Pulmonary edema is a common condition seen in the hospital by respiratory care practitioners. It is important for respiratory care practitioners to have an understanding of the condition itself, along with the skill set to quickly recognize pulmonary edema. It is also important for respiratory care practitioners to stay current on the most effective treatment options available for patients with pulmonary edema. Pulmonary edema is a condition which results from excess fluid in the lungs. This excess fluid then accumulates in the interstitial tissue and the alveoli. This is an issue because the fluid in the alveoli impairs the gas exchange of oxygen and carbon dioxide which takes place between the alveolar-capillary membrane; impairment …show more content…
According to the Mayo Clinic (2014), cardiogenic pulmonary edema results from elevated pressures within the heart. Pulmonary edema can result when pulmonary venous pressures exceed 25-28 mmHg (Balachandran, 2014). These elevated pressures can lead to pulmonary edema as fluid that is not effectively pumped out into the body becomes backed up and is forced through the capillaries and into the alveoli. Cardiogenic pulmonary edema typically occurs when the left ventricle becomes unable to efficiently pump received blood to the rest of the body. Common causes of cardiogenic pulmonary edema include: “coronary artery disease, cardiomyopathy, heart valve problems, and uncontrolled high blood pressure” (Mayo Clinic, …show more content…
The narrowing of these arteries can lead to weakening of the left ventricle due to the increased workload; eventually the left ventricle cannot effectively pump, resulting in blood backing up into the lungs. The fluid is then forced into the blood, through the capillaries and into the alveoli; this is known as congestive heart failure (Mayo Clinic, 2014). Another cause of cardiogenic pulmonary edema is cardiomyopathy. Cardiomyopathy also causes a weakening in the ventricles. Unlike coronary artery disease which is a result of the narrowing of the arteries, cardiomyopathy is caused by damage to the cardiac muscle (Mayo Clinic, 2014). This damage can make the heart unable to properly handle sudden demands such as increased heart rate, blood pressure, infection or water retention (Mayo Clinic, 2014). When the heart is unable to handle these sudden demands, fluid backs up into the lungs and collects in the alveolar sacs. A third cause of cardiogenic pulmonary edema is heart valve
Al Waysmoking was a 72 year-old retired factory worker who was a chain smoker. He is experiencing fatigue, shortness of breath, but continues to smoke. Upon exam his Nurse Practitioner notes that he has a prolonged expiratory phase, expiratory wheezes, and an increased anteroposterior chest diameter. His nail beds were cyanotic and he had moderate pitting edema. Pulmonary Function Testing (PFT) revealed that Al had a decreased VC and an increased RV and FRC.
Pathophysiology When Pulmonary Stenosis is present, resistant to blood flow cause right ventricular hypertrophy – right atrial pressure will increase – reopening of the foramen ovale, shunting of unoxygenated blood into the left atrium, systemic circulation. Clinical manifestation: Cyanosis, characteristic murmur , cardiomegaly . Treatment: Baloon angioplasty (neonate).
Cardiomyopathy can occur from the lack of dystrophin on the heart muscles. Cardiomyopathy makes it difficult for the patient to breathe. The heart becomes weak and swollen. It is not able to pump enough blood throughout the body, which will cause life-threatening results.
Damaged heart valves, toxic exposure, such as alcohol, prolonged arrhythmias, and infections are all other causes
By decreasing atelectasis, this decrease ventilation perfusion gap and increases gas exchange move pulmonary secretions, Increase lung compliance, Manual hyperinflation may be showed in patients demanding mechanical ventilation and self-ventilating tracheostomy patients who have Chest x-ray alter the lung collapse and consolidation or by areas which are less ventilated on auscultation. The capability to monitor patients’ response (Heart rate, blood pressure and oxygen saturations) is essential. Manual hyperinflation can reduce respiratory drive by decreasing the partial pressure of carbon dioxide in arterial blood (PaCO2) this is an significant concern in treatment of subject with chronic obstructive pulmonary disease [1] In monitoring units physiotherapists deal with intubated patients normally with lung collapse, it is seen that furthermost of the patients went for bronchoscopy technique to expand the lung. Pulmonologists are going for bronchoscopy which is very expensive procedure and having risks of bleeding and infection.
