any condition that deprives O2 in

the lungs

hypercapnia and hypoxemia

pulmonary arterial vasoconstriction  pulmonary vascular bed (emphysema or

pulmonary emboli)

increased resistance in the pulmonary

circulatory system

pulmonary hypertension

right ventricular
hypertrophy

cor pulmonale
DEFINITION ASSESSMENT

is a condition in which the right ventricle RISK FACTORS Right ventricular failure
of the heart enlarges (with or without right-sided  edema on feet & legs
heart failure) as a result of diseases that affect Chronic obstructive pulmonary
the structure or function of the lung or its
 distended neck veins
disease (COPD)
vasculature.  enlarged palpable liver
Chronic blood clots in the lungs
It is a type of pulmonary arterial hypertension due  pleural effusion
Cystic fibrosis
to a known cause  ascites
Scarring of the lung kyphoscoliosis
 heart murmurs
Obstructive sleep apnea
hypercapnia
 headache
 confusion
NURSING INTERVENTIONS  somnolence
Others
 Reposition the bed ridden patient often   shortness of breath
COR PULMONALE  wheexzing
to prevent atelectasis.
 Provide meticulous respiratory care,  cough
 fatigue
including oxygen therapy and for COPD
 edema
patients.
 hypertension
 Measure ABG levels and watch for signs
of respiratory failure as change in pulse
DRUGS
rate, deep labored respirations; and
increased fatigue produced by exertion.  bronchodilators- improve ventilation
 diuretics- reduce peripheral edema
 digitalis- relive pulmonary hypertension if
LABORATORY/ DIAGNOSTIC TEST
the patient also has left ventricular failure,
 CT scans, which take images of parts of a supraventricular dysrhythmia, or right
NURSING DIAGNOSIS the body ventricular failure that does not respond
 an echocardiogram, which uses sound to other
 Decreased cardiac output r/t restricted cardiac
waves to produce images of your heart  therapy.
muscle contractility as evidenced by ECG MEDICAL MANAGEMENT
 Impaired gas exchange r/t expiratory airflow  chest X-rays, which take images of
various parts of your chest 
obstruction as evidence of  02 sat level oxygen therapy- improve gas exchange and reduce pulmonary
 a lung scan, which is used to detect
 Impaired tissue perfusion r/t decreased cardiac arterial pressure and pulmonary vascular resistance
blood clots  chest physical therapy & bronchial hygiene maneuvers- to
contractility & expiratory airflow obstruction
 lung function tests, which determine
 activity intolerance r/t decreased cardiac activity remove accumulated secretions
how well your lungs work  bed rest, Na restriction- reduce peripheral edema
and labored respiration
 right heart catheterization 
 disturbed sleep pattern r/t shortness of breath ECG monitoring- indicate high incidence of dysrhythmias