EMPHYSEMA

PRESENTED BY:
MIS. M.K.KAKU
NURSING TUTOR
 INTRODUCTION
• Emphysema is a progressive disease of lung in
which the alveoli becomes inflamed and
losses elasticity.
• As a result air becomes trapped in the air
sacks which becomes overstretched and may
rupture.
• Emphysema is form of COPD occurs together
with chronic bronchitis.
 CAUSES & RISK FACTORS
• Emphysema develops due to:
 Smoking and passive smoke exposure
 Inhaling toxins or other irritants
 Alpha1- antitrypsin deficiency – A genetic d defect
 Family history
 Exposure to pollutants at work (chemicals, fumes or dust)
 Frequent lower respiratory infection
 HIV infection
 Age : 50 or older
 TYPES OF EMPHYSEMA
• There are three morphological types of
emphysema
o Centriacinar/ centrilobular: It begins in the
respiratory bronchioles and spread peripherally.
Mostly occur in long term cigarette smokers
involves upper part of the lungs.
o Panaciner: There is destruction of bronchiolus,
alveolar duct and alveoli in the lower half of the
lungs.
 These type is generally observed in patient
with deficiency of Alpha-1 Antitrypsin
deficiency.
o Paraseptal Emphysema: Here, the process is
localized around the septa of the lung or
pleura. It involves the distal airway structures,
alveolar ducts and alveolar sacs.
 CLINICAL MENIFESTATION
• Symptoms of emphysema includes...
 Shortness of breath
 Rapid breathing
 Chocking sensation while lying flat
 Cynosis
 Barrel chest
 Breathing through pursed lips
 Coughing up sputum
 Loss of appetite
 Heart failure
 DIAGNOSIS
• History and physical examination
• Pulmonary ventilation perfusion test
• Chest X – Ray
• CT Scan
• ABG (Arterial blood gas analysis)
• Pulse oximetry
• Testing for Alpha1 antitrypsin deficiency
• Sputum examination
• Pulmonary function test
• Complete blood count
 MANAGEMENT
• Management includes,
 Oxygen therapy
 Medications :
o Bronchodilators: To relax the smooth muscles surround
the bronchioles. The long acting agents include
salmeterol, tiotropium.
o Steroids: To reduce the inflammation.
o Antibiotics: It helps to fight with respiratory infections
o Breathing exercises
o Postural drainage
• Surgical management includes,
 Lung reduction surgery
 Bullectomy
 Lung Transplantation
• Pulmonary Rehabilitation:
 Pulmonary rehabilitation is probably effective
which includes education, nutrition
counselling, special breathing techniques and
quitting smoking.
 NURSING MANAGEMENT
• Asses vital signs regularly.
• Administer oxygen and medicines.
• Instruct patient to take plenty of fluids and
adequate nutrition.
• Instruct patient not to take gas producing foods.
• Instruct for breathing exercise.
• Prevention of complications
• Prevention of complication by quitting smoking
of patient.