Pulmonary Edema Flashcards
Define pulmonary edema
the accumulation of fluid within the alveolar space; not a direct consequence of primary pulmonary Dz, but rather a secondary condition
Pulmonary Edema vs Pleural Effusion
Location: alveolar space (pulmonary edema) vs pleural space (pleural effusion)
Where fluid comes from: interstitial space (pulmonary edema) vs interstitial or other (pleural effusion)
How is a “dry” alveolus maintained?
Interaction between pulmonary circulation and pulmonary lymphatic system maintains a slight negative pressure in the pulmonary interstitium (space between the cells and alveolar wall) –> this acts as a vacuum to suck any fluid that leaks into the alveolar space out of the alveoli –> extra fluid carried away via lymphatic vessels or absorbed by blood vessels
Common clinical signs of Pulmonary Edema (list them)
Dyspnea w/ Tachypnea & Increased Respiratory Effort
Exercise Intolerance
Crackling Sounds
+/- Cough
Why do P with pulmonary edema have dyspnea, tachypnea, and increased respiratory effort?
P having trouble breathing due to fluid in the alveoli that’s displacing the gas exchange in the alveolar space, so P is trying to compensate by breathing harder
Why doe P with pulmonary edema exhibit exercise intolerance
If P having trouble breathing, P is not likely to be active
If a cough happens to be present with pulmonary edema, what does it sound like?
moist sounding cough, but mostly non-productive
Name the 2 types of pulmonary edema
cardiogenic
non-cardiogenic
What is cardiogenic edema?
occurs when cardiac Dz leads to increased pressure within the pulmonary vasculature and subsequently changes the pressure within the interstitium to positive pressure
What is non-cardiogenic edema?
occurs when something other than heart Dz changes the interstitial pressure or overwhelms the lymphatic system
ie) airway obstruction, neurogenic (seizure) edema
What does a thoracic rad typically show if pulmonary edema is present?
indistinct radiopaque areas in the lung field
What medication can be used with pulmonary edema? How does it work?
Furosemide
decreases the overall blood volume which decreases the pressure within the circulatory system –> allows for movement of fluid accumulating within the alveoli to travel back in to the circulatory system
Other therapies that can be used with pulmonary edema
- O2 therapy
- ventilation therapy if severe; for long term care, place a temporary tracheotomy tube
