This presentation discusses empyema thoracis, an infection where pus develops in the pleural space between the lungs and chest wall. It will cover the definition, pathogenesis, causes, signs and symptoms, diagnosis, treatment, complications, and nursing management of empyema thoracis. The objectives are to understand empyema thoracis, its pathogenesis and causes, signs and symptoms, diagnosis, treatment and nursing management, and complications. Empyema thoracis is usually caused by a bacterial pneumonia that leads to a parapneumonic pleural effusion progressing to pus in the pleural space in three stages. Treatment involves chest tube drainage of pus, antibiotics, thoracentesis, and possible ple

1. PRESENTATION TOPIC

2. PRESENTATION OUTLINE
o DEFINITION OF EMPYEMA THORACIC
o PATHOGENESIS
o CAUSES
o SIGNS AND SYMPTOMS
o DIAGNOSIS
o TREATMENT
o COMPLICATIONS
o NURSING MANAGEMENT

3. OBJECTIVES
At the end of the presentation, you must be able to know
about:
o EMPYEMA THORACIC
o PATHOGENESIS OF EMPYEMA THORACIC
o CAUSES OF EMPYEMA THORACIC
o SIGNS AND SYMPTOMS
o DIAGNOSIS
o TREATMENT AND NURSING MANAGEMENT
o COMPLICATIONS

4. DEFINTION OF EMPYEMA THORACIC
Empyema is an infection in which pus develops in your
pleural space. Pus is a thick, discolored (white,
yellow, pink or green) fluid that the body creates to
help fight infection. It consists of white blood
cells, dead tissue and bacteria.
Your pleural space is a hollow area (cavity) between
your lungs and underneath your chest wall.
Other names for empyema include pyothorax and
purulent pleuritis.

6. PATHOGENESIS
Pleural empyema is usually secondary to an infection at another site, most
often pulmonary. It occurs most commonly after infection of a para-
pneumonic pleural effusion, commonly present in bacteria pneumonia.
Progression of such an effusion to empyema is said to have a three stage
evolution.
Exudative stage: there’s an increase in pleural fluid with or without the
presence of pus.
Fibrinopurulent stage: when fibrous septa form localized pus pockets.
Organizing stage: there’s scarring of the pleural membranes with possible
inability of the lung to expand.
For more insight:
visit http://clevelandclinic.com

7. CAUSES
o TUBERCULOSIS
o LUNG CANCER
o CHEST SURGERY
o CHEST INJURIES OR TRAUMA
o BACTERIA PNEUMONIA
o LUNG ABSCESS

8. SIGNS AND SYMPTOMS
o DSYPNOEA
o DECREASED MOVEMENT OF THE CHEST WALL OF THE AFFECTED SIDE
o PLEURITIC PAIN
o DULLNESS TO PERCUSSION
o DECREASED BREATH SOUND
o FEVER
o WEIGHT LOSS
o NIGHT SWEAT
o COUGH
o CHEST PAIN

9. DIAGNOSIS
o PHYSICAL EXAMINATION
o CHEST X-RAY
o SPUTUM FOR AFB (ACID FAST BACILLUS TEST)
o THORACENTESIS
o CT-SCAN

10. TREATMENT
The goal of treatment is to cure the infection and remove
the collection of pus from the lung;
CHEST TUBE TO DRAIN FLUID
ANTIBIOTICS (Amoxicillin-clavulanate, Piperacillin-
tazobactam)
THORACENTESIS
PLEURODESIS DOXYCYCLINE AND TALE

11. COMPLICATIONS
o LUNG DAMAGE
o PLEURAL SCARRING
o RESPIRATORY FAILURE
o SEPSIS
o DEATH

12. NURSING MANAGEMENT
o MONITORING VITAL SIGNS
o LUNG-EXPANDING BREATHING EXERCISE
o CARE OF INTERCOSTAL CHEST DRAINAGE TUBE
o OBSERVATION OF DRAINAGE, SIGNS AND SYMPTOMS OF
INFECTION
o ADMINISTERING OXYGEN IF REQUIRED
o ENCOURAGE PATIENT TO HAVE ADEQUATE REST AND SLEEPS