Week 2 - Pleural Effusion/Pulmonary Edema

Question 1

what is pulmonary edema

Answer 1

• abnormal accumulation of fluid in the alveoli & iterstitial space of the lungs

Question 2

how does a pulmonary edema happen

Answer 2

• due to increase hydrostatic pressure or decreased oncotic pressure causes fluid to leave the capillaries & enter the interstitial space
• fluid eventually enters the alveoli

Question 3

what is the impact of pulmonary edema

Answer 3

• interferes w gas exchange

Question 4

what is the most common cause of pulmonary edema

Answer 4

• left sided heart hailure

Question 5

what else can cause pulmonary edema (2)

Answer 5

• hypoalbuminemia from liver disease and nephrotic syndrome

- overhydration w IV fluids

Question 6

what are symptoms of pulmonary edema (11) think of how it effects breathing, vitals, etc.

Answer 6

• severe dyspnea
• cyanosis
• anxiety
• fatigue
• cool, clammy skin
• increased HR
• increased RR
• increased or decreased BP
• wheezes
• coughing
• crackles
• frothy, blood tinged sputum

Question 7

what is the goal of treatment for pulmonary edema (4)

Answer 7

• improve gas exchange
• reduce anxiety
• improve oxygenation
• remove the fluid

Question 8

what is the treatment for pulmonary edema (4)

Answer 8

• o2
• if severe, noninvasive ventilatory support or intubation & mechanical ventilation
• diuretics (ex. lasix)
• other drugs depending on cause (ex. HF meds)

Question 9

what IV drug can be used to decrease O2 demands, and anxiety

Answer 9

• IV morphine

Question 10

what is a pleural effusion

Answer 10

• collection of excess fluid in the pleural space

Question 11

what causes a pleural effusion (5)

Answer 11

side effect of serious diseases such as:

• increased hydrostatic P in left sided HF
• hypoalbuminemia in liver & renal disease
• inflammatory diseases
• pulmonary malignancies
• infection

Question 12

what is a empyema

Answer 12

• pleural effusion containing pus

Question 13

what are manifestations of a pleural effusion (5)

Answer 13

• progressive dyspnea
• decreased movement of chest wall on affect side
• pleuritic pain from underlying disease
• dullness to percussion
• absent or decreased breath sounds over affected area

Question 14

what are manifestations of an empyema (5)

Answer 14

• fever
• night sweats
• cough
• weight loss
• • signs of pleural effusion

Question 15

what is done to determine the type of pleural effusion

Answer 15

• a sample of pleural fluid is obtained via thoracentesis

Question 16

what is a thoracentesis

Answer 16

• a procedure to remove fluid from the pleural space

Question 17

what else is a thoracentesis used to do besides determine cause of pleural effusion

Answer 17

• can remove fluid is the pleural effusion is severe enough to impair breathing

Question 18

how much fluid is removed at a time during a thoracentesis

Answer 18

1000-1200 mL

Question 19

what is the main goal of treatment for pleural effusion

Answer 19

• treat the underlying cause

ex. heart failure

Question 20

what is treatment for an empyema

Answer 20

• antibiotics

Question 21

what should you monitor after a thoracentesis to remove fluid (4)

Answer 21

rapid removal can result in:

• hypotension
• hypoxemia
• pulmonary edema
• xray done after to ensure no pneumothorax was caused by perforation