pleuritis and it treatment nursing management .pptx

pleuritis

1. PLEU R ITIS Presented by- Mrs. Khushnasib Associate Professor

2. Introduction Pleurisy (pleuritis) refers to inflammation of both layers of the pleurae ( parietal and visceral) Pleurisy is inflammation of the pleura covering the lungs and the chest wall

3. Causes of pleurisy Pneumonia (bacterial, viral) TB Pulmonary infarction, embolism Pulmonary abscess Upper respiratory tract infection Pulmonary neoplasm trauma to the chest wall after thoracotomy procedure

4. Pathophysiology Infection/ inflammation/trauma ( causative factors) Inflammation of pleura Irritate the sensory fibers of the parietal pleura During respiration ( intensified on inspiration), the pleural membrane rub together the result is severe, sharp, knifelike pain.

5. Clinical Manifestations Chest pain becomes severe, sharp, and knifelike on inspiration (pleuritic pain) May become minimal or absent when breath is held May be localized or radiate to shoulder or abdomen Intercostal tenderness on palpation. Pleural friction rub grating or leathery sounds heard in both phases of respiration; heard low in the axilla or over the lung base posteriorly; may be heard for only a day or so Evidence of infection; fever, malaise, increased white cell count

6. Diagnostic Evaluation Chest X-ray may show pleural thickening. Sputum examination may indicate infectious organism. Examination of pleural fluid obtained by thoracentesis for smear and culture . Pleural biopsy may be necessary to rule out other conditions.

7. Management (pneumonia, infarction); inflammation usually resolves when the primary disease subsides Prescribed analgesics and topical applications of heat or cold for symptomatic relief of pain T h e underlying cause and to relieve the pain . obj e ctiv es o f tr e at me n t a r e t o dis c o v er th e T reat m e n t fo r th e und e r lyi ng pri ma r y dis e as e Indo me th a ci n inflammatory drug (NSAID), (Indo c i n) , a nonst e r o i d al a n t i -

8. If the pain is severe, an intercostal nerve block may be required.

9. Complications Severe pleural effusion. Atelectasis due to shallow breathing to avoid pain

10. N u r si n g A s s e ss m e n t Ineffective Breathing Pattern related to stabbing chest pain

11. Easing Painful Respiration Assist patient to find comfortable position that will promote respiration; lying on affected side decreases stretching of the pleura and, therefore, the pain decreases. Instruct patient in splinting chest while taking a deep breath or coughing. Administer or teach self-administration of pain medications as ordered. Employ nonpharmacologic interventions for pain relief, such as application of heat, muscle relaxation, and imagery. Assist with intercostal nerve block if indicated.

12. Evaluate patient for signs of hypoxia thoroughly when anxiety, restlessness, and agitation of new onset are noted, before administering as needed sedatives. Consider evaluation by a health care provider when these signs are present, especially if accompanied by cyanotic nail beds, circumoral pallor, and increased respiratory rate.

13. Evaluation: Expected Outcomes Respirations deep without pain

14. Thank You