COPD MEDICAL SURGICAL NURSING presentation.pptx

BSC NURSING

1. Basic presentation PREPARED BY MR.JITENDRA BHARGAV

2. I NTRODUCTION:- Pleural effusion occurs when too much fluid collects in the pleural space (the space between the two layers of the pleura). It is commonly known as "water on the lungs." It is characterized by shortness of breath, chest pain, gastric discom- fort (dyspepsia) and cough

3. Pleural effusion is an accumulation of fluid in the pleural space. It may be transudate (serous) or exudate. OR Pleural effusion is a condition which is characterized by build up of fluid in the space betwwn the lungs and chest cavity OR प्लुरिसी या pleuritis का अर्थ है - दोनो प्लुरल मेम्ब्रेन का inflamed / संक्रमित होना। फेफड़ों को चारो ओर से प्लुरा मेम्ब्रेन covering रहती है। इस प्लुरल मेम्ब्रेन ( pleural membrane DEFINITION:-

4. Depend on the type of fluid accumulated 1. Hydrothorax - Serous fluid 2. Haemothorax - blood 3. Pyothorax - pus (empyema) 4. Pneumothorax - Air

5. E TIOLOGY/CAUSES:- Transudative - watery fluid exudative - protein rich fluid OTHER Heart failure पेट में पानी भरना ( Ascites) यकृत संबंधी प्रवाह ( Hepatic disease) रक्त कैंसर ( Blood cancer) सीने में चोट लगना ( Chest trauma) एम्फाइमा ( Empyema) आदि। फेफड़ों में घाव ( lung abscess) Pneumonia. Tuberculosis Nephrotic syndrome Connective tissue disease Pulmonary embolism Neoplastic tumor (cancer) Liver cirrhosis Renal failure Auto immune disease- RA, lupus Ruptured esophagus Pulmonary infarction

6. सीने में दर्द ( Chest pain) साँस लेने में तकलीफ ( Dsypenoea ) साँस लेने में फेफड़ों में घरघराहट होना ( Pulmonary crackles) खून में कमी ( Anemia) भूख न लगना ( Anorexia) वजन घटना ( Weight loss) बुखार, थकान, कमजोरी ( Fever, fatigue, weakness) Enhancing your presentation S IGN AND SYMPTOM’S:-

7. DIAGNOSTIC EVALUATION:- Chest X-ray Physical Examination :- decrease chest movement of affected side dull sound on percussion reduce breath sound pleural friction rub - rough, scratching sound C.T.Scan Pleural fluid tapping LDL examination Protein level Sputum examination

8. PATHOPHYSIOLOGY:- Due to etiology factor ↓ Increased pressure in pulmonary capillary ↓ Increased amount of fluid enter the interstitial space of lungs ↓ Increased interstitial pressure in interstitial space

9. COMPLICATIONS:- Emphysema Respiratory failure Lung damage Tuberculosis Jaundice Death

10. M EDICAL MANAGEMENT:- Antibiotics to kill bacteria Diuretics - remove extra water from body NSAID - to reduce fever and pain Intercostal drainage (Thoracentesis) Tube Thoracostomy:-large quantity of fluid by inserting a tube in the pleural space

11. S URGICAL MANAGEMENT:- Thoracotomy:- make incision in the chest and drain Pleurodesis :- inject irritating substance into the pleural space which inflame the pleura and chest wall which then bind tightly to each other as they heal Pleural decortication :- removing inflammed and unhealthy tissue through a small cut in chest.

12. N URSING MANAGEMENT:- Pt को समय पर medicine दी जानी चाहिये। Pt की proper position होनी चाहिये ताकि प्रभावित प्लूरल मेम्ब्रेन में तनाव न हो। Pain killer देनी चाहिये ताकि pain कम हो। PT को खासते समय अपने हाथों को या तकिये द्वारा rib cage पर दबाव बनाये रखने की सलाह Pain killer के पश्चात् patient को deep breathing .exercise तथा खांसी करने हुत प्रेरित करे ताकि mucus secretion को airways से हटने में सहायता हो। PT को खांसी के उपचार हेतु antitussives प्रदान करें Pt को high Fowler position provide करे ताकि patient को breath लेने में आसानी हो। Pt को thoracentesis procedure हेतु physical and mental रूप से तैयार करे । Pt के respiratory status को प्रति 4 hours में monitor करे । Pt को breath लेते समय chest को support देना ( splinting) सिखाये ताकि pleuritic pain कम हो।

13. Thank you PREPARED BY MR.JITENDRA BHARGAV