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!