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Respiratory 2 notes

Respiratory 2 notes - PLEURAL CONDITIONS o Pleura is the...

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PLEURAL CONDITIONS: o Pleura is the membrane that covers the lungs and the surface of the chest walls. o Pleurisy= pleuritis : inflammation of the pleurae both visceral and parietal  o Develops in conjunction with pneumonia, or an upper respiratory infection o Taking a deep breath, coughing, or sneezing worsens Pleuritic pain o Assessment of pleuritis:  pleural friction rub heard early, but disappears as more fluid  accumulates in pleura, pain, impaired perfusion o Can occur in conjunction with other conditions such as pneumonia o Localized, sharp, knifelike pain upon respiration, cough, sneezing o Auscultation of pleural friction rub that disappears as fluid develops o Viewed by z-ray o Treatment:  treat underlying cause, prevent recurrence, relieve symptoms, evaluate tissue  with thoracentesis o  patient may be on NSAIDS to decrease inflammation, rest o Pleural Effusion:  is a collection of fluid in the pleural space (between visceral and pleural  linings) and is rarely a problem, but secondary to other diseases (CHF, chest trauma) o Fluid sucked in from hydrostatic and oncotic pressure o Treatment:  treat underlying cause, prevent recurrence, relieve symptoms, evaluate tissue  with thoracentesis Nursing Management: o   Pleurisy : Pain management, position for comfort, teach. Turn onto affected side.  SOB with larger effusion Decreased or absent breath sounds Percussion dull or flat Decreased excursion:  x-ray Promote rest NSAIDS treatment of choice for pleuritis (check liver function studies) RHF with pleuritis= hepatomegaly o Pleural Effusion:  Monitor, comfort, pain, chest tube management, teach, consider care  for underlying cause, analgesics, thoracentesis. PNEUMONIA: o Inflammation of the lung parenchyma that is caused by a microbial agent.  o Pneumonitis refers to inflammation of the lung tissue.  1
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o The most common cause of death from infectious diseases. (7 th  leading cause; over 65 years 5 th  leading cause) o Leading cause of pneumonia: atelectasis Current classifications refers to:  o Community acquired (CAP)  – developed in community or in first 48 hrs of  Hospitalization. o Hospital Acquired (HAP, nosocomial)  – onset of pneumonia symptoms more than  48 hrs after admission. Patients who are intubated or receive frequent suctioning are at greater risk of  hospital acquired o Immunocompromised pneumonia o Aspiration Pneuomonia  inhalation of gastric juices or hydrocarbons triggers  inflammatory change and inactivates surfactant over a large area Right lung greater risk for aspiration Pneumonia Pathophysiology: o Preventive factors in upper airway are not effective …. So infective organism can reach 
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  • Spring '08
  • Dupuy
  • Pleural friction rub, bacterial pneumonia, Pleural effusion Pneumonia, pneumonia pathophysiology, Immunocompromised pneumonia

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Respiratory 2 notes - PLEURAL CONDITIONS o Pleura is the...

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