Empyema 
Pathophysiology
Aetiology
Clinical Manifestations
Risk Factors
Nursing care plan
Fever
Stabbing chest pain; worsens with inspiration
Dry cough
Pus in mucus
Weight loss
Difficulty in breathing
Empyema develops secondary after a pulmonary infection such as bacterial pneumonia.
Bacteria invade the plueral space as pneumonia progresses.
Neutrophils accumulate and fibrin is deposited creating pus in the pleural space.
Pleural fluid pH and glucose concentration decreases.
Fibroblasts grow between the visceral and parietal pleural surfaces forming a pleural peel membrame.
In case of thoracic surgical procedure, the vacated space fills up with Serosanguineous fluid also introducing infection to the pleural space.
Surgical history of thoracotomy
Medical history of pneumonia
Lung abscess
Heamothorax
Chronic Obstructive Pulmonary Disease
Penetrating chest trauma
Diabetic people
Chronic Obstructive Pulmonary Disorder
Having had chest trauma or surgery previously
Lung disease such as chronic bronchitis
Nursing Diagnosis
Assessment
Nursing interventions
Expected Outcomes
Definition accumulation of fluid and pus in the pleural space due to infection. It is also a pneumonia complication.
An extension of infection
Gastroesophageal reflux disease
Imaging; chest X-ray or Chest CT scan
Thoracentesis; sample of the pleural fluid
Hyperthermia
Dyspnoea
Sputum with pus
Physical exam to reveal diminished breath sounds
Subjective data on signs and sympotoms
Brief medical and surgical history is taken
Observe the sputum color, viscosity, and odor
Demonstrate proper splinting of chest and effective coughing while in upright position.
Assist with bronchoscopy and/or thoracentesis, if indicated.
Assist with comfort measures to reduce fever and chills
Perform seal drainage care, post thoracotomy care
Encourage personal hygiene
Monitor vital signs 4 hourly
Observe for breathing patterns.
Evaluate general nutritional state, obtain baseline weight.
Normal breathing patterns
Eliminate infection
Remove airway obstructions
Normal vital signs
Maintain hygiene
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