Can be used for medical surgical nursing 1

1. PULMONARY EDEMA
Definition
Is a condition characterized by accumulation of fluid
in the interstitial spaces

2. SIGN AND SYMPTOMS
1.Dyspnea
2.Tachypnea
3.shortness of breath
4.coughing
5.wheezing

3. Causes
• 1.increased hydrostatic pressure secondary to heart
failure
• 2.increased capillary permeability…fluid and protein
leaks out to the interstitial spaces of the lung….
pneumonia
• 3.dedcreased oncotic pressure due to reduction in
albumin
• 4.kidney failure. Fluid retention due to inability of the
kidney to regulate electrolytes and fluid balance
• 5.excessive iv fluid administration

4. Pathogenesis
• Pulmonary edema occurs as a result of disruption
in the balance of fluid movement across the
pulmonary capillary into the lung tissue caused by
factors like congestive heart failure leading to
increased hydrostatic pressure or fluid overload
state, increased capillary permeability allow
substances to leak out, low level of albumin causes
reduced oncotic pressure, all this mechanism leads
to accumulation of fluid in the alveoli and
interstitial of the lungs

5. DIAGNOSIS
• Chest x ray for septal lines thickening of inner lobar
fissures.
• Medical history about heart or kidney diseases
• Physical examination.auscultation for crackles
• ECG.indicate heart problem
• Blood test.ie level of creatinine
• Arterial blood gas to assesses severity of hypoxia

6. Complications
• 1.cardiogenic shock
• 2.respiratory failure
• 3.hypoxemia
• 4.arrythmias
• 5.acute respiratory distress syndrom

7. Nursing management
• 1.vital signs monitoring i.e. oxygen saturation
• 2 monitor oxygen saturation closely
• 3.Positioning the client in semi or high fowlers
• 4.monitor fluid intake and output
• 5.patient education to adhere to medication

8. Medical management
• 1.treatment of underlying condition i.e. heart
failure dobutamine
• 2.oxygen therapy
• 3.diuretics i.e. furosemide
• 4.vasodilators. nitroglycerin to reduce fluid
overload
• 5.morphine administered to reduce anxiety
• 6.mechanical ventilation i.e. use of endotracheal
tube

9. POSSIBLE NURSING DIAGNOSIS
• 1. Impaired gaseous exchange related to fluid
accumulation in the alveoli as evidenced by
dyspnea
• 2 Decresed cardiac output related to increased
pulmonary vascular resistance and impaired cardiac
output as evidenced by paleness in the skin
• 3.anxiety related to dyspnea, fear of suffocation