Pulmonary Edema (Nursing)

00:00 Hi welcome back to our video series in the respiratory system.

00:05 Now in this, we're gonna look at something very serious - pulmonary edema.

00:10 Okay so let's start with, what is edema? Now I know you're familiar with that term but have you ever really stopped to think and break down what really it is? So pause the video for just a second, write some quick notes I promise it will pay off.

00:26 Wake your brain if we're moving in this topic.

00:35 Okay, hopefully you came up with some answers but now let's kind of break it down a little more.

00:40 Edema in general means "swelling", so if you got that, points for you.

00:46 so when you think about edema, you think about swelling.

00:49 Now usually, we think about patients whom we see like their legs are swollen, their feet are swollen, that's generally a very common place to see edema.

00:58 But I want you to go down even deeper and think about what is going on in your patient's body.

01:04 See, edema is usually caused because fluid from inside the blood vessels seeps outside the blood vessels and into the surrounding tissue.

01:14 So edema, is fluid in inappropriate places because the fluid from inside the blood vessels has seeped outside the blood vessels in the surrounding That's what edema is.

01:27 Now, in your legs it's not that big a deal but it does depend on what else is going on.

01:33 Edema is never a good thing but it can be really serious in certain tissues.

01:40 So take what you know about edema, right it's fluid sleeping out into tissues.

01:46 What is pulmonary edema? Yeah, well this is the worst type of edema because pulmonary edema affects your lungs and affects oxygen delivery to the rest of your body.

02:00 So here's what's going on.

02:01 Let's take that definition of what we know about edema.

02:04 That's fluid seeping out of the blood vessels and into the surrounding tissues.

02:09 In this case, in pulmonary edema, the surrounding tissues are the alveoli.

02:15 They are supposed to be the air sacs of the lungs, not the water balloons of the lungs.

02:20 Well in pulmonary edema, the alveoli kind of become like water balloons.

02:25 You've got fluid in the alveoli and then the alveoli can't do what they're designed to do.

02:30 Remember their job is to have those capillaries right around them around them so they can exchange oxygen and carbon dioxide.

02:37 So they'll pick up the carbon dioxide that comes back from the tissues and give oxygen so the blood can take that out to the rest of the body.

02:45 If those alveoili are filled with fluid, remember that excess fluid that seeped out into the tissues, if the alveoli are filled with fluid, they're not gonna be able to perform their job.

02:56 So edema in the lungs is the worst case scenario for edema.

03:00 Edema in the legs - not so fantastic but it's not as life threatening.

03:06 Pulmonary edema if it gets very severe and isn't addressed could actually become life-threatening because of the lack of oxygen to the brain, to the heart into other important organs in my body.

03:18 So it's really important that you understand what are the causes of pulmonary edema.

03:23 Well we often look to the heart because fluid volume overload or more fluid in the patient's heart or body can handle, that is a number one cause of pulmonary edema Now take a look at the picture of that heart.

03:37 See the normal heart? You've got the four chambers, got the wall separating them cause remember your heart is a muscle.

03:45 It's supposed to be a really strong muscle but in heart failure, a lot of times there's hypertrophy.

03:51 Now if you look at the picture of congestive heart failure, we've shown you someone who's left ventricle looks really weird.

03:59 Doesn't it? Well one of the common causes of congestive heart failure is a patients heart that isn't able to pump efficiently.

04:08 So one example would be someone who has left ventricular hypertrophy.

04:12 Now remember the job of the left ventricle is to push blood out to the rest of the body, right? Right atrium - right ventricle - to the lungs, gets oxygenated - goes back to the left atrium - left ventricle, and then out to the rest of the body.

04:27 So it's really important that you have a strong left ventricle.

04:31 Now let's say your patient has hypertension, like chronic hypertension and they don't treat it, right? They don't get medical help, they don't take their antihypertensives, Well the heart initially says,"Woah! I really got to work harder to push blood out of this body" so then it says,"I know what I'll do, I'll get stronger".

04:49 So that wall gets thicker and stronger.

04:51 Well, initially that's really helpful, but over a period of time that vessel wall gets hypertrophied.

05:00 So the left ventricle, that ventricle wall becomes hypertrophied, it gets really thick and it becomes too thick.

05:09 So what was helpful initially, now is problematic because it just can't function efficiently and that's a cause of pulmonary edema.

05:20 A heart that doesn't pump efficiently is going to have backup and problems, pulmonary edema So I know if I have a CHF patient, I am hyperalert watching for pulmonary edema.

05:35 I'm going to explain to you why that happy but for now make sure you have solid in your mind one of the causes of pulmonary edema is overloading the heart.

05:45 You've got more fluid on board that the patient's heart or body can handle.

05:50 Pulmonary edema is a sign of that that woah, were way out of control with fluid-volume balance.

05:56 Now CHF is one of the ways that your heart can't handle very much fluid because that wall is thick or not as effective in functioning anymore.