Pulmonary edema

Presented by
Paulette Simms
and
Keneshia Stewart - Thompson
 definition
 Pulmonary edema also known as
Hypoxemic Respiratory Failure is an
abnormal accumulation of fluid in the lung
tissue, alveolar space or both. It is a
severe life threatening condition.
 etiology
 Pulmonary edema can be classified by its underlying
causes cardiogenic and non cardiogenic.
 Cardiogenic causes of pulmonary edema results from
high pressure in the blood vessels of the lung due to
poor heart function. Congestive heart failure due to
poor heart pumping function, heart attach, or abnormal
heart valves can lead to accumulation of more than the
usual amount of blood in the blood vessels of the lungs.
 Non cardiogenic causes of pulmonary edema can result
from kidney failure, trauma ,lung injury, inhalation of
toxins, lung infections, cocaine smoking, or radiation to
the lungs.
Pictures of pulmonary edema
Picture cont.
 Signs and symptoms.
 Symptoms of pulmonary edema may include:
 Coughing up blood or bloody froth
 Difficulty breathing when lying down .
 Feeling of "air hunger" or "drowning" (if this
feeling wakes you from sleep and causes you to
sit up and try to catch your breath, it's called
"paroxysmal nocturnal dyspnea")
 Grunting, gurgling, or wheezing sounds with
breathing
 Cont.
 Anxiety or restlessness
 Decrease in level of alertness (consciousness)
 Leg swelling
 Pale skin
 Sweating (excessive)
 shortness of breath
 pathophysiology
 Increase hydrostatic pressure in the
pulmonary vessels create an imbalance in the
starling forces resulting in an increase of fluid
filtration into the interstitial spaces of the lung
that exceeds the lymphatic capacity to drain
the fluid away, as capillary and interstitial
pressure increases further the tight junction of
the aveolar walls are disrupted and the fluid
enters the avioli along with RBC and protein.
 Cont.
 Ventilation and gas exchange are severely
disrupted and hypoxia worsens.
 Diagnostic test& treatment
Possible tests include:

 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 (such as weakness,
thickness, failure to relax properly, leaky or narrow heart
valves, or fluid surrounding the heart)
 Electrocardiogram (ECG) to look for signs of a heart
attack or problems with the heart rhythm
 Oxygen therapy
 Medication that may be prescribed eg.
diuretics, which remove excess fluids from
the body
 NURSING Management
 Nursing care of the client with pulmonary
edema focuses on relieving the pulmonary
effects of the disorder.
 Intervention should be directed towards
improving oxygenation, reducing fluid
volume and providing emotional support.
 The client is typically anxious and having
significant shortness of breath. Managing
the client’s anxiety and reducing the
dyspnea are imperative
 Nursing diagnosis
 Impaired gas exchange r/t Fluid in lungs
Evidence by shortness of breath and
oxygen saturation below 85%.
 Anxiety r/t sensation of suffocation and
fear
 Intervention & Rationale
 Monitor vital signs every 15 mints.R to get
a base line reading.
 Administer oxygen as ordered R To
promote gas exchange.
 Administer medication. R To reduce
cardiac work load and improve
contractibility.
 Place patient in high fowler’s position with
legs dangling. R this faclitate breathing
and decrease venous return.
 Cont,

Maintain accurate intake and output record.

 References
 www.health.nytimes.com/health/guides/disease
/pulmonary-edema/overview.html
 Black J,Hokanson Hawks.J, Medical surgical
nursing clinical managementfor positive
outcomes eighth edition, Saunders Elsevier
(evolve
 The end
 thank

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