيات المدير العام
علاء شعت
This document discusses the body's compensatory mechanisms in response to hemorrhagic shock. In the early, compensated stage of shock, the body attempts to maintain blood pressure and perfusion through mechanisms like increased sympathetic nervous system stimulation, activation of the renin-angiotensin-aldosterone axis, and baroreceptor reflexes. The patient described has a urinary output of 20ml/hr, which is within the normal range of 30-50ml/hr, indicating the body is still able to adequately perfuse the kidneys. Later stages of decompensated and irreversible shock occur if compensation is insufficient to maintain circulation.
Cardiogenic vs noncardiogenic pulmonary edema (ARDs)abdelrazekdawod
The document discusses the differential diagnosis and treatment of cardiogenic and non-cardiogenic pulmonary edema. Cardiogenic pulmonary edema is caused by left heart failure leading to increased pulmonary venous pressure and fluid accumulation in the lungs. Non-cardiogenic pulmonary edema includes conditions like ARDS which has an acute inflammatory process in the lungs. Treatment for both involves supportive care like oxygen supplementation and ventilation, while cardiogenic pulmonary edema additionally responds to diuretics and vasodilators to reduce preload and afterload on the heart.
Pulmonary edema is fluid accumulation in the lungs that impairs gas exchange and can cause respiratory failure. Cardiac failure occurs when the heart cannot maintain adequate cardiac output or can only do so with elevated filling pressure. Left ventricular failure can be systolic, with reduced contractility, or diastolic, with impaired relaxation. Common causes include coronary artery disease, myocardial infarction, cardiomyopathy, and valvular heart disease. Treatment involves oxygen, diuretics, ACE inhibitors, beta blockers, and management of triggers like infections, arrhythmias, and electrolyte imbalances.
Pulmonary edema is an abnormal buildup of fluid in the lungs causing shortness of breath. It can be caused by conditions affecting the heart like heart failure, heart attack, or heart valve problems. Symptoms include cough, trouble breathing, and anxiety. Diagnosis involves listening to the lungs, blood tests, chest x-ray, and echocardiogram. Treatment is focused on relieving symptoms like giving oxygen, using diuretics to remove fluid, and treating the underlying cause. Nursing care focuses on monitoring the patient, administering medications, educating on treatment and preventing future episodes.
Pulmonary edema is a condition where fluid builds up in the lungs, making breathing difficult. It is usually caused by issues with the heart like a heart attack or valve problems that back fluid up into the lungs. Symptoms include extreme shortness of breath, anxiety, coughing, and pale skin. Diagnosis involves listening to the chest, chest x-rays, and echocardiograms. Treatment requires immediate hospitalization for oxygen, diuretics to remove fluid, heart medications, and treating the underlying heart condition. Pulmonary edema can be life-threatening but is often curable with prompt treatment and managing the long-term heart disorder.
This document discusses cardiac tamponade and pericardial effusion. Pericardial effusion is an abnormal collection of fluid in the pericardial cavity. Cardiac tamponade is a clinical syndrome caused by excess accumulation of fluid in the pericardial space, reducing ventricular filling and causing hemodynamic compromise. Causes include rapidly developing issues like trauma or surgery, or long term issues like infections, tumors, or hypothyroidism. Symptoms include breathlessness, chest pain, and fatigue. Treatment for severe cases involves pericardiocentesis, while milder cases may be treated conservatively with oxygen, fluids, rest, and drugs.
Drug-induced pulmonary/ respiratory disease is any disorder occurring to the respiratory organs due to the use of medication or drugs.
Pulmonary edema is a condition by which there occurs fluid accumulation in the lungs causing the patient difficult to breathe
Excessive fluid administration in compensated and decompensated heart failure patient considered as common cause
As a result capillary hydrostatic pressure increases due to left ventricular failure.
Oncotic pressure ( pressure with which fluid moves into vessel), also plays a role.
When there is an imbalance between hydrostatic and oncotic pressure fluid accumulates in the sac
تم تحميل هذا الملف من
منتديات تمريض مستشفى غزة الاوروبي
http://egh-nsg.forumpalestine.com/
لتحميل اجمل واروع المحاضرات فقط قم بزيارتنا وسوف تكون من الاوائل
مع تحيات المدير العام
علاء شعت
This document discusses the body's compensatory mechanisms in response to hemorrhagic shock. In the early, compensated stage of shock, the body attempts to maintain blood pressure and perfusion through mechanisms like increased sympathetic nervous system stimulation, activation of the renin-angiotensin-aldosterone axis, and baroreceptor reflexes. The patient described has a urinary output of 20ml/hr, which is within the normal range of 30-50ml/hr, indicating the body is still able to adequately perfuse the kidneys. Later stages of decompensated and irreversible shock occur if compensation is insufficient to maintain circulation.
