Pulmonary Edema - Research Paper Example

Pulmonary Edema Pulmonary Edema Introduction Pulmonary edema is a condition in which affectsan individual’s lungs. Normally, under the condition fluid fills up the air spaces and even takes up space in the parenchyma within the lungs. The accumulation of these fluids usually hinders the exchange of oxygen and carbon dioxide, which could in turn lead to respiratory failure. Basically, there are two causes of pulmonary edema. The first is the inability of the heart’s left ventricle to be able to remove the blood completely from the pulmonary circulation. The second reason is usually cited as any injury that may be caused to the parenchyma of the lungs (Krodel, Bittner, Abdulnour, Brown, & Eikermann, 2010). Pulmonary edema if left untreated could lead to a number of complications and could eventually lead to death of the patient. Clinical manifestation of pulmonary edema One of the most common conditions of pulmonary edema is the patient’s difficulty in breathing and in some cases the coughing is accompanied by the patient coughing up pink frothy sputum that is actually blood. Anxiety and pale skin are also attributed to pulmonary edema along with the patient sweating in great amounts. Patients in some cases cannot lie down in a straight position because of their inability to breathe properly. If a patient lies down then he or she would exhibit signs of breathlessness or shortness of breath (Ford & Mazzaferro, 2012). Patients can even suffer breathlessness during the night when they are asleep. Patients wake up from their sleep at night in a state of great anxiety (Ford & Mazzaferro, 2012). In cases where the patient suffers from a chronic case of pulmonary edema, there are symptoms that need to be looked for in the patient. One of the symptoms of chronic pulmonary edema is peripheral edema, where other parts of the body tend to swell up. In most cases peripheral edema is observed within the limbs of the patient. When pressed upon this swelled area, the skin takes a greater time to return to its normal state. An increased jugular venous pressure and swelling of the liver are also observed in patients with acute pulmonary edema. There has even been cases where patients with chronic pulmonary edema have displayed symptoms such as the heart making a third beat and crackling sounds being made by the patient at the end of each breath (Ford & Mazzaferro, 2012). Diagnostic tests for pulmonary edema Due to the seriousness of the illness, most physicians and medical personnel diagnose pulmonary edema based on the symptoms of the patient. The initial test conducted is an X-ray of the chest. The chest X-ray helps physicians determine if there is any fluid present in the alveolar. The X-ray also shows an increase in the vascular shadowing which takes the pattern of batwing peri-helium. In some cases the X-ray may even shows pleural effusions (Krodel, Bittner, Abdulnour, Brown, & Eikermann, 2010). In order to confirm the diagnosis, physicians conduct an ECG (Echocardiography). An ECG test helps physicians understand the condition, which the heart is in. Various abnormalities within the heart can also be detected using ECG. Through the ECG physicians can examine the weak activity of the left ventricle of the heart (Ford & Mazzaferro, 2012). Treatment and prognosis of pulmonary edema The treatment of pulmonary edema varies from patient to patient and largely depends upon the severity and cause of the illness. In the majority of cases, physicians treat patients that have cardiac pulmonary edema with heart medications and diuretics. In cases where patient’s condition is severe and medications provided to patients through the mouth are not having any effect, diuretics are directly inserted into the patient’s blood stream via IV bags and tubes (Ford & Mazzaferro, 2012). In the case of non-cardiac pulmonary edema, the treatment is based on the cause; for example, if the cause is a severe infection then in such a case the best treatment would be to provide antibiotics to the patient. During treatment, it is also essential that oxygen levels of patients be monitored. If oxygen levels in the blood are too low then oxygen supplements are to be provided to the patient (Ford & Mazzaferro, 2012). Latest research in the field of medicine has contributed a great deal towards obtaining methods that reduce the mortality rate in patients with pulmonary edema and