Pulmonary edema

pulmonary edema ppt

1. Pulmonary Edema PREPARED BY : ANISH THAVASIMUTHU (B Sc Nursing ) TAMIL NADU Dr.M.G.R University

2. Anatomy of lung

3. DEFINITION Pulmonary edema is an abnormal buildup of fluid in the lungs. This build up of fluid leads to shortness of breath.

4. CAUSES Congestive cardiac failure Heart attack, Cardiomyopathy Leaking or narrowed heart valves (mitral or aortic valves) Sudden, severe high blood pressure. Certain medicines High altitude exposure Kidney failure Narrowed arteries that bring blood to the kidneys Lung damage caused by poisonous gas or severe infection Major injury

5. Symptoms Coughing up blood or bloody froth Orthopnea paroxysmal nocturnal dyspnea Grunting , gurgling, or wheezing sounds with breathing Problems speaking in full sentences because of shortness of breath Anxiety or restlessness Decrease in level of consciousness Leg or abdominal swelling Pale skin Excessive Sweating

6. Examinations The health care provider will listen to your lungs and heart with a stethoscope to check for: Abnormal heart sound Crackles  in your lungs, called rales Increased heart rate (tachycardia) Rapid breathing (tachypnea) The health care provider will perform a thorough physical exam. Leg or abdominal swelling Abnormalities of your neck veins (which can show that there is too much fluid in your body) Pale or blue skin color (pallor or cyanosis )

7. Diagnostic test Blood chemistries Blood oxygen levels( oximetry or arterial blood gases) Chest x-ray Complete blood count (CBC) Echocardiogram (ultrasound of the heart) to see if there are problems with the heart muscle Electrocardiogram ( ECG ) to look for signs of a heart attack or problems with the heart rhythm

8. Treatment Pulmonary edema is almost always treated in the emergency room or hospital. You may need to be in an intensive care unit (ICU). Oxygen is given through a face mask or tiny plastic tubes are placed in the nose. A breathing tube may be placed into the windpipe (trachea) so you can be connected to a breathing machine (ventilator) if you cannot breathe well on your own. The cause of edema should be identified and treated quickly. For example, if a heart attack has caused the condition, it must be treated right away. Medicines that may be used include: Diuretics that remove excess fluid from the body Medicines that strengthen the heart muscle, control the heartbeat, or relieve pressure on the heart .

9. pharmacological management Morphine : reduce anxiety Diuretic therapy : reduce fluid overload and pulmonary congestion Vasodialator therapy ( nitroglycerine) : reduce the amount of blood returning to the heart and reduces resistance heart must pump. Contractility enhancement therapy: ( Digoxin,dopamine , dobutamine ) Improves the , ability of the heart muscle to pump more effectively, allowing for complete emptying of blood from left ventricle and a subsequent decrease in fluid backing up in to the lungs. Aminophylline : Prevent bronchospasm associated with pulmonary congestion .

10. Initial nursing care Supplimental oxygen with face mask Elevate the head side and keep sitting posture Monitor vital signs Iv line Catheterization Cardiac monitoring Ecg Pulse oxymetry

11. Nursing care Help the patient relax to promote oxygenation. Place the patient in high Fowler’s position to enhance lung expansion. Administer oxygen as ordered. Carefully record the time morphine is given and the amount administered. Assess the patient’s condition frequently. Watch for complications of treatment such as electrolyte depletion. Monitor vital signs every 15 to 30 minutes or more often as indicated. Urge the patient to comply with the prescribed medication regimen to avoid future episodes of pulmonary edema. Explain all procedure to the patient and his family. Emphasize reporting early signs of fluid overload. Review all prescribed medications with the patient. Discuss ways to observe physical energy.

12. complication Dysrrythmias Respiratory failure