EMPHYSEMA

EMPHYSEMA

DEFINITION:-

It is defined as impaired gas exchange (Oxygen, Carbon dioxide) resulting from destruction of walls of over distended alveoli or permanent dilation of air spaces (distal to terminal bronchiole).


RISK FACTORS:-

Cigarette smoking.

Pipe, cigar and other smoking

COPD

Environmental pollution

Allergens

Infectious agents.


PATHOPHYSIOLOGY:-

Due to cigarette smoking or other smoking

↓

Deficiency of alpha-1 antitrypsin

↓

Decrease antielastic activity of bronchiales or alveoli

↓

Dilation of distal terminal bronchioles


SIGN/SYMPTOMS:-

Sputum production

Cough

Dyspnea on exertion

Barrel chest

Cyanosis

Stress anxiety depression


TYPES:-

Panlobular Emphysema: It is hyper inflammated alveolar duct, bronchioles.

They are essentially enlarged.

Centrilobular Emphysema: These are mainly in centre of secondary lobules.


COMPLICATIONS:-

Respiratory failure

Pneumonia

Atelectasis

Pneumothorax.


DIAGNOSTIC FINDING:-

Spirometry

History collection

ABG (Arterial Blood Gas) Analysis

Pulmonary Function Test (PFT).


MEDICAL MANAGEMENT:-

Bronchodilators: are used to relieve bronchospasm and reduce airway obstruction.

Example

Salbutamol

Formoterol

Terbutaline

Also bronchodilator are essential in case of increase oxygen distribution in lungs and relax smooth muscles.

Anticholinergic Agents

Example

Ipratropium bromide which inhibits acetylcholine neurotransmitter that conveys information in parasympathetic nervous system.

The actions of these drugs include relaxation of smooth muscles and bronchodilator

Corticosteroids

Example

Beclomethasone

Budesonide

Flunisolide

Antitussive Agents

Example

Morphine, Codeine

Dextromethorphan

Mucolytics Agents

Example

Bromohexine: 8-16 mg

Antibiotic Therapy


NURSING MANAGEMENT:-

Impaired gas exchange related to abnormalities due to destruction of alveolar capillary membrane.


Nursing Intervention:

Monitor oxygen saturation and give supplemental oxygenation as ordered.

Watch patient for restlessness, anxiety, confusion, headache, cyanosis, shortness of breath, which is commonly caused by acute respiratory insufficiency and may signal respiratory failure.

Ineffective breathing pattern related to shortness of breath.


Nursing Intervention:

Assess breathing pattern of patient

Teach and supervise breathing retraining exercise to improve Dyspnea.

Provide comfortable position to patient.

Imbalanced nutrition less than body requirement related to increase work of breathing, air swallowing and drug effects.


Nursing Intervention:

Take nutritional history, (intake, output) weight and height.

Encourage patient for frequent little meals if patient is dyspnoeic.

Encourage snacking for high calorie, high protein snacks such as nuts, cheese.

Avoid food producing gas and abdominal discomfort.

Give supplement oxygen while patient is eating to relieve dyspnea as directed.

Activity intolerance due to fatigue, hypoxia, SOB (Shortness of breath).


Nursing Intervention:

Encourage the patient for active and passive daily exercise

Anxiety related to disease condition


Nursing Intervention:

Reduce anxiety level of patient by giving feedback to patient.

Comments

Post a Comment

Popular posts from this blog

PNEUMONIA

Image
PNEUMONIA DEFINITION: - It is an inflammation of lung parenchyma which is associated with marked increase interstitial and alveolar fluid. CAUSES/AETIOLOGY:- Bacterial infection: Gram +ve: Strep. Pneumonia Strep. aurious. Gram -ve: H. influenza Pseudomonas Anaerobic bacteria Viral infection: Influenza virus Para influenza virus Adenovirus Fungus infection: Candidiasis Histoplasmosis Mycoplasma and protozoa in AIDS. CLASSIFICATION:- Community Acquired Pneumonia It occurs in normal healthy persons Bacterial infection Viral infection Hospital Acquired Pneumonia It occurs either when immunity is week or in lung disorders or anatomical abnormal lungs. TYPES:- Segmental Pneumonia:  Only in one small segmental lobes of lung. Bilateral Pneumonia:  Both side segmental lobes of lungs are affected. Lobar Pneumonia:  Complete lobe affected. Broncho Pneumonia:  Patchy like formation in the lungs. RISK FACTORS:- Air pollution/Aspiration Bed rest/prolonged immobility Ch...
Read more

COPD

Image
DEFINITION:-  COPD is the progressive and partially reversible disease of the airway  Comprises primarily of two related disease- chronic bronchitis and Emphysema  Chronic obstruction of the flow of air through the airway and out of the lungs permanent and progressive obstruction over time. Chronic bronchitis is defined clinically as a daily cough with production of sputum at least 3 month per year for 2 or more consecutive year.  It involves inflammation and swelling of the lining of the air way that leads to narrowing and obstruction of the air way.  The inflammation also stimulate production of mucus which can cause further obstruction of the airway.  EMPHYSEMA  It is permanent enlargement of the alveoli due to destruction of the wall between alveoli which leads to reduce the elasticity of the lungs over all.  Loss of elasticity leads to collapse of the bronchioles, obstructing air flow out of the alveoli. Air become trapped to the alveoli and reduce the ab...
Read more

OSTEOMYELITIS

Image
OSTEOMYELITIS DEFINITION:- It is an inflammation of bone due to infection, it may affect any bone. CAUSES:- Bacterial infection: - Staphylococcus Aureus - Streptococcus Viral infection Fungal infection PATHOPHYSIOLOGY:- Due to infection in medullary part of bone ↓ Infection spreads to periosteum ↓ Oedema or abscess formation ↓ Narcotic bone (sequestra) ↓ Peritonsillar abscess (Pus formation) SIGNS AND SYMPTOMS:- Fever Inability in weight bearing Signs of sepsis Erythema Chills Nausea Malaise Restlessness Spontaneous fracture. Night sweats Swelling, tenderness, and warmth at infection site.DIAGNOSTIC FINDING:- DIAGNOSTIC FINDING:- C.B.C - WBC es - ESR es X-ray C.T. scan/MRI Radionuclide bone scan COMPLICATIONS:- Non-healing wound Sepsis Immobility Amputation. MEDICAL MANAGEMENT:- Antibiotics, - Penicillin - Tetracycline - Cephalosporin, e.g., cefalexin Analgesics and antipyretics as prescribed Application of plaster cast and traction FNAC (Fine needle aspiration cytology) fo...
Read more