increase their lifespan. One such research conducted by Mariani et al. (2011) suggests that noninvasive ventilation (NIV) is one way in which patients with cardiogenic pulmonary edema can be helped. The method also reduces the need for physicians and practitioners to intubate patients (Mariani, et al., 2011). Another study conducted by Nouira et al. (2011) puts forward CPAP (Continuous Positive Air Pressure) as a means to reduce mortality amongst elderly patients of cardiac pulmonary edema. The study indicates that CPAP provided to elderly patients that are in critical condition improves their chances of survival. The method also improves the oxygenation of the patient when his or her breathing becomes difficult (Nouira, et al., 2011). The prognosis of cardiac pulmonary edema depends upon a number of factors. These factors include age of the patient, underlying cause and other medical conditions from which the patient might be suffering. In general when proper treatment is provided to patients with pulmonary edema their chances of survival range from 80%-85%. However this number significantly drops if there is a delay in the provision of proper treatment (Sovari, 2012). If left untreated pulmonary edema could result in a coma and could even lead to the patient’s death. Nursing responsibilities As mentioned above, it is important to provide immediate treatment to patients with pulmonary edema. When a patient is brought to a hospital then it becomes the responsibility of the nurse to monitor the patient’s vitals and provide him or her with the supplementary oxygen through a mask (Ford & Mazzaferro, 2012). After placing the mask the nurse must insert an IV line into the patient’s vein. It is then important to reposition the patient and place him or her in a high flower position. The high flower position would allow the lung to expand. During the process of monitoring it is vital that nurses take care of a few things, which include administration of morphine, oxygen, development in the condition of the patient and observe if crackling sound appears when the patient takes a few breaths (Ford & Mazzaferro, 2012). Conclusion Pulmonary edema is definitely a serious condition that affects an individual’s respiratory system. The condition has been known to have two underlying causes. The first is due to the irregular functioning of the left ventricle of the heart. Such cases have been termed as cardiac pulmonary edema. Second underlying cause has been cited due to the damage that is inflicted upon the parenchyma situated within the lungs. Such cases have been termed as non-cardiac pulmonary edema. Non-cardiac pulmonary edema can occur due to a number of factors. There are multiple symptoms that can help diagnose pulmonary edema. The most common symptoms are shortness of breath, coughing up blood, heavy sweating and waking up from sleep at nights due to breathlessness. Initial diagnosis can be made by doctors from studying the symptoms of the patient. However to confirm for pulmonary edema diagnostic tests are carried out which include but are not limited to chest X-rays and ECG. It is essential to provide immediate treatment to pulmonary edema patients. If left untreated the illness could result in a coma or even death. It is essential that nurses monitor patients with pulmonary edema regularly and should ensure that oxygen levels within their blood are high enough. Reference List Ford, R. B., & Mazzaferro, E. (2012). Kirk & Bistners Handbook of Veterinary Procedures and Emergency Treatment. St. Louis: Elsevier Health Sciences. Krodel, D. J., Bittner, E. A., Abdulnour, R., Brown, R., & Eikermann, M. (2010). Case Scenario: Acute Postoperative Negative Pressure Pulmonary Edema. Anesthesiology, 200-207. Mariani, J., Macchia, A., Belziti, C., DeAbreu, M., Gagliardi, J., Doval, H., et al. (2011). Noninvasive Ventilation in Acute Cardiogenic Pulmonary Edema: A Meta-Analysis of Randomized Controlled Trials. Journal of Cardiac Failure, 850-859. Nouira, S., Boukef, R., Bouida, W., Kerkeni, W., Beltaief, K., Boubaker, H., et al. (2011). Non-invasive pressure support ventilation and CPAP in cardiogenic pulmonary edema: a multicenter randomized study in the emergency department. Intensive Care Medicine, 249-256. Sovari, A. A. (2012, February 3). Prognosis. Retrieved February 22, 2014, from http://emedicine.medscape.com/: http://emedicine.medscape.com/article/157452-overview#aw2aab6b2b3aa Read More