Treatments for Cor pulmonale
Treatments for Cor pulmonale
The list of treatments mentioned in various sources
for Cor pulmonale
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
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Book Excerpts: Treatment of Cor pulmonale
Treatments of Cor pulmonale: Online Medical Books
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for more information about the treatments of Cor pulmonale.
Pulse pressure, widened:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
If the patient’s level of consciousness (LOC) is decreased, and you suspect that his widened pulse pressure results from increased ICP, check his vital signs. Maintain a patent airway, and prepare to hyperventilate the patient with a handheld resuscitation bag to help reduce partial pressure of carbon dioxide levels and, thus, ICP. Perform a thorough neurologic examination to serve as a baseline for assessing subsequent changes. Use the Glasgow Coma Scale to evaluate the patient’s LOC. (See Glasgow Coma Scale, page 374.) Also, check cranial nerve function — especially in cranial nerves III, IV, and VI — and assess pupillary reactions, reflexes, and muscle tone. Insertion of an ICP monitor may be necessary. If you don’t suspect increased ICP, ask about associated symptoms, such as chest pain, shortness of breath, weakness, fatigue, or syncope. Check for edema, and auscultate for murmurs.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Cor pulmonale:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment of cor pulmonale is designed to reduce hypoxemia, increase the patient’s exercise tolerance and, when possible, correct the underlying condition.
In addition to bed rest, treatment may include administration of:
❑ a cardiac glycoside (digoxin)
❑ antibiotics when respiratory infection is present; culture and sensitivity of a sputum specimen helps select an antibiotic
❑ potent pulmonary artery vasodilators (such as diazoxide, nitroprusside, hydralazine, angiotensin-converting enzyme inhibitors, calcium channel blockers, or prostaglandins) in primary pulmonary hypertension
❑ oxygen by mask or cannula in concentrations ranging from 24% to 40%, depending on PaO2, as necessary; in acute cases, therapy may also include mechanical ventilation; patients with underlying COPD generally shouldn’t receive high concentrations of oxygen because of possible subsequent respiratory depression
❑ a low-salt diet, restricted fluid intake, and diuretics, such as furosemide, to reduce edema
❑ phlebotomy to reduce the RBC count
❑ anticoagulants to reduce the risk of thromboembolism.
Depending on the underlying cause, some variations in treatment may be indicated. For example, a tracheotomy may be necessary if the patient has an upper airway obstruction. Steroids may be used in the patient with a vasculitis autoimmune phenomenon or acute exacerbations of COPD.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Pulmonary hypertension:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment usually includes oxygen therapy to decrease hypoxemia and resulting pulmonary vascular resistance. It may also include vasodilator therapy (nifedipine, diltiazem, or prostaglandin E). For patients with right-sided heart failure, treatment also includes fluid restriction, cardiac glycosides to increase cardiac output, and diuretics to decrease intravascular volume and extravascular fluid accumulation. Treatment also aims to correct the underlying cause.
Some patients with pulmonary hypertension may be candidates for heart-lung transplantation to improve their chances of survival.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Pulse pressure, widened:
Emergency Interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
Ifthe patient’s level of consciousness (LOC) is decreased, and you suspect that his widened pulse pressure results from increased ICP, check his vital signs and oxygen saturation. Maintain a patent airway. Provide supplemental oxygen and ventilatory support to keep the patient’s partial pressure of arterial oxygen above 90 mm Hg or his oxygen saturation above 95%. Give osmotic diuretics, such as mannitol, by I.V. infusion to decrease ICP. Insert an indwelling urinary catheter; monitor intake and output during mannitol therapy. Start ICP monitoring. Administer analgesics as ordered. Hyperventilation therapy to decrease the patient’s partial pressure of arterial carbon dioxide and to treat ICP remains controversial but may be needed for short intervals when ICP and neurologic deterioration increase. Perform a neurologic examination. Use the Glasgow Coma Scale (see page 480) to evaluate LOC. Check cranial nerve function—especially cranial nerves III, IV, and VI—and assess papillary reactions, reflexes, and muscle tone. Continue ICP monitoring. If you don’t suspect increased ICP, ask about associated symptoms, such as chest pain, shortness of breath, weakness, fatigue, or syncope. Check for edema and auscultate for murmurs.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Cor pulmonale:
Treatment
(Handbook of Diseases)
The goals of treatment include reducing hypoxemia, increasing the patient’s exercise tolerance and, when possible, correcting the underlying condition. In addition to bed rest, treatment may include administration of:
❑ cardiac glycosides (digoxin)
Clinical tip Cardiac glycosides (digoxin) are of questionable value and may increase the risk of toxicity.
