25 terms

Lung Abscess

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what is a lung abscess?
reversible b/c as soon as you kill the bacteria this disease will stop but you will have perminant lung damage.
restrictive b/c you can't ventilate scar tissue.
what does a lung abscess cause?
necrosis of lung tissue, in extreme cases ends up as a cavity that gets filled with room air.
necrosis tissue turns into moosh w/ a hard surface on it.
what does a lung abscess start and progress?
starts out as something that looks like pneumonia (signs & symptoms) as it progresses the tissue starts to die off and can effect all the tissue in the lungs including alveoli.
can rupture through the bronchus causing liquid to burst into the pleural wall & cause pleural effusion.
what is the most common cause of lung abscess?
aspiration (gastric fluids or anything else foreign)
what are other causes of lung abscess?
bronchial obstruction that leads to secondary infection or vascular obstruction (blocking off of blood supply), or certain interstitial infections, penetrating chest would (bacteria from knife)
what are anatomic alterations of the lungs w/ a lung abscess?
alveolar consolidation, alveolar-cap & bronchial wall destruction, tissue necrosis, cavity formation, fibrosis & calcification of lung parenchyma, atelectasis, excessive airway secretions.
why would atelectasis be caused from lung abscess?
from obstructed airways.
what is the goal of the inflammatory response around an abscess and how does this work?
to isolate or kill the bacteria, inflames the tissue around the necrotising tissue so it doesn't spread.
where are lung absessed usually found?
superior segments of the lower lobes and posterior segment of the upper lobes.
why are lung absessed more commonly found in the right lung that the left lung?
b/c the main stem bronchis right is more downward that the left so things tend to flow straight down to the right.
what people are most likely to get lung abscesses?
alcohol abuse, seizure disorders, general anestesia, head trauma, stroke patients, swallowing disorders.
what organisms are the most common found in aspiration that cause lung abscesses?
GP- peptococci & peptostreptococci
GN- bacteroides fragilis, prevotella melaninogenica, fusobacterium.
normal mouth flora.
KNOW.
what are some parasites known to cause lung absesses?
paragonimus, echinococcus, entamoeba histolytica,
what are common vital signs of lung absesses patients?
increased RR, HR, BP
what are some physical examinations of a patient with lung abscess?
chest pain/ decreased chest expansion, cyanosis, cough, sputum production & hemoptysis
why would there be chest pain?
b/c there is a hole in the lung covered by a scar, even if you could get air in the lung part of it can't expand properly.
what are typical chest assessment findings of a person w/ lung abscess?
(right over the abscess)
increased tactile & vocal fremitus, crackles & rhonchi, dull percussion note, bronchial breath sounds, diminished breath sounds
what are the results of a PFT test for lung abscess patients?
restrictive lung disease so both are decreased you can't get air in or out.
low FVC low FV1 and normal ratio. w
what are typical ABG results for lung abscess patient?
respiratory alkalosis.
when severe looks like respiratory acidosis (acute ventilatory failure) .
how do you know if a lung abscess ruptures?
pain b/c it leaked into your pleurals or if it leaks into the bronchi you will have a sudden large amount of secretions.
what does a sputum sample look like from a lung abscess patient?
anaerobic- foul smells roundish or grey, usually bloody streaks b/c of the amount of damage done to the capillary vessels causing them to bleed.
what is a key point on an xray to let you know it is a lung abscess?
straight line on xray! only thing that causes a straight line.
what are xray findings of a lung abscess patient?
straight line, cavity formation, increased opasity, pleural effusion, fibrosis & calcification.
how do we treat a lung abscess?
antibiotics to kill the bacteria that is killing the lung tissue.
if the bacteria can't be identified we would use a broad spectrum antibiotic to kill everything.
what are respiratory care treatments used to treat lung abscess?
oxygen therapy for hypoxia and decrease WOB, bronchiolhygiene, lung expansion if atelectasis is present, or if abscess ruptures into pleural space we would remove fluid from pleural space.
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