Professional Documents
Culture Documents
By:
Christopher Ekpo
CSON-COHS
UTECH
Necrosisof the pulmonary tissue and
formation of cavities containing necrotic
debris or fluid.
Athick-walled abscess, courtesy,
emedicine.com
The formation of multiple small (< 2 cm)
abscesses is occasionally referred to as
necrotizing pneumonia or lung gangrene.
Both lung abscess and necrotizing
pneumonia are manifestations of a
similar pathologic process
(Kamangar, 2009).
A male predominance for lung abscess is
reported in published case series.
Occur more commonly in elderly
patients.
A case series from an urban centre with
high prevalence of alcoholism reported a
mean age of 41 years.
Mostpatients with primary lung abscess
improve with antibiotics, with cure rates
documented at 90-95%.
Hostfactors associated with a poor
prognosis include advanced age,
debilitation, malnutrition, human
immunodeficiency virus infection or other
forms of immunosuppression, malignancy,
and duration of symptoms greater than 8
weeks
Bronchiectasis,
Lung cancer,
Lung infarction,
Pulmonary embolism,
Sarcoidosis.
Alcoholism
Seizure disorders,
Stroke,
Drug overdose,
General anaesthesia,
Neuromuscular diseases.
Others are: periodontal disease,
dysphagia
Most frequently, the lung abscess arises
as a complication of aspiration
pneumonia caused by mouth anaerobes.
Generally, patients
with in lung abscess
have evidence of gingival disease.
Clinical
findings of concomitant
consolidation may be present (eg,
decreased breath sounds, dullness to
percussion, bronchial breath sounds,
coarse inspiratory crackles).
Assessment cont’d.
Evidence of pleural friction rub and signs
of associated pleural effusion, empyema,
and pyopneumothorax may be present.
Signs include dullness to percussion,
contralateral shift of the mediastinum,
and absent breath sounds over the
effusion.
Digital clubbing may develop rapidly.
Review laboratory & Xray findings.
Interventions:
Position client for comfort.
Monitor vital signs.
Administer medications as ordered by
the physician- antimicrobials, analgesics
etc.
Perform oral hygiene.
Encourage rest and limitation of physical
activity during febrile periods.
Monitor chest tube functioning if in place.
Carry out drainage procedures to hasten
resolution.
Measure and record the volume of sputum.
Evaluate for signs of hypoxia.
Provide high protein and high calorie diet.
Monitor weight weekly.
Adequate fluid intake if not contraindicated.
Haemoptysis.
Empyema.
Bronchopleural fistula.
Pleuralfibrosis
Respiratory failure
NEEDS/DIAGNOSES
OXYGEN
Ineffective breathing pattern RT.
presence of suppuration AEB dyspnoea,
mucopurulent, foul-smelling sputum.
RCA
Activity intolerance RT. imbalance
between oxygen supply and demand
AEB dyspnoea, verbalization of
weakness,etc.
Assignment
Identify the needs and formulate
appropriate nursing diagnoses.
List the interventions/ rationale
Chalkboard illustration required
involve learners here
Hirshberg, B., Sklair-Levi, M., Nir-Paz, R.,
Ben-Sira, L., Krivoruk, V &
Kramer, M.(1999).
Factors predicting mortality of patients
with lung abscess. Chest,115,(3),746-50
Kamangar, N.(2009). Lung Abscess.
Retrieved from:
http://www.emedicine.medscape.com/ar
ticle/299425
Mwandumba, H.& Beeching, N.(2000).
Pyogenic lung infections: factors for
predicting clinical outcome of lung
abscess and thoracic empyema.
Curr Opin Pulm Med.6,(3),234-9
Pohlson, E., McNamara, J., Char, C.&
Kurata, L. (1985).Lung abscess: a
changing pattern of the disease.
Am J Surg. 150,(1),97-101.