SAIMS COLLEGE OF NURSING INDORE

(M.P)

LESSON PLAN
GNM 2ND YEAR

SUBJECT:-
MEDICAL SURGICAL NURSING- I
Programme: GNM 2ND YEAR
• Group: GNM 2ND YEAR
• Subject: MEDICAL SURGICAL NURSING-I
• Topic: EMPYEMA
• Time allotted:1 HOUR

Central objective:
At the end of the class the students will be able to know about definition, causes, sign and symptoms,
treatment.

Specific objective:
 To Define Empyema.
 To enumerate the Causes of Empyema
 To enlist the risk factors of Empyema
 To describe the Clinical Manifestations of Empyema.
 To Enumerate the diagnostic evaluation for Empyhema.
 To brief the management of Empyema.
S.NO. HOURS SPECIFIC CONTENT TEACHING AV EVALUATIONS
OBJECTIVES LEARNING AIDS
ACTIVITIES

1. 10 min To Define Empyema is a collection of Lecture cum Black What is the

Empyema. pus in the cavity between the discussion Board definition of
lung and the membrane that empyema.
surrounds it (pleural space); it
consists of an effusion
containing polymorpho
nuclear leukocytes and fibrin.
Empyema is caused by an
infection that spreads from
the lung and leads to an
accumulation of pus in the
pleural space
2. 10 min To enumerate The most common cause of Listening and PPT What are the
the Causes of empyema – watching Causes of
Empyema empyema?
 lung infections
pneumonia
  steroid use,
 cancer treatment.
 weak immune system,
such as from HIV
infection
3. 10 min To enlist the Risk factors Lecture cum PPT What are the risk
risk factors of discussion factors of
empyema  pulmonary (lung) empyema?
conditions
including bacterial
pneumonia
 lung abscess,
thoracic surgery
trauma or injury to
the chest
 rarelya needle
inserted through the
chest wall to draw
off fluid in the
 pleural space
(thoracentesis).
4. 5 To describe Shortness of breath Lecture cum Flip What are the
min the Clinical • Dry cough discussion Chart clinical
Manifestations • Fever and chills - 105°F manifestation of
of Empyema. (40.6°C) empyema?
• Excessive sweating,
especially night sweat
General discomfort,
uneasiness, or ill feeling
(malaise)
Unintentional weight loss
• Chest pain, which worsens
on deep inhalation
(inspiration)
• Decreased breath sounds or
a friction rub.
5. 5 To Enumerate • Thoracentesis Lecture cum Black What are the
min the diagnostic • Pleural fluid gram stain and discussion board diagnostic
evaluation. the culture evaluation of
• Computed Tomography empyema?
 scan of the chest
• Chest X-ray
6. 15 To brief the MEDICAL- Lecture cum PPT What are the
min management  Antibiotics are discussion management of
of Empyema. prescribed to control the empyema?
infection.
 The antibiotics
commonly used -
penicillin and
vancomycin
 Also given Oxygen
therapies
SURGICAL-
 Thoracentesis
 intrapleuralfibrinolytic
therapy
 chest tube insertion and
surgical management
either through VATS or
thoracotomy.
 The end goal of the
surgical management of
empyema is to achieve
full evacuation of pleural
exudates
NURSING-
 Provide meticulous chest
tube care,
 use aseptic technique for
changing dressings
around the tube insertion
site in empyema.
 Ensure tube patency by
watching for fluctuations
Of Auld in the
underwater seal
chamber.
 Watch for bubbling in
the water-seal chamber,
indicating the presence
 of air in the pleural
spaces.
 Record the amount,
colour, and consistency
of any tube drainage.
 If the patient has open
drainage through a rib
resection or intercostal
tube.
 Use hand and dressing
precautions.

BIBLIOGRAPHY
1. Lippincott, Mannual of nursing practice, edition 5th.

2. Saunders, textbook of medical surgical nursing, edtion 3rd published by mosby.

3. BT Basawantthappa, medical surgical nursing, published by jaypee, edtion 4th,

4. The journal of nursing research july 2007,