Lung abscess.ppt

Lung abscess:

Lung abscess Conducted by: Ms.Monika (Clinical instructor) Army college of nursing

Definition :

Definition Lung abscess is the collection of pus within the lungs. Lung abscess is defined as necrosis of the pulmonary tissue and formation of cavities containing necrotic debris or fluid caused by microbial infection In its early stage ,the abscess resembles a localized pneumonia. If a lung abscess remains unidentified & untreated ,tissue necrosis may occur.

Etiology :

Etiology Primary abscess is infectious in origin, caused by aspiration or pneumonia in the healthy host; bronchiectasis, immunocompromised state. Patients at the highest risk for developing lung abscess have the following risk factors: Periodontal disease Seizure disorder Alcohol abuse Dysphagia

Pathophysiology :

Pathophysiology Most frequently, the lung abscess arises as a complication of aspiration pneumonia caused by mouth anaerobes. The patients who develop lung abscess are predisposed to aspiration and commonly have periodontal disease. A bacterial reaches the lower airways, and infection is initiated because the bacteria are not cleared by the patient's host defense mechanism. This results in aspiration pneumonitis and progression to tissue necrosis 7-14 days later, resulting in formation of lung abscess.

Clinical manifestation:

Clinical manifestation The clinical effects of lung abscess include a cough that may produce bloody, purulent, or foul-smelling sputum pleuritic chest pain Dyspnea excessive sweating chills; fever; headache; malaise and weight loss. Complications include rupture into the pleural space, massive hemorrhage. A chronic lung abscess may cause localized bronchiectasis. Failure of an abscess to improve with antibiotic treatment suggests a possible underlying neoplasm or other causes of obstruction.

Diagnostic evaluation :

Diagnostic evaluation The following tests are used to diagnose a lung abscess: 1. Auscultation of the chest may reveal crackles and decreased breath sounds. 2. Chest X-ray 3bronchoscopy may be used to obtain cultures to identify the causative organism. 4. Blood cultures, Gram stain, and culture of sputum are also used to detect the causative organism. 5. White blood cell count commonly exceeds 10,000/ul.

Treatment for Lung Abscess :

Treatment for Lung Abscess Antibiotic therapy often lasts for months until radiographic resolution or definite stability occurs. Clindamycin is often the drug of choice. Symptoms usually disappear in a few weeks. Postural drainage may facilitate discharge of necrotic material into upper airways, oxygen therapy may relieve hypoxemia. A poor response to therapy may require resection of the lesion or removal of the diseased section of the lung All patients need proper follow-up and serial chest X-rays.

Special Considerations and Prevention of Lung Abscess :

Special Considerations and Prevention of Lung Abscess To prevent a lung abscess in the unconscious patient and the patient with seizures, first prevent aspiration of secretions. Do this by suctioning the patient and by positioning him to promote drainage of secretions. Provide chest physiotherapy (including coughing and deep breathing). Increase fluid intake to loosen secretions, and provide a quiet, restful atmosphere

Nursing management :

Nursing management Note the color ,quantity ,quality & smell of the expectorated material including the presence of blood. Use gloves when handling articles contaminated with sputum Provide frequent opportunities for the client to use mouthwash ,brush the teeth. Encourage long term dental care. Long term antibiotics administration is usually ,observe oral mucous membrane.

Cont………….d:

Cont………….d Teaching about medication should cover: The reasons for taking them. Specific direction such as time of day ,frequency & to take in relation with food. Potential side effect Reassessment after the antibiotics course is completed with culture of sputum to evaluate the effectiveness of treatment.