Pulmonary edema or congestion happens when the left ventricle of the heart fails. This is simply because the inefficiency of its ventricle to pump effectively causes the blood to back up to the pulmonary capillaries as the pulmonary venous blood rises its pressure into the tissues and alveoli impairing the gas exchange. Pulmonary congestion will be manifested in crackles, difficulty of breathing, frothy pink-tinged sputum and shortness of breath. In addition, the decreased amount of blood ejected from the left side causes ineffective tissue perfusion. This is detrimental to other vital organs such as the kidneys.
As a result, these patients can’t bring the carbon dioxide out, they become retain the carbon dioxide which makes it so hard for them to breathe
Patients with existing heart disease are at higher risk of ADHF, causing dyspnea, edema, and fatigue, which can lead
Blood will flow from the left ventricle into the right ventricle with this particular defect. The defect causes increased blood flow into the lungs and can eventually result in pulmonary hypertension. Pulmonary hypertension will causes damage to the small blood vessels in lungs progressively through time. This is known as pulmonary vascular disease. As the damage progresses, pulmonary hypertension will increase and the small blood vessels become thickened and blocked affecting the flow of blood.
Causes and symptoms Shock is caused by three major categories of problems: cardiogenic (meaning problems associated with the heart 's functioning); hypovolemic (meaning that the total volume of blood available to circulate is low); and septic shock (caused by overwhelming infection, usually by bacteria). Cardiogenic shock can be caused by any disease, or event, which prevents the heart muscle from pumping strongly and consistently enough to circulate the blood normally. Heart attack, conditions which cause inflammation of the heart muscle (myocarditis), disturbances of the electrical rhythm of the heart, any kind of mass or fluid accumulation and/or blood clot which interferes with flow out of the heart can all significantly affect the heart 's ability to adequately pump a normal quantity of blood.
When the blood supply thickness increases the muscle itself may become inadequate. This means that your heart has to work harder to push blood round your body. To cope with this extra effort, your heart muscles become thicker and stiffer, which can make the heart, become enlarged. An enlarged heart will not pump as well as it should, and this can cause you complications. In particular, an enlarged heart is a common cause of heart
causes of peripheral edema in patients with heart failure are related to compensatory changes that influence hydrostatic pressure and fluid retention? (Cooper 2011). Input and Output need to be monitored ? accurate measuring for intake and output is important for the client with fluid overload.? (Metheny 2010).
Impaired gas exchange is a nursing diagnosis for a patient suffering current or future problems with oxygen/carbon dioxide balance (unknown, 2012). Gas exchange is the passage of oxygen and carbon dioxide in opposite directions across the alveolocapillary membrane (Miller-Keane, 2003). With impaired gas exchange a patient can have an excess or deficit in oxygenation and/or carbon dioxide elimination at the alveolar-capillary membrane (Gulanick & Myers 2014). The structure and organization of the lung is meant to maximize its surface area to increase gas diffusion. Having such a large surface area increases the amount of gas that can diffuse into and out of the lungs.
Myocardial Infarction which is another word for Heart-attack. When you have an heart-attack your blood is not getting to your heart's muscle. This means your arteries are clogged. Blood is pumped through your arteries to all of the parts in your body. If you have a heart condition you shouldn't smoke, you should diet and exercise, you should watch your Blood Pressure if you have to take medication for your Blood Pressure make sure you take the prescribed medication.
As the right side of the heart pumps oxygen-deprived blood along the pulmonary arteries to the lungs, blood loses carbon dioxide and collects oxygen in the lungs (Rogers, 66). "The pulmonary veins open into the left atrium of the heart," recalls Rogers (66). This is pulmonary circulation. When the left side of the heart pumps blood along the aorta and around every part of the body, it takes oxygen to the tissues where it is needed and collects nutrients and waste products (Rogers, 67). This is circulation is called the systematic circulation.