General Assessment Of Clients With Respiratory Disorders Flashcards
(110 cards)
1
Q
Risk Factors for Respiratory disease
A
- smoking
- exposure to secondhand smoke
- personal and family history of lung disease
- genetic makeup
- allergens and evironmental pollutants
- recreational and occupational exposure
2
Q
Nursing History
A
- demographic data
- personal and family history
- diet history
- occupational history and socio economic status
- current health problems
3
Q
Nursing History:
Age, gender, and race can affect the physical and diagnostic findings related to respiratory function. Many of the diagnostic studies relevant to respiratory disorders (e.g., pulmonary function tests) use these?______________ for determining predicted normal values.
A
Demographic Data
4
Q
Nursing History:
Personal and Family History
A
- medical history
- Smoking history
- medication use
- allergies
- travel and area of residence
5
Q
Whether the pulmonary problena is acute or chronic, the chief complaint is likely to include _______,_________,_________,_____________.
A
- cough
- sputum production
- chest pain
- shortness of breath at rest or on exertion
6
Q
During the interview, the nurse explores the history of the present illness, preferably in chronologic order.
This analysis of the problems) includes the following:
A
- onset
- duration
- location
- frequency
- progressing and radiating patterns
- quality and numbers of symptoms
- aggravating and relieving factors
- associated signs and symptoms
- treatments
7
Q
Physical Assessment/ Examination
A
- Assessment of sinuses and nose
- assessment of pharynx, trachea and larynx
- assessment of lungs and thorax
- assessment of normal breath sounds ( adventitious breath sounds)
- other indicators of respiratory adequacy
8
Q
Physical Assessment/examination
Other indicator of respiratory adequacy
A
- cyanosis
- skin and mucous membrane
- general appearance
- endurance
9
Q
Physical Assessment/examination
Other indicator of respiratory adequacy
A
- cyanosis
- skin and mucous membrane
- general appearance
- endurance
10
Q
A skin test to detect if you have been infected with TB bacteria/ Mycobacterium Tubercle Bacilli
A
Skin Test Mantoux Test
11
Q
A skin test to detect if you have been infected with TB bacteria/ Mycobacterium Tubercle Bacilli
A
Skin Test Mantoux Test
12
Q
Skin Test Mantoux Test:
Meaning of PPD?
- skin test used to diagnose latent TB Infection
A
Purified Protein Derivative
13
Q
Skin Test Mantoux Test:
For HIV clients, induration of _______ is considered positive.
a. 3 mm
b. 4 mm
c. 5 mm
A
c. 5 mm
14
Q
Skin Test Mantoux Test
(1)______ Mantoux test signifies exposure to (2)___________.
For (1)
a. Positive (+)
b. Negative (-)
A
- a. Positive
- Mycobacterium tubercle bacilli
15
Q
Skin Test Mantoux Test
- Site?
a. Subcutaneous
b. Intradermal
c. Intramascular - read __________ after injection
a. 49-70hrs
b. 50-75hrs
c. 48-72hrs
A
- B. Intradermal
- C. 48 - 72 hrs
16
Q
Non invasive method of continuously monitoring the oxygen saturation of hemoglobin.
A
Pulse Oximetry
17
Q
Pulse Oximetry
Ideal normal pulse oximetry values are:
A
95% - 100%
18
Q
Throat, nasal and nasopharyngeal ___________ can identify pathogens responsible for respiratory infections
A
Cultures
19
Q
Done for analysis to identify pathogenic organisms and to determine whether malