Pulmonary Edema
-is a diffuse extravascular accumulation of
fluid in the pulmonary tissues and air sacs. -Excess water in the lungs
Etiologic Factors
Modifiable: Drugs Diet Physical activities Inhaled toxins Trauma Non-Modifiable: Age Aortic Valve Disease Diabetes CNS injury
Assessment:
Inspection Dyspnea, coughing, cyanosis, orthopnea, frothy blood sputum, diaphoresis Palpation Barely perceptible pulse (Thready pulse), cold, clammy skin
Assessment:
Percussion Dullness over lung bases Auscultation Tachycardia, Diffuse Rales, decrease Blood Pressure
Diagnostic & Laboratory Test Findings
Arterial Blood Gas (PaCO2 ) Chest X-ray (Pulmonary vascular Redistribution, interstitial markings) Pulmonary Artery Catheterization ( Confirmation) ECG & Echocardiogram (Cardiac Abnormality)
Pathophysiology & Complications
Inhalation of Toxic Gases (Ammonia)
) Capillary Injury capillary permeability H2 O & Plasma Leak
Edema/ Tumor Compression of Lymphatic System
Heart Disease
(L) Ventricle fails
(L) Atrial Pressure
Obstruction of the lymphatic System
Alveoli
Backflow of Blood to the Lungs
Amount of Fluid exceeds lymphatic systems ability to remove it
Pulmonary Capillary Hydrostatic Pressure
Fluid Move to Interstitial Space
Pulmonary Edema
Hydrostatic Pressure exceeds Oncotic Pressure
Nursing Diagnosis
Impaired Gas Exchange Anxiety Risk for Impaired Spontaneous Ventilation
Treatment
Medical Management Laboratory Examinations Diagnostic Test
Pharmacological Management
Diuretics (intravenous)- Furosemide, 40mg or bumetanide, 1mg Vasodilators ( IV nitropusside) Digitalis (Digoxin)- stimulate heart action, heart muscle contractility Bronchodilators Supplemental Oxygen Morphine- venous capacitance, lowering left atrial pressure, relieves anxiety ( initial dose: 4-8 mg IV/ Subcutaneous , may repeat after2 -3 hours
Nursing Management
Position patient in sitting position with legs dangling/ Semi Fowlers position (Facilitate respiration & reduces venous return) Assist with Mechanical Ventilation Assist in administration of Medications Monitoring of O2 and Arterial Blood Gases Monitoring of Clients Respiratory status Instruct client to Reduce Fluid Intake
Client Education
may be able to lower your risk of pulmonary edema by Eating a diet that is low in sodium, saturated fat, trans fat, and Cholesterol Participating in a regular exercise program Quitting smoking Regular Check-up
Thank You!