Cardiogenic vs noncardiogenic pulmonary edema (ARDs)abdelrazekdawod
The document discusses the differential diagnosis and treatment of cardiogenic and non-cardiogenic pulmonary edema. Cardiogenic pulmonary edema is caused by left heart failure leading to increased pulmonary venous pressure and fluid accumulation in the lungs. Non-cardiogenic pulmonary edema includes conditions like ARDS which has an acute inflammatory process in the lungs. Treatment for both involves supportive care like oxygen supplementation and ventilation, while cardiogenic pulmonary edema additionally responds to diuretics and vasodilators to reduce preload and afterload on the heart.
Pulmonary edema is fluid accumulation in the lungs that impairs gas exchange and can cause respiratory failure. Cardiac failure occurs when the heart cannot maintain adequate cardiac output or can only do so with elevated filling pressure. Left ventricular failure can be systolic, with reduced contractility, or diastolic, with impaired relaxation. Common causes include coronary artery disease, myocardial infarction, cardiomyopathy, and valvular heart disease. Treatment involves oxygen, diuretics, ACE inhibitors, beta blockers, and management of triggers like infections, arrhythmias, and electrolyte imbalances.
Pulmonary edema is an abnormal buildup of fluid in the lungs causing shortness of breath. It can be caused by conditions affecting the heart like heart failure, heart attack, or heart valve problems. Symptoms include cough, trouble breathing, and anxiety. Diagnosis involves listening to the lungs, blood tests, chest x-ray, and echocardiogram. Treatment is focused on relieving symptoms like giving oxygen, using diuretics to remove fluid, and treating the underlying cause. Nursing care focuses on monitoring the patient, administering medications, educating on treatment and preventing future episodes.
Pulmonary edema is a condition where fluid builds up in the lungs, making breathing difficult. It is usually caused by issues with the heart like a heart attack or valve problems that back fluid up into the lungs. Symptoms include extreme shortness of breath, anxiety, coughing, and pale skin. Diagnosis involves listening to the chest, chest x-rays, and echocardiograms. Treatment requires immediate hospitalization for oxygen, diuretics to remove fluid, heart medications, and treating the underlying heart condition. Pulmonary edema can be life-threatening but is often curable with prompt treatment and managing the long-term heart disorder.
This document discusses cardiac tamponade and pericardial effusion. Pericardial effusion is an abnormal collection of fluid in the pericardial cavity. Cardiac tamponade is a clinical syndrome caused by excess accumulation of fluid in the pericardial space, reducing ventricular filling and causing hemodynamic compromise. Causes include rapidly developing issues like trauma or surgery, or long term issues like infections, tumors, or hypothyroidism. Symptoms include breathlessness, chest pain, and fatigue. Treatment for severe cases involves pericardiocentesis, while milder cases may be treated conservatively with oxygen, fluids, rest, and drugs.
Drug-induced pulmonary/ respiratory disease is any disorder occurring to the respiratory organs due to the use of medication or drugs.
Pulmonary edema is a condition by which there occurs fluid accumulation in the lungs causing the patient difficult to breathe
Excessive fluid administration in compensated and decompensated heart failure patient considered as common cause
As a result capillary hydrostatic pressure increases due to left ventricular failure.
Oncotic pressure ( pressure with which fluid moves into vessel), also plays a role.
When there is an imbalance between hydrostatic and oncotic pressure fluid accumulates in the sac
Pulmonary edema is fluid accumulation in the lungs caused by fluid leaking from blood vessels into the lungs. It can be cardiogenic (caused by heart problems increasing blood pressure in the lungs) or non-cardiogenic. Symptoms include shortness of breath, cough, and cyanosis. Diagnosis involves chest x-ray, echocardiogram, and measuring wedge pressure. Treatment focuses on reducing preload on the heart, lowering afterload, and providing supportive care like oxygen. Outcomes depend on the underlying cause but most cardiogenic cases resolve within 3 days with medical management.
Cor pulmonale is enlargement of the right ventricle caused by high blood pressure in the lungs, usually due to chronic lung diseases like COPD. Over time, the increased pressure strains and enlarges the right ventricle. Symptoms include dyspnea, cough, wheezing, edema, and fatigue. Diagnosis involves physical exam, pulmonary function tests, echocardiogram, and biomarkers like BNP. Treatment focuses on managing the underlying lung condition, using diuretics, oxygen therapy, and occasionally surgery or transplant.
This document discusses the case of a 62-year-old man presenting with acute dyspnea. On examination, the patient is pale, sweaty, coughing pink sputum, and in respiratory distress. His pulse is 140 BPM, respiratory rate is 30, and oxygen saturation is 85%. The document outlines potential causes of acute dyspnea including pulmonary edema and provides guidance on evaluating, diagnosing, and initially managing such a patient. Key factors to consider include the patient's medical history, signs of heart failure on examination, and portable chest x-ray findings suggestive of pulmonary edema. The goals of treatment are to place the patient in a sitting position, provide high-flow oxygen, administer diuretics and opioids,
Acute pulmonary edema refers to excess fluid in the lungs that can have cardiogenic or non-cardiogenic causes. Cardiogenic pulmonary edema is often due to left ventricular dysfunction that leads to increased pulmonary capillary pressure. Common causes of left ventricular dysfunction include congestive heart failure, myocardial infarction, cardiomyopathy, and valvular diseases. Pulmonary edema progresses through three stages as excess fluid builds up first in small blood vessels then the lung interstitium and alveoli, impairing gas exchange.
