Question

Case Study - Pulmonary Edema

A 60-year-old man was admitted to intensive care unit because of dyspnea and pulmonary vascular congestion. The patient had reportedly been well until seven days earlier,when he began to have dyspnea during moderate exertion. Fourdays before admission, he felt a nonradiating, "heavy" discomfort in the lower retrosternal and epigastric areas when he stooped, bent over, or walked short distances. There was no orthopnea, sweating, nausea, or edema. Patient was admitted to the hospital. BP 150/80 mmHg HR 90-100 bpm. Inspiratory crackles were heard at both lung bases. The abdomen was normal, and there was no peripheral edema. Laboratory tests were performed, levels of CK and CK MB were normal, as was the level of troponin. The levels of urea nitrogen, creatinine,glucose, calcium, magnesium, electrolytes, LFT were normal.

Case study questions -Please answer with APA citations.

In YOUR OWN WORDS - explain the pathopysiology behind pulmonary edema. Pretend you were explaining it to another nursing student (correct terminology please)

What are some nursing interventions that can be directed to help this patient during his hospital stay (identify 3 goals for discharge)?

What is some patient / family education that is likely required for when he goes home?

Answer 1

Pulmonary edema is a condition characterised by fluid accumulation in the lungs which is caused by leakage or extravasation of fluid from pulmonary vasculature into the interstitium and alveoli of the lungs

PATHHOPHYSIOLOGY

Pulmonary edema is often characterised by by diificulty in breathing but also includecoughing up blood,excessive sweating ,anxiety and pale skin .other mainfestations include orthopnea which is inability to lie down flat due to brethlessness and paroxymal nocturnal dyspnea which means episode of severre sudden breathlessness at night. These symtoms may arise due to left ventricular failure.Fluid overload in lungs cause swelling in legs.Jugular venous pressure which is induectly observed pressure over the venous system via visualisation of internal jugular vein and hepatomegaly .upon ausculation inspiratory cracles could be heard .Nursing interventionns are:1]help the patient relax to promote oxygenation 2]administer oxygen as ordered 3}place the patient inhigh fowlers position 4]asses the vital signs every 10 to 15 mins or as frequently as required5]be alert in development of non productive cough6]ausculate the lung feild for breath sound and alert for crackles6]watch complication on treatment with electrolytes7]monitor oxymetryandabg results for presence of hypoxemia AS WELL AS ECG FOR DYSRHTYMMIA 8}emergency equipment should be kept ready such as airway,intubation tray.9}record weight daily 10]mouth care to reduce mucous membrane dryness

Pateint and family education :

1] teach the patient about the early symtoms and its onset 2]if coughinf develos sit with legs gangling over side of the bed 3}teach patient to take slow and deep breath 4}take sodium restricted diet 5]watch for gain in weight.

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