Empyema(농흉), emphysema(폐기종) case study (간호과정 3개)

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1. Empyema(농흉)

Empyema는 흉막강에 화농성 액체, 즉 농이 고인 상태로 폐렴, 폐결핵, 폐농양, 흉부외상, 감염으로 발생한다. 흉막이 두꺼워지고 섬유성 조직이 폐와 흉벽을 유착시키기 때문에 치료하기가 매우 어렵다. 합병증으로 흉막섬유증(pleural fibrosis)이 초래되면 병소 부위가 쭈그러들고, 세로막 내의 기관이 병소 쪽으로 당겨져서 척추측만증이 나타난다. 주요 증상으로는 호흡곤란, 창백함, 피로, 체중감소, 허약, 고열, 흉막통증, 마른기침 등이 있다. 진단을 위해 최근 병력 사정, 흉벽의 움직임 감소, 촉진 시 진탕음 감소, 발열, 오한, 야간발한, 체중감소 등을 확인하며, 흉막천자를 통해 천자액을 검사한다. 치료는 항생제요법과 조기배농이 주요하며, 흉막섬유증이 초래되어 폐환기를 억제하면 유착된 흉막을 분리하는 수술인 흉막 박리술(decortication)을 시행한다.
2. Emphysema(폐기종)

폐기종은 폐포벽의 파괴로 인해 폐포가 비정상적으로 확장되고 폐탄성이 감소하는 질환이다. 주요 증상으로는 호흡곤란, 만성기침, 객담 배출, 천명음 등이 있다. 진단을 위해 폐기능 검사, 흉부 X선 검사, CT 검사 등을 시행한다. 치료는 금연, 산소요법, 기관지확장제 및 스테로이드 흡입제 투여, 폐이식 등이 있다. 간호중재로는 호흡운동 격려, 산소요법, 기도 분비물 관리, 영양 관리 등이 필요하다.

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1. Empyema(농흉)

Empyema, also known as pleural empyema, is a serious medical condition characterized by the accumulation of pus in the pleural space, the area between the lungs and the chest wall. This condition can be life-threatening if left untreated, as it can lead to respiratory distress, sepsis, and other complications. The primary causes of empyema include bacterial, viral, or fungal infections, as well as trauma or certain underlying medical conditions. Symptoms of empyema may include chest pain, fever, shortness of breath, and a persistent cough. Diagnosis typically involves imaging tests, such as chest X-rays or CT scans, as well as fluid analysis from the pleural space. Treatment for empyema often involves a combination of antibiotics, drainage of the pleural fluid, and, in some cases, surgical intervention. Prompt and appropriate treatment is crucial to prevent the spread of infection and to improve the patient's overall prognosis. In severe cases, thoracic surgery may be necessary to remove the infected pleural tissue and to facilitate the healing process. Overall, empyema is a serious medical condition that requires prompt and effective treatment to prevent potentially life-threatening complications. Ongoing research and advancements in medical care continue to improve the management and outcomes for patients with this condition.
2. Emphysema(폐기종)

Emphysema is a chronic lung disease characterized by the destruction and enlargement of the alveoli, the tiny air sacs in the lungs responsible for gas exchange. This condition leads to a progressive loss of lung function and can significantly impact a person's quality of life. The primary cause of emphysema is long-term exposure to irritants, such as cigarette smoke, air pollution, or occupational dusts and chemicals. Genetic factors may also play a role in the development of the disease. Symptoms of emphysema include shortness of breath, chronic cough, wheezing, and a feeling of tightness in the chest. Treatment for emphysema typically involves a combination of lifestyle modifications, medication, and, in some cases, oxygen therapy or lung transplantation. Quitting smoking is one of the most important steps in managing the condition, as it can slow the progression of the disease and improve overall lung function. Medications, such as bronchodilators and corticosteroids, can help to alleviate symptoms and improve breathing. In severe cases, oxygen therapy may be necessary to ensure adequate oxygen levels in the blood. In some patients, lung transplantation may be considered as a last resort treatment option. Ongoing research into the pathogenesis and management of emphysema is crucial to improving the lives of those affected by this debilitating condition. Continued efforts to reduce exposure to risk factors, develop more effective treatments, and improve the overall quality of life for individuals with emphysema are essential.