The document describes pulmonary edema and congestive heart failure. Pulmonary edema is an abnormal accumulation of fluid in the lungs, causing anxiety, suffocation, pale skin, and noisy breathing. Diagnosis involves lung auscultation and chest x-ray. Treatment includes oxygen, diuretics, morphine, and positioning the patient. Congestive heart failure occurs when the heart cannot supply enough oxygen to tissues, causing hypoxia, low blood pressure, crackles, and decreased urine output. It is diagnosed using a pulmonary artery catheter and treated with vasodilators, diuretics, inotropic medications, and balloon pumps while monitoring the patient's condition.
This document summarizes the circulation and key features of several vascular beds in the body. It discusses:
1. The cerebral circulation receives 14% of cardiac output and has good autoregulation over a wide range of blood pressures. Local factors like H+, K+, and adenosine cause vasodilation while endothelin causes vasoconstriction in pathological states.
2. The coronary circulation receives 4% of cardiac output. Flow parallels metabolism with greater metabolism resulting in greater flow. Local metabolites are a major influence on flow.
3. The skin circulation receives 4% of cardiac output at rest and is mainly involved in thermoregulation. Vasoconstrictors and vasodilators influence flow
This document presents information on cor pulmonale delivered by Mr. Om Verma. It begins with objectives of reviewing anatomy and physiology of the respiratory and cardiovascular systems and defining cor pulmonale. It then reviews anatomy of the respiratory and cardiovascular systems, defines cor pulmonale as enlargement of the right ventricle due to lung disease, and discusses etiology including COPD, blood clots, cystic fibrosis. It also covers pathogenesis, clinical manifestations, diagnosis involving tests like echocardiogram, management including oxygen therapy and drugs, and nursing care for patients.
Rheumatic heart disease is a chronic condition resulting from rheumatic fever, which is caused by a streptococcus infection. This infection leads to inflammation in connective tissues like the heart, joints, blood vessels and skin. Over time, this inflammation can cause scarring and deformity of the heart valves through swelling, erosion and fibrous thickening of the valve leaflets. Major symptoms include heart murmurs, joint pain and skin rashes. Treatment focuses on antibiotics to destroy the bacteria, anti-inflammatories to reduce symptoms, and management of any heart valve complications.
Cardiac tamponade is a condition caused by the accumulation of fluid in the pericardial sac, which surrounds the heart. Normally there is a small amount of fluid present, but too much fluid builds pressure and prevents the heart from filling properly. Symptoms include chest pain, difficulty breathing, and low blood pressure. The excess fluid must be drained through procedures like pericardiocentesis in order to relieve pressure on the heart and stabilize the patient. Left untreated, cardiac tamponade can cause loss of consciousness and sudden death due to insufficient blood flow.
This document summarizes a medical student tutorial session on acute dyspnea. It discusses the causes, presentation, diagnosis and management of pulmonary edema. Pulmonary edema can be either cardiogenic or non-cardiogenic in origin, depending on factors that increase capillary hydrostatic pressure or permeability. The history, physical exam, chest x-ray and ECG are important for determining the underlying cause and guiding treatment, which involves oxygen, diuretics, afterload reduction and treating the root cause. Immediate treatment should begin before completing diagnostic tests.
This document discusses infective disorders of the heart including endocarditis, pericarditis, and myocarditis. It begins with definitions of key terms like infection, inflammation, and various heart conditions. It then reviews heart anatomy and the layers of the pericardium, myocardium, and endocardium. Causes, symptoms, diagnostic tests and treatment are described for each condition. Endocarditis is an infection of the inner lining of the heart that can damage valves if untreated. Pericarditis is inflammation of the protective sac around the heart. Myocarditis is inflammation of the heart muscle itself.
The document summarizes the physiology of the pulmonary circulatory system in three parts:
1) It describes the anatomy of the pulmonary vessels and pressures within the pulmonary system. The pulmonary artery branches into two main vessels with low pressure, distributing deoxygenated blood to the lungs.
2) It explains fluid dynamics within the lungs and how pulmonary edema develops if pressures rise above safety thresholds. The lungs maintain a negative interstitial pressure to prevent fluid buildup.
3) It covers fluid in the pleural cavity and how a negative pressure is needed to keep the lungs expanded via lymphatic drainage and fluid reabsorption. Pleural effusions can occur if drainage is blocked.
- Right heart failure is characterized by low cardiac output, hypotension, hepatic enlargement and raised jugular venous pressure. It has a high mortality rate comparable to left heart failure.
- Failure occurs when the right ventricle can no longer compensate for increased volume. Determining preload is difficult but high right atrial pressures indicate elevated right ventricular pressures and volume.
