Lung Abscess

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Lung Abscess

1. DESCRIPTION:
a. A localized lesion in the lung containing pus and necrotic tissues that collapses and forms
cavities, or pockets, in the lung.
b. May occur from aspiration of vomitus or infected material (nasotracheal secretions or blood)
from the upper respiratory tract; or secondary to bronchial oibstruction due to a tumor, where
infection or necrosis within the tumor mass results in accumulation of secretions.
c. May be also a sequel of necrotizing pneumonias, tuberculosis, pulmonary embolism, trauma,
bronchial neoplasms.

2. NURSING ASSESSMENT:
a. Initially cough, with small amount of sputum, a ↓ grade fever, and malaise.
b. In time, sputum becomes copious and often foul-smelling, sometimes containing blood.
c. Pleuritic chest pain.
d. Sometimes, onset is sudden, with chills, high fever, cough and malaise.

3. MEASURES TO REDUCE RISK OF SUPPURATIVE LUNG DISEASE


a. Patients who must have teeth extracted while their gums and teeth are infected maybe given
antibiotic therapy before any dental manipulations.
b. Patient is instructed to maintain adequate dental and oral hygiene, since anaerobic bacteria play a
role in the pathogenesis of lung abscess.
c. Give appropriate antimicrobial therapy to those with pneumonia.

4. MANAGEMENT
a. Adequate drainage thru postural drainage aided by percussion, effective coughing and breathing
exercises.
b. Sometimes, bronchoscopy is needed to drain abscess.
c. ↑ protein, ↑ calorie diet – since chronic infection is associated with a catabolic state.
d. Antibiotic therapy duration may be from 6-18 weeks to prevent relapse.
e. Surgery if medical intervention is inadequate.

5. NURSING INTERVENTIONS FOR LUNG ABSCESS


a. Antibiotic administration as indicated.
b. Chest Physiotherapy
c. Ensure proper nutritional intake
d. Emotional support
PATHOPHYSIOLOGY OF LUNG ABSCESS

Pre Disposing Factor Risk Factor


Hygiene Oral Hygiene
Lifestyle Alcoholism
Immune System Aspiration of Oral Immunocompromised
Anaerobes to the lungs Patients

Cough with small Secondary


amount of sputum Inflammatory Response Mechanical or
↓ Grade Fever
Functional
Obstruction
Cavity extend to or
Directly to bronchus

Abscess becomes
Encapsulated

Bronchu
Necrotizes Pleuritic Chest

Continuous
Production
of
Sputum

Purulent
Sputum In
time may
became foul

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