NUR 634 Topic 4 DQ 1

Discussion: Select one pulmonary condition or disorder.

NUR 634 Topic 4 DQ 1 Assessment Description

Select one pulmonary condition or disorder. Then complete the following:

Briefly discuss the condition/disorder.

Describe the symptoms and physical exam findings associated with the condition/disorder.

Identify appropriate laboratory, imaging, and other diagnostic/screening tools that apply to the disorder and explain how they will help you with your diagnosis.

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List two other conditions that could cause a similar presentation (differential diagnoses) and explain how you would “rule out” those differentials.

Support your description with a minimum of two APRN-approved scholarly resources. You may not select a condition or disorder that has already been profiled by another learner; you must select a different one.

NUR 634 Topic 4 DQ 1 Sample

Pulmonary edema is a condition characterized by excess fluid accumulation within the alveolar spaces and interstitium. The condition is caused by an imbalance in hydrostatic pressures when there is an increase in capillary hydrostatic pressures, a decrease in plasma oncotic pressure, or an increase in capillary permeability. The causes of pulmonary edema can either be cardiac or non-cardiac. Cardiac causes of pulmonary edema include coronary artery disease, cardiomyopathy, left-sided heart failure, and valvular diseases (Degefu et al., 2023). On the other hand, non-cardiac causes of pulmonary edema include acute respiratory distress syndrome, renal and hepatic failure, and sepsis. NUR 634 Topic 4 DQ 1 Pulmonary edema increases diffusion distance for respiratory gases, predisposing the patients to hypoxia and hypercapnia.

Patients experiencing pulmonary edema often present with a history of worsening dyspnea, orthopnea, paroxysmal nocturnal dyspnea, sweating, and pink frothy cough. In addition, they may also experience confusion, anxiety, and disorientation due to hypoxia and hypercapnia (Zanza et al., 2023). On physical examination, it is common to find tachypnea and the use of respiratory accessory muscles, tachycardia, reduced oxygen saturation, distended jugular veins, and cyanosis. A respiratory examination may reveal reduced chest expansion on inspiration, dull percussion notes, fine crackles, crepitations, or wheezes on auscultation.

Arterial blood gas analysis and pulse oximetry are two crucial tests needed to assess oxygen saturation and level of hypercapnia. NUR 634 Topic 4 DQ 1 Additionally, a full hemogram, sputum analysis, cardiac enzymes, and serum electrolytes can be used to identify the cause of the edema, such as heart failure. Imaging tests used include an initial chest radiograph (CXR) and computed tomography (CT) used to characterize the extent of edema (Barile, 2020). Other imaging tests used include electrocardiogram and echocardiogram to identify cardiac causes of pulmonary edema.

Bacterial pneumonia and acute pulmonary embolism may present similarly to pulmonary edema. However, a sputum analysis in bacterial pneumonia reveals the presence of bacterial and pus cells on microscopy, which are absent in pulmonary edema (Zanza et al., 2023). On the other hand, a CXR in acute pulmonary embolism reveals a wedge-shaped opacity in the lung periphery, indicative of a lung infarct.

NUR 634 Topic 4 DQ 1 References

Barile, M. (2020). Pulmonary Edema: A Pictorial Review of Imaging Manifestations and Current Understanding of Mechanisms of Disease. European Journal of Radiology Open, 7. https://doi.org/10.1016/j.ejro.2020.100274

Degefu, N., Jambo, A., Nigusse, S., Dechasa, M., Gashaw, T., & Getachew, M. (2023). The Burden and Contributing Factors of Cardiogenic Pulmonary Edema Among Acute Heart Failure Patients Admitted to Tertiary Hospital, Eastern Ethiopia. Open Access Emergency Medicine: OAEM, 15, 405-414. https://doi.org/10.2147/OAEM.S436352

Zanza, C., Saglietti, F., Tesauro, M., Longhitano, Y., Savioli, G., Balzanelli, M. G., Romenskaya, T., Cofone, L., Pindinello, I., Racca, G., & Racca, F. (2023). Cardiogenic Pulmonary Edema in Emergency Medicine. Advances in Respiratory Medicine, 91(5), 445-463. https://doi.org/10.3390/arm91050034 NUR 634 Topic 4 DQ 1