- Treatment aims to reduce afterload and optimize preload. Afterload reduction can be achieved through selective pulmonary vasodilation using inhaled nitric oxide, prostacyclins or phosphodiesterase inhibitors.
Cardiac tamponade is caused by fluid accumulation in the pericardial space, reducing heart filling and function. It requires urgent treatment to remove fluid via pericardiocentesis or surgery. Symptoms include low blood pressure, increased heart rate, and difficulty breathing due to restricted heart movement. A diagnosis is made through echocardiography identifying fluid and heart compression.
Cardiogenic shock is defined as the heart's inability to contract and pump blood efficiently due to inadequate oxygen supply to the heart. It can result from intrinsic heart problems like myocardial infarction, dysrhythmias, or valve disease, or from other causes like pulmonary embolism or bacterial infection. This leads to impaired left ventricular pumping, decreased cardiac output, and reduced tissue perfusion. Treatment involves stabilizing the patient, treating the underlying cause, increasing oxygen delivery, and improving heart function through medications, devices, or surgery. The goals are to support vital organ function and prevent further organ damage.
Blood flow, pressure, and resistance are key components of circulation. Resistance depends on vessel length and diameter, with smaller diameters resulting in greater resistance. Blood pressure includes systolic, diastolic, and mean arterial pressures. The circulatory system is regulated through neural, chemical, and renal mechanisms to maintain homeostasis. Issues like hypotension, hypertension, and shock can occur if regulation is compromised.
Cardiac tamponade is a medical emergency caused by excess fluid in the pericardium putting pressure on the heart. It can occur due to a rapid accumulation of fluid from conditions like cardiac surgery, chest trauma, or cancer. Symptoms include decreased blood pressure, jugular vein distension, and muffled heart sounds. Diagnosis involves echocardiogram, which shows collapsed heart chambers, or CT scan, which images the excess fluid. Treatment is drainage of the pericardial fluid, often guided by imaging.
Cardiac tamponade occurs when fluid accumulates in the pericardium and compresses the heart, restricting blood flow. It has an incidence of about 2 in 10,000 people. Causes include aortic aneurysm, cancer, heart attack, infection, and other conditions. Symptoms include low blood pressure, distended neck veins, muffled heart sounds (Beck's triad). Diagnosis involves echocardiogram, x-rays, and other imaging tests. Treatment focuses on draining fluid via pericardiocentesis and supporting blood pressure/heart function. Nursing care monitors symptoms, vital signs, and educates the patient.
Cardiac tamponade is a life-threatening condition where fluid accumulates in the pericardium and compresses the heart. It can result from various causes such as viral pericarditis, cancer, kidney failure, and chest trauma. Symptoms include decreased blood pressure, increased heart rate, distended neck veins, and difficulty breathing. Diagnosis involves echocardiogram, CT scan, or MRI. Treatment is pericardiocentesis to drain the fluid with the aim of improving heart function and relieving symptoms. Nursing care focuses on monitoring vital signs, administering oxygen, IV fluids, antibiotics, and inotropic drugs if needed.
Pulmonary edema is often caused by congestive heart failure. When the heart is not able to pump efficiently, blood can back up into the veins that take blood through the lungs. As the pressure in these blood vessels increases, fluid is pushed into the air spaces (alveoli) in the lungs.
Acute pulmonary edema can be either cardiogenic or non-cardiogenic in origin. Cardiogenic pulmonary edema is caused by elevated pulmonary capillary hydrostatic pressure due to conditions that increase left atrial pressure like heart failure, myocardial infarction, or valvular disease. It presents with dyspnea, crackles on exam, and chest x-ray findings of vascular congestion and fluid in the lungs. Treatment involves oxygen, diuretics, vasodilators, and inotropes. Non-cardiogenic pulmonary edema is caused by damage to the lung capillaries from conditions like near-drowning or neurogenic injury and presents with hypoxemia that does not resolve with oxygen alone.
Pulmonary edema is fluid accumulation in the lungs caused by fluid leaking from blood vessels into the lungs. It can be cardiogenic (caused by heart problems increasing blood pressure in the lungs) or non-cardiogenic. Symptoms include shortness of breath, cough, and cyanosis. Diagnosis involves chest x-ray, echocardiogram, and measuring wedge pressure. Treatment focuses on reducing preload on the heart, lowering afterload, and providing supportive care like oxygen. Outcomes depend on the underlying cause but most cardiogenic cases resolve within 3 days with medical management.
Cor pulmonale is enlargement of the right ventricle caused by high blood pressure in the lungs, usually due to chronic lung diseases like COPD. Over time, the increased pressure strains and enlarges the right ventricle. Symptoms include dyspnea, cough, wheezing, edema, and fatigue. Diagnosis involves physical exam, pulmonary function tests, echocardiogram, and biomarkers like BNP. Treatment focuses on managing the underlying lung condition, using diuretics, oxygen therapy, and occasionally surgery or transplant.
