NCLEX Pulmonary Edema

NCLEX Pulmonary Edema

Pulmonary edema is a condition caused by excess fluid in the lungs.  This fluid collects in the numerous air sacs in the lungs, making it difficult to breathe.  In most cases, heart problems cause pulmonary edema.  But fluid can accumulate for other reasons, including pneumonia, exposure to certain toxins and medications, trauma to the chest wall, and exercising or living at high elevations.

Pulmonary edema that develops suddenly (acute pulmonary edema) is a medical emergency requiring immediate care.  Although pulmonary edema can sometimes prove fatal, the outlook improves when you receive prompt treatment for pulmonary edema along with treatment for the underlying problem.  Treatment for pulmonary edema varies depending on the cause but generally includes supplemental oxygen and medications.

Signs and Symptoms

Sudden (acute) Pulmonary Edema Symptoms

• Extreme SOB of 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
• Blood tinged frothy sputum
• Chest pain and palpitations

Long-term (chronic) Pulmonary Edema Symptoms

• Having more SOB than normal when physically active
• Difficulty breathing with exertion
• Difficulty breathing when lying flat
• Wheezing
• Awakening at night with a breathless feeling relieved by sitting up
• Rapid weight gain when pulmonary edema develops
• Swelling in your lower extremities
• Fatigue

High Altitude Pulmonary Edema Symptoms

• Shortness of breath after exertion, which progresses to SOB at rest
• Cough, fever, and chest discomfort
• Difficulty walking uphill
• Blood tinged sputum, palpitations
• Headaches

Causes

Cardiogenic Pulmonary Edema

Cardiogenic pulmonary edema is a type of pulmonary edema caused by increased pressures in the heart.  This condition usually occurs when the diseased or overworked left ventricle isn’t able to pump out enough of the blood it receives from your lungs (CHF).  As a result, pressure increases inside the left atrium and then in the veins and capillaries in your lungs, causing fluid to be pushed through the capillary walls into the air sacs.  Medical conditions that can cause the left ventricle to become weak and fail includes

• Coronary artery disease
• Cardiomyopathy
• Heart valve problems
• Hypertension

Noncardiogenic Pulmonary Edema

Pulmonary edema that isn’t caused by increased pressures in your heart is called noncardiogenic pulmonary edema.  In this condition, fluid may leak from the capillaries in your lung’s air sacs because the capillaries themselves become ore permeable or leaky, even without the buildup of back pressure from your heart.  Some factors that can cause noncardiogenic pulmonary edema includes:

• ARDS
• High altitudes
• Nervous system conditions
• Adverse drug reactions
• Pulmonary embolism
• Viral infections
• Lung injury
• Exposure to certain toxins
• Smoke inhalation
• Near drowning

Complications

• Lower extremity and abdominal swelling
• Pleural effusion
• Congestion and swelling of the Liver

Treatment

• Preload reducers such as Lasix, Nitroglycerin, Procardia
• Morphine for pain
• Afterload reducers such as MS Contin
• Blood pressure meds