❑ antibiotics when respiratory tract infection is present (a culture and sensitivity of a sputum specimen aids in the selection of antibiotics)
❑ potent pulmonary artery vasodilators (such as diazoxide, nitroprusside, hydralazine, angiotensin-converting enzyme inhibitors, calcium channel blockers, and prostaglandins) in primary pulmonary hypertension
❑ oxygen by mask or cannula in concentrations ranging from 24% to 40%, depending on Pao2, as necessary; in acute cases, therapy may also include mechanical ventilation; patients with underlying COPD generally shouldn’t receive high concentrations of oxygen because of possible subsequent respiratory depression
❑ low-sodium diet, restricted fluid intake, and diuretics, such as furosemide, to reduce edema
❑ anticoagulation with small doses of heparin to reduce the risk of thromboembolism.
❑ lung transplants are currently being done and have had favorable results. Lung transplantation may be considered for patients with end-stage COPD, fibrotic lung disease and pulmonary hypertension who have severe symptoms despite maximal medical therapy.
Depending on the underlying cause, some variations in treatment may be necessary. For example, a tracheotomy may be necessary if the patient has an upper airway obstruction, and steroids may be used in patients with a vasculitis autoimmune phenomenon or acute exacerbations of COPD.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Pulmonary hypertension:
Treatment
(Handbook of Diseases)
Appropriate treatment usually includes oxygen therapy to decrease hypoxemia and resulting pulmonary vascular resistance. For patients with right-sided heart failure, treatment also includes fluid restriction, cardiac glycosides to increase cardiac output, and diuretics to decrease intravascular volume and extravascular fluid accumulation. An important goal of treatment is correction of the underlying cause.
CLINICAL TIP: Patients with primary pulmonary hypertension usually respond to epoprostenol (PGI2) as a continuous home infusion.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Pulse pressure, widened:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
If the patient displays increased ICP, continually reevaluate his neurologic status and compare your findings carefully with those of previous evaluations. Stay alert for restlessness, confusion, unresponsiveness, or a decreased LOC. Keep in mind, however, that increasing ICP is commonly signaled by subtle changes in the patient’scondition, rather than the abrupt development of any one sign or symptom.
Patient teaching
Explain needed dietary modifications such as restricted sodium and saturated fats. Stress the importance of planning rest periods. If the patient has a decreased LOC, discuss specific safety measures. If the condition is related to increased body temperature, discuss fever management, proper cooling measures if exposed to excessive heat for long periods, and proper fluid consumption with the patient.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Pulse pressure, widened:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Ifthe patient’s level of consciousness (LOC) is decreased, and you suspect that his widened pulse pressure results from increased ICP, check his vital signs. Maintain a patent airway, and prepare to hyperventilate the patient with a handheld resuscitation bag to help reduce partial pressure of carbon dioxide levels and, thus, ICP. Perform a thorough neurologic examination to serve as a baseline for assessing subsequent changes. Use the Glasgow Coma Scale to evaluate the patient’s LOC. (See Glasgow Coma Scale, page 396.) Also, check cranial nerve function — especially in cranial nerves III, IV, and VI — and assess pupillary reactions, reflexes, and muscle tone. Insertion of an ICP monitor may be necessary. Check for edema and auscultate for murmurs.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Pulse pressure, widened:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ If the patient displays increased ICP, continually evaluate his neurologic status.
▪ Be alert for restlessness, confusion, unresponsiveness, or decreased LOC.
▪ Watch for subtle changes in the patient's condition.
Patient teaching
▪ Explain diagnostic tests, such as blood studies, computed tomography scan, and magnetic resonance imaging.
▪ Explain the underlying disorder and treatment plan.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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