19 February 2012

What is Pulmonary edema? Nursing Diagnosis and Intervention

What is Pulmonary edema?
Fluid builds up in the lungs as a result of ineffective pumping of blood by the heart as a result of left-sided heart failure, AMI, worsening of heart failure, or volume overload. The patient experiences hypoxia, which is insufficient oxygen supply to tissues, caused by decreased oxygenation of the blood. Several noncardiac issues may lead to pulmonary embolism.

Causes of Pulmonary edema
  • High blood pressure
  • Diabetes
  • Coronary or valvular heart disease
  • Obesity
  • Being at high altitude
  • Central nervous system injury
  • Infection
  • Hanta virus
  • Inhaling toxins
Symptoms of Pulmonary edema
  • Extreme shortness of breath or difficulty breathing (dyspnea) that worsens when lying down
  • A feeling of suffocating or drowning
  • Wheezing or gasping for breath
  • Anxiety, restlessness or a sense of apprehension
  • A cough that produces frothy sputum that may be tinged with blood
  • Excessive sweating
  • Pale skin
  • Chest pain, if pulmonary edema is caused by heart disease
  • A rapid, irregular heartbeat (palpitations)

Nursing Diagnosis of Pulmonary edema
• Anxiety
• Excess fluid volume
• Impaired gas exchange

Nursing Intervention of Pulmonary edema

Place the patient in full Fowler’s position to enhance air exchange and diaphragmatic movement, sitting with legs dangling over sides of bed.
• Monitor cardiovascular function for changes in heart sounds, extra sounds,murmurs.
• Monitor respirations for changes in lung sounds, chest expansion.
  Decrease sodium in diet.
• Sleep with head elevated i.e. three pillows, or blocks under head of bed frame.
Check oxygen saturation (pulse oximetry).
• Record fluid intake and output.
• Weigh the patient daily. Call physician if patient gains 2 lbs daily.
• Call physician if BUN and creatinine increase.
• Record characteristics of sputum.
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