This document discusses the case of a 62-year-old man presenting with acute dyspnea. On examination, the patient is pale, sweaty, coughing pink sputum, and in respiratory distress. His pulse is 140 BPM, respiratory rate is 30, and oxygen saturation is 85%. The document outlines potential causes of acute dyspnea including pulmonary edema and provides guidance on evaluating, diagnosing, and initially managing such a patient. Key factors to consider include the patient's medical history, signs of heart failure on examination, and portable chest x-ray findings suggestive of pulmonary edema. The goals of treatment are to place the patient in a sitting position, provide high-flow oxygen, administer diuretics and opioids,
Acute pulmonary edema refers to excess fluid in the lungs that can have cardiogenic or non-cardiogenic causes. Cardiogenic pulmonary edema is often due to left ventricular dysfunction that leads to increased pulmonary capillary pressure. Common causes of left ventricular dysfunction include congestive heart failure, myocardial infarction, cardiomyopathy, and valvular diseases. Pulmonary edema progresses through three stages as excess fluid builds up first in small blood vessels then the lung interstitium and alveoli, impairing gas exchange.
The document describes pulmonary edema and congestive heart failure. Pulmonary edema is an abnormal accumulation of fluid in the lungs, causing anxiety, suffocation, pale skin, and noisy breathing. Diagnosis involves lung auscultation and chest x-ray. Treatment includes oxygen, diuretics, morphine, and positioning the patient. Congestive heart failure occurs when the heart cannot supply enough oxygen to tissues, causing hypoxia, low blood pressure, crackles, and decreased urine output. It is diagnosed using a pulmonary artery catheter and treated with vasodilators, diuretics, inotropic medications, and balloon pumps while monitoring the patient's condition.
This document summarizes the circulation and key features of several vascular beds in the body. It discusses:
1. The cerebral circulation receives 14% of cardiac output and has good autoregulation over a wide range of blood pressures. Local factors like H+, K+, and adenosine cause vasodilation while endothelin causes vasoconstriction in pathological states.
2. The coronary circulation receives 4% of cardiac output. Flow parallels metabolism with greater metabolism resulting in greater flow. Local metabolites are a major influence on flow.
3. The skin circulation receives 4% of cardiac output at rest and is mainly involved in thermoregulation. Vasoconstrictors and vasodilators influence flow
This document presents information on cor pulmonale delivered by Mr. Om Verma. It begins with objectives of reviewing anatomy and physiology of the respiratory and cardiovascular systems and defining cor pulmonale. It then reviews anatomy of the respiratory and cardiovascular systems, defines cor pulmonale as enlargement of the right ventricle due to lung disease, and discusses etiology including COPD, blood clots, cystic fibrosis. It also covers pathogenesis, clinical manifestations, diagnosis involving tests like echocardiogram, management including oxygen therapy and drugs, and nursing care for patients.
Rheumatic heart disease is a chronic condition resulting from rheumatic fever, which is caused by a streptococcus infection. This infection leads to inflammation in connective tissues like the heart, joints, blood vessels and skin. Over time, this inflammation can cause scarring and deformity of the heart valves through swelling, erosion and fibrous thickening of the valve leaflets. Major symptoms include heart murmurs, joint pain and skin rashes. Treatment focuses on antibiotics to destroy the bacteria, anti-inflammatories to reduce symptoms, and management of any heart valve complications.
Cardiac tamponade is a condition caused by the accumulation of fluid in the pericardial sac, which surrounds the heart. Normally there is a small amount of fluid present, but too much fluid builds pressure and prevents the heart from filling properly. Symptoms include chest pain, difficulty breathing, and low blood pressure. The excess fluid must be drained through procedures like pericardiocentesis in order to relieve pressure on the heart and stabilize the patient. Left untreated, cardiac tamponade can cause loss of consciousness and sudden death due to insufficient blood flow.
This document summarizes a medical student tutorial session on acute dyspnea. It discusses the causes, presentation, diagnosis and management of pulmonary edema. Pulmonary edema can be either cardiogenic or non-cardiogenic in origin, depending on factors that increase capillary hydrostatic pressure or permeability. The history, physical exam, chest x-ray and ECG are important for determining the underlying cause and guiding treatment, which involves oxygen, diuretics, afterload reduction and treating the root cause. Immediate treatment should begin before completing diagnostic tests.
This document discusses infective disorders of the heart including endocarditis, pericarditis, and myocarditis. It begins with definitions of key terms like infection, inflammation, and various heart conditions. It then reviews heart anatomy and the layers of the pericardium, myocardium, and endocardium. Causes, symptoms, diagnostic tests and treatment are described for each condition. Endocarditis is an infection of the inner lining of the heart that can damage valves if untreated. Pericarditis is inflammation of the protective sac around the heart. Myocarditis is inflammation of the heart muscle itself.
The document summarizes the physiology of the pulmonary circulatory system in three parts:
1) It describes the anatomy of the pulmonary vessels and pressures within the pulmonary system. The pulmonary artery branches into two main vessels with low pressure, distributing deoxygenated blood to the lungs.
