Pulmonary_Conditions for nursing students

Medical

1. Cor Pulmonale Definition: Cor pulmonale is right ventricular hypertrophy and failure due to pulmonary hypertension caused by chronic lung diseases.

2. Etiology • Chronic obstructive pulmonary disease (COPD) • Pulmonary hypertension • Interstitial lung diseases • Obstructive sleep apnea • Chronic pulmonary embolism

3. Pathophysiology • Chronic lung disease leads to hypoxia and vasoconstriction. • Increased pulmonary vascular resistance causes right ventricular hypertrophy. • Eventually, right heart failure occurs.

4. Signs and Symptoms • Dyspnea on exertion • Fatigue • Peripheral edema • Jugular venous distension (JVD) • Ascites • Hepatomegaly

5. Medical Management • Oxygen therapy (2-4 L/min via nasal cannula) • Diuretics (Furosemide 20-80 mg IV/PO) • Vasodilators (Sildenafil 20 mg PO TID) • Inotropic agents (Digoxin 0.125-0.25 mg PO daily)

6. Nursing Interventions • Monitor oxygen saturation and administer oxygen as prescribed. • Assess for fluid overload and monitor daily weight. • Educate patient on low-sodium diet and fluid restriction. • Encourage smoking cessation.

7. Surgical Intervention • Lung transplant in severe cases • Pulmonary thromboendarterectomy (for chronic thromboembolic disease)

8. Complications • Right heart failure • Arrhythmias • Severe hypoxemia

9. Prevention • Manage underlying lung disease • Avoid smoking • Regular pulmonary rehabilitation

10. Pulmonary Embolism Definition: Pulmonary embolism (PE) is a blockage of the pulmonary artery by a thrombus, air, fat, or amniotic fluid.

11. Etiology • Deep vein thrombosis (DVT) • Hypercoagulable states (e.g., cancer, pregnancy) • Prolonged immobility • Post-surgical complications • Trauma

12. Pathophysiology • A thrombus dislodges and travels to the pulmonary arteries. • It obstructs blood flow, leading to ventilation-perfusion mismatch. • Hypoxia and increased pulmonary vascular resistance occur, possibly leading to shock.

13. Signs and Symptoms • Sudden dyspnea • Chest pain (pleuritic) • Hemoptysis • Tachypnea • Tachycardia • Hypotension (in massive PE)

14. Medical Management • Anticoagulants (Heparin IV 5000 units bolus, then 1000 units/hr) • Thrombolytics (Alteplase 100 mg IV over 2 hours) • Oxygen therapy (as needed to maintain SpO2 >90%) • Pain management (Morphine 2-4 mg IV PRN)

15. Surgical Intervention • Pulmonary embolectomy in life-threatening cases • Inferior vena cava (IVC) filter placement

16. Pulmonary Edema Definition: Pulmonary edema is the accumulation of fluid in the alveoli and interstitial spaces of the lungs, leading to impaired gas exchange.

17. Etiology • Left heart failure • Acute myocardial infarction • Hypertension crisis • Kidney failure • High-altitude exposure

18. Pathophysiology • Increased hydrostatic pressure in pulmonary capillaries causes fluid to leak into alveoli. • Gas exchange is impaired, leading to hypoxia. • Surfactant dilution further worsens lung compliance.

19. Signs and Symptoms • Severe dyspnea • Pink, frothy sputum • Crackles on auscultation • Hypoxemia • Orthopnea

20. Medical Management • Oxygen therapy (High-flow or CPAP if severe) • Diuretics (Furosemide 40 mg IV) • Vasodilators (Nitroglycerin 5 mcg/min IV, titrate as needed) • Morphine (2-4 mg IV for anxiety and vasodilation)

21. Prevention • Control blood pressure and heart disease • Monitor fluid balance in at-risk patients • Avoid excessive IV fluids in heart failure patients