Flashcards in Care of Patients with Infectious Respiratory Problems Deck (43)
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Rhinitis:
Inflammation of nasal mucosa
“Hay fever” or “allergies”
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Manifestations- allergic rhinitis
Headache
Nasal irritation and congestion
Sneezing and rhinorrhea
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Manifestations – viral / bacterial rhinitis
Same as allergic rhinitis
Also systemic – sore/ dry throat, low-grade fever, malaise
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Interventions of Rhinitis
Antihistamines, leukotriene inhibitors, mast cell stabilizers
Decongestants
Antipyretics
Antibiotics
Supportive therapy
Complementary and alternative therapy – vitamin C, zinc
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Sinusitis:
Inflammation of sinus mucous membranes
Usually caused by Streptococcus pneumoniae, Haemophilus influenzae, Diplococcus, Bacteroides
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Manifestations of Sinusitis:
Pain
Purulent nasal drainage
Fever
Erythema
Swelling
Fatigue
Dental pain
Ear pressure
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Nonsurgical management of Sinusitis:
Broad-spectrum antibiotics
Analgesics (pain and fever)
Decongestants
Steam humidification
Hot/wet packs over sinus area
Nasal saline irrigations
Increased fluids
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Pharyngitis:
Sore throat is common inflammation of pharyngeal mucous membranes
Odynophagia, dysphagia, fever, hyperemia
Viral versus Bacterial
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Strep throat can lead to serious medical complications!
Screen with Rapid Antigen Test (RAT)
Results in 15 minutes
-Epiglottitis is rare complication
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Tonsillitis :
Inflammation/infection of tonsils and lymphatic tissues
Contagious airborne infection, usually bacterial
Antibiotics for 7-10 days
Surgical intervention
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Peritonsillar Abscess (PTA)
-Complication of acute tonsillitis
-Manifestations:
Pus causing one-sided swelling with deviation of the uvula
Trismus and difficulty breathing
Bad breath, swollen lymph nodes
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Peritonsillar Abscess (PTA): Treatment
Percutaneous needle aspiration of abscess
Antibiotics
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Laryngitis
Inflammation of mucous membranes lining the larynx; possible edema of vocal cords
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Signs & symptoms of Laryngitis:
Acute hoarseness, dry cough, difficulty swallowing, temporary voice loss (aphonia)
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Laryngitis Treatment focused on relief and prevention:
Voice rest, steam inhalation, increased fluid intake, throat lozenges
Reduce use of tobacco and alcohol
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Influenza
Highly contagious acute viral respiratory infection
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Influenza Signs& Symptoms
Severe headache, muscle ache, fever, chills, fatigue, weakness, anorexia
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Influenza: Vaccination is advisable
Who?
People older 50 yearly vaccines because they are at risk
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Influenza: Antiviral agents may be effective if
started within 24-48 hours of symptoms
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Pandemic Influenza:
“Spanish Influenza”
Mostly prevalent among animals and birds; virus can mutate, becoming infectious to humans
Example: H1N1 (swine flu)
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Pandemic Influenza: Treatment
Strict isolation precautions
Antiviral drugs
-Oseltamivir (Tamiflu), zanamivir (Relenza)
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Pneumonia:
-Excess fluid in lungs resulting from inflammatory process
-Inflammation triggered by infectious organisms, inhalation of irritants
-Inflammation occurs in interstitial spaces, alveoli
-WBC’s to infection site
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Pneumonia S&S:
Reduces gas exchange, leads to hypoxia
Septicemia
Atelectasis- alveolar collapse
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Risk for Pneumonia:
Community-acquired infectious pneumonia
Nosocomial or Health care-acquired
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Pneumonia: Community-acquired infectious pneumonia:
Older adult; never received vaccine or >5 years
Did not receive influenza previous year
Chronic health problems
Exposure to influenza or respiratory viral
Tobacco use/ secondhand, alcohol
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Pneumonia: Nosocomial
Older adult, chronic lung disease
Gram-negative colonization (mouth, throat, stomach)
Altered LOC, recent aspiration, poor nutrition
Presence of ET tube, NG, Trach
Immunocompromised, mechanical ventilation (VAP)
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Clinical Manifestations of Pneumonia:
Increased respiratory rate- dehydration
Dyspnea
Hypoxemia
Cough
Purulent
Vital signs
Lung sounds
Myalgia
Tripod position
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Interventions of Pneumonia:
Hand washing
Sterile water for NG
Aspiration precautions
Oxygen
Incentive spirometry
Smoking education
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Lab assessments for Pneumonia:
Gram stain, culture and sensitivity of sputum
CBC
ABGs
Serum BUN
Electrolytes
Creatinine
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Imaging & Diagnostic Assessment fir Pneumonia:
Chest x-ray
Pulse oximetry
Transtracheal aspiration
Bronchoscopy
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Pneumonia: Community-Based Care
Home care management
Teaching for self-management
Health care resources
Prevention
-Immunization of appropriate persons
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Pulmonary Tuberculosis:
Highly communicable; caused by Mycobacterium tuberculosis
Transmitted via aerosolization
Secondary TB
Increased incidence secondary to HIV infection
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Manifestation of TB
Progressive fatigue
Lethargy
Nausea
Anorexia
Weight loss
Irregular menses
Low-grade fever, night sweats
Cough, mucopurulent sputum, blood streaks
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Diagnostic assessment of TB:
Manifestation of signs/symptoms
NAA (Nucleic acid amplification) test (results in 2 hr)
Sputum smear for acid-fast bacillus
Sputum culture confirms it
Tuberculin (Mantoux) test – PPD (Purified Protein derivative) given intradermally in forearm: if +, then chest x-ray
Induration of 10 mm or greater diameter = Positive for exposure
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PPD Skin test
Positive reaction does not mean that active disease is present, but does indicate exposure to TB or dormant disease
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Interventions of TB:
Combination drug therapy with strict adherence:
Isoniazid
Rifampin
Pyrazinamide
Ethambutol
Negative sputum culture = No longer infectious
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Notes on TB medications
INH- empty stomach, avoid ETOH, dark urine yellow skin = liver toxicity
Rifampin – red/ orange urine, additional contraceptive, ETOH, liver toxicity
PZA – water, sunscreen, ETOH, liver toxicity
EMB – ETOH, vision changes, water
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Pertussis:
Respiratory infection – Bordetella pertussis
Contagious, respiratory droplets
Childhood to adult
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When Pertussis occurs:
Catarrhal stage- Common cold- mild cough
Paroxysmal- Severe coughing ‘fits’- “whooping” cough
Recovery - Can last for months
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Diagnosis for Pertussis
Sputum cultures
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Greatest risk for developing TB:
contact with untreated, HIV, crowded areas prisoners, shelters, mental health, homeless, drug abusers, lower socioeconomic, foreign
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TB is the most common
-bacterial infection
2nd TB reactivated when defenses lowered especially older adults or HIV
Acid-base bacilli AFB
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