2) It explains fluid dynamics within the lungs and how pulmonary edema develops if pressures rise above safety thresholds. The lungs maintain a negative interstitial pressure to prevent fluid buildup.
3) It covers fluid in the pleural cavity and how a negative pressure is needed to keep the lungs expanded via lymphatic drainage and fluid reabsorption. Pleural effusions can occur if drainage is blocked.
- Right heart failure is characterized by low cardiac output, hypotension, hepatic enlargement and raised jugular venous pressure. It has a high mortality rate comparable to left heart failure.
- Failure occurs when the right ventricle can no longer compensate for increased volume. Determining preload is difficult but high right atrial pressures indicate elevated right ventricular pressures and volume.
- Treatment aims to reduce afterload and optimize preload. Afterload reduction can be achieved through selective pulmonary vasodilation using inhaled nitric oxide, prostacyclins or phosphodiesterase inhibitors.
Cardiac tamponade is caused by fluid accumulation in the pericardial space, reducing heart filling and function. It requires urgent treatment to remove fluid via pericardiocentesis or surgery. Symptoms include low blood pressure, increased heart rate, and difficulty breathing due to restricted heart movement. A diagnosis is made through echocardiography identifying fluid and heart compression.
Cardiogenic shock is defined as the heart's inability to contract and pump blood efficiently due to inadequate oxygen supply to the heart. It can result from intrinsic heart problems like myocardial infarction, dysrhythmias, or valve disease, or from other causes like pulmonary embolism or bacterial infection. This leads to impaired left ventricular pumping, decreased cardiac output, and reduced tissue perfusion. Treatment involves stabilizing the patient, treating the underlying cause, increasing oxygen delivery, and improving heart function through medications, devices, or surgery. The goals are to support vital organ function and prevent further organ damage.
Blood flow, pressure, and resistance are key components of circulation. Resistance depends on vessel length and diameter, with smaller diameters resulting in greater resistance. Blood pressure includes systolic, diastolic, and mean arterial pressures. The circulatory system is regulated through neural, chemical, and renal mechanisms to maintain homeostasis. Issues like hypotension, hypertension, and shock can occur if regulation is compromised.
Cardiac tamponade is a medical emergency caused by excess fluid in the pericardium putting pressure on the heart. It can occur due to a rapid accumulation of fluid from conditions like cardiac surgery, chest trauma, or cancer. Symptoms include decreased blood pressure, jugular vein distension, and muffled heart sounds. Diagnosis involves echocardiogram, which shows collapsed heart chambers, or CT scan, which images the excess fluid. Treatment is drainage of the pericardial fluid, often guided by imaging.
Cardiac tamponade occurs when fluid accumulates in the pericardium and compresses the heart, restricting blood flow. It has an incidence of about 2 in 10,000 people. Causes include aortic aneurysm, cancer, heart attack, infection, and other conditions. Symptoms include low blood pressure, distended neck veins, muffled heart sounds (Beck's triad). Diagnosis involves echocardiogram, x-rays, and other imaging tests. Treatment focuses on draining fluid via pericardiocentesis and supporting blood pressure/heart function. Nursing care monitors symptoms, vital signs, and educates the patient.
Cardiac tamponade is a life-threatening condition where fluid accumulates in the pericardium and compresses the heart. It can result from various causes such as viral pericarditis, cancer, kidney failure, and chest trauma. Symptoms include decreased blood pressure, increased heart rate, distended neck veins, and difficulty breathing. Diagnosis involves echocardiogram, CT scan, or MRI. Treatment is pericardiocentesis to drain the fluid with the aim of improving heart function and relieving symptoms. Nursing care focuses on monitoring vital signs, administering oxygen, IV fluids, antibiotics, and inotropic drugs if needed.
Pulmonary edema is often caused by congestive heart failure. When the heart is not able to pump efficiently, blood can back up into the veins that take blood through the lungs. As the pressure in these blood vessels increases, fluid is pushed into the air spaces (alveoli) in the lungs.
Acute pulmonary edema can be either cardiogenic or non-cardiogenic in origin. Cardiogenic pulmonary edema is caused by elevated pulmonary capillary hydrostatic pressure due to conditions that increase left atrial pressure like heart failure, myocardial infarction, or valvular disease. It presents with dyspnea, crackles on exam, and chest x-ray findings of vascular congestion and fluid in the lungs. Treatment involves oxygen, diuretics, vasodilators, and inotropes. Non-cardiogenic pulmonary edema is caused by damage to the lung capillaries from conditions like near-drowning or neurogenic injury and presents with hypoxemia that does not resolve with oxygen alone.
Pulmonary edema is an abnormal buildup of fluid in the lungs that causes shortness of breath. It occurs when fluid leaks into the tiny air sacs (alveoli) and spaces around the alveoli in the lungs. Pulmonary edema can be caused by issues with the heart like heart failure or heart attack that increase blood pressure in the lungs. Symptoms include cough, difficulty breathing, and wheezing. Treatment focuses on addressing the underlying cause, giving oxygen, diuretics to remove fluid, and in severe cases, use of a ventilator.
Cor pulmonale, also known as pulmonary heart disease, is a type of right heart failure caused by lung disease. It is characterized by enlargement and failure of the right ventricle due to increased pulmonary blood pressure and resistance. Common causes include chronic obstructive pulmonary disease (COPD) and pulmonary embolism. Symptoms may include dyspnea, edema, and cyanosis. Diagnosis involves echocardiogram, chest x-ray, and right heart catheterization. Treatment focuses on managing the underlying lung condition with oxygen therapy and medications to dilate blood vessels in the lungs such as vasodilators. Nursing care aims to improve oxygenation and manage symptoms like anxiety from dyspnea. Complications can
Pulmonary edema is the accumulation of fluid in the interstitium and alveoli of the lungs. It can be caused by conditions that increase hydrostatic pressure or decrease oncotic pressure leading to fluid movement from capillaries into lung tissue. The main types are cardiogenic pulmonary edema from heart failure or damage and non-cardiogenic edema from toxic inhalation or infections. Symptoms range from shortness of breath to cough with frothy sputum. Diagnosis involves physical exam, chest x-ray, and tests like ABG analysis and echocardiogram. Treatment focuses on oxygen therapy, positioning, diuretics, and vasodilators to reduce pulmonary congestion.
1. Pulmonary edema occurs when fluid builds up in the tiny air sacs (alveoli) in the lungs, causing shortness of breath.
2. It can be caused by conditions that increase hydrostatic pressure in the pulmonary capillaries like heart failure (cardiogenic pulmonary edema) or disrupt the alveolar-capillary membrane like pneumonia or inhaled toxins (non-cardiogenic pulmonary edema).
3. The document provides definitions, classifications, signs and symptoms, differential diagnosis, and management approaches for dyspnea and pulmonary edema.
Shock is defined as a condition where the circulatory system cannot provide adequate circulation to vital organs due to low blood pressure. There are several types of shock including hypovolemic, cardiogenic, septic, anaphylactic, and neurogenic shock. The pathophysiology of shock involves low cardiac output, vasoconstriction, and eventual organ failure if not treated. Management of shock focuses on treating the underlying cause, fluid resuscitation, vasopressors or inotropes, antibiotics for septic shock, and monitoring for signs of adequacy of resuscitation such as improving vital signs and urine output.
Pulmonary hypertension is a condition defined by abnormally high blood pressure in the lungs. It occurs when pressure in the pulmonary arteries is greater than normal. The document discusses the causes of pulmonary hypertension, including primary pulmonary hypertension which has no identifiable cause as well as secondary causes like lung diseases. Common signs and symptoms include shortness of breath, dizziness, and swelling in the legs. The condition is diagnosed through tests like chest X-rays, echocardiograms, and pulmonary function tests. Treatment focuses on reducing fluid retention, improving heart function, and vasodilation through medications. In severe cases, lung or heart-lung transplants may be required.
Acute respiratory failure occurs when the respiratory system fails to maintain adequate gas exchange. There are two main types: hypoxemic respiratory failure, characterized by low oxygen levels, and acute ventilatory failure, characterized by high carbon dioxide levels. Hypoxemic failure is most common and can result from conditions that impair gas exchange like pneumonia or pulmonary edema. Ventilatory failure involves impaired breathing and can be caused by conditions that increase breathing workload like COPD. Diagnosis involves blood gas analysis and imaging. Treatment focuses on supporting oxygenation and ventilation through oxygen supplementation, ventilation support, and treating underlying causes.
Acute respiratory failure occurs when the respiratory system fails to maintain adequate gas exchange. There are two main types: hypoxemic respiratory failure, characterized by low oxygen levels (PaO2) with normal or low carbon dioxide (PaCO2) levels; and ventilatory (hypercapnic) respiratory failure, characterized by high PaCO2 levels. Hypoxemic failure is most common and can result from conditions that impair gas exchange like pneumonia or pulmonary edema. Ventilatory failure involves impaired ventilation and can be caused by conditions that obstruct airflow like COPD. Diagnosis involves blood gas analysis and imaging. Treatment focuses on supporting oxygenation and ventilation through oxygen supplementation, ventilation support, and treating the underlying cause.
Acute respiratory failure happens quickly and without much warning. It is often caused by a disease or injury that affects your breathing, such as pneumonia, opioid overdose, stroke, or a lung or spinal cord injury. Respiratory failure can also develop slowly
Acute respiratory distress syndrome (ARDS) occurs when fluid leaks into the alveolar sacs, causing them to fill and collapse. This prevents proper gas exchange and leads to hypoxemia and potentially organ dysfunction. ARDS develops suddenly and commonly affects hospitalized patients with preexisting conditions due to direct lung injury or indirect systemic inflammation. It progresses through exudative, proliferative, and fibrotic phases, causing increased stiffness and damage to lung tissue over time. Treatment focuses on mechanical ventilation with PEEP to reinflate lungs and prevent further collapse, as well as managing complications. The goal is to improve oxygen levels and prevent additional organ problems.
Pulmonary edema is fluid accumulation in the lungs caused by fluid leaking from blood vessels into the lung tissue and air spaces. It can be caused by issues that increase pressure in the blood vessels of the lungs like heart failure, or by problems that damage the blood vessel walls. Symptoms include shortness of breath, cough, and anxiety. Treatment depends on the underlying cause but aims to reduce fluid buildup and support breathing. Differentiating cardiogenic from non-cardiogenic pulmonary edema involves considering medical history, symptoms, physical exam findings, and chest imaging results.
Pulmonary edema occurs when fluid accumulates in the lungs, impairing gas exchange and potentially causing respiratory failure. It can be cardiogenic, due to left ventricular failure reducing blood flow from the lungs, or non-cardiogenic, such as from injury to the lung tissue. Treatment focuses on improving respiration, treating the underlying cause, and preventing further lung damage, using supportive therapies like oxygen along with diuretics, morphine, nitrates, and positioning the patient upright.
Cor pulmonale is a condition where the right ventricle of the heart enlarges and fails due to high blood pressure in the pulmonary arteries, usually caused by long-term lung diseases that reduce oxygen levels. It most commonly results from chronic obstructive pulmonary disease (COPD). Symptoms include shortness of breath, swelling, and chest pain. Diagnosis involves physical exam, imaging, blood tests, and right heart catheterization. Treatment focuses on improving oxygen levels, reducing pulmonary pressures, and managing the underlying lung condition.
Non invasive ventilation in cardiogenic pulmonary edemaSamiaa Sadek
Cardiogenic pulmonary edema (CPE) is caused by increased hydrostatic pressure in the pulmonary capillaries due to elevated left atrial pressure. This imbalance in hydrostatic and oncotic pressures across the capillary membrane leads to fluid filtration into the lungs. CPE progresses through three stages as fluid accumulates first in the lung interstitium then alveoli, impairing gas exchange. Treatment aims to reduce preload and afterload on the heart along with diuresis. Noninvasive ventilation with CPAP or BiPAP improves oxygenation and reduces workload of breathing by increasing lung volume while also decreasing cardiac preload and afterload.
Cor pulmonale is a condition where the right ventricle of the heart enlarges and fails due to long-standing increased workload from diseases that affect the lungs like COPD. It is defined as hypertrophy and dilation of the right ventricle resulting from increased pulmonary vascular resistance. The main causes are chronic hypoxemia and pulmonary thromboembolism which lead to remodeling of the pulmonary arteries and increased pressure in the lungs. Over time, this puts strain on the right ventricle and can cause it to fail. Treatment focuses on reducing pulmonary pressures through oxygen therapy and vasodilators while managing symptoms of right heart failure.
The document discusses breathlessness/dyspnoea by defining it, describing its pathophysiology, types, differential diagnosis, clinical assessment, investigations, and treatment. Breathlessness has no defined receptors or localized brain representation and can be caused by health issues like exercise or diseases of the lungs, heart, or muscles. Its assessment considers consciousness, cyanosis, breathing efforts, oxygenation, speech, and cardiovascular status. Investigations may include chest X-rays, ECGs, blood gases, and tests to identify specific causes, while treatment depends on the initial diagnosis.
This document provides definitions and information about different types of dyspnea (shortness of breath). It discusses the pathophysiology and various causes of dyspnea like asthma, COPD, cardiac failure, pulmonary embolism. The document describes how to take history and examine patients presenting with dyspnea. It outlines investigations like chest imaging and laboratory tests. Differential diagnoses are provided for acute and chronic dyspnea. Management strategies for emergencies and exacerbations of conditions like asthma and COPD are briefly covered.
Pulmonary embolism occurs when a blood clot blocks an artery in the lungs, usually originating from deep vein thrombosis. Symptoms range from sudden shortness of breath to chest pain. Diagnosis involves tests like CT scans, V/Q scans, echocardiograms and blood tests. Treatment consists of oxygen, anticoagulant drugs, and sometimes fibrinolytics for massive clots. Long term prevention focuses on continued anticoagulation and devices like IVC filters for recurrent embolisms despite treatment.
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تم تحميل هذا الملف من
منتديات تمريض مستشفى غزة الاوروبي
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لتحميل اجمل واروع المحاضرات فقط قم بزيارتنا وسوف تكون من الاوائل
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تم تحميل هذا الملف من
منتديات تمريض مستشفى غزة الاوروبي
http://egh-nsg.forumpalestine.com/
لتحميل اجمل واروع المحاضرات فقط قم بزيارتنا وسوف تكون من الاوائل
مع تحيات المدير العام
علاء شعت
تم تحميل هذا الملف من
منتديات تمريض مستشفى غزة الاوروبي
http://egh-nsg.forumpalestine.com/
لتحميل اجمل واروع المحاضرات فقط قم بزيارتنا وسوف تكون من الاوائل
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5. 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.
6. 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
8. 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.
10. 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
11. 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.
12. 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
13. 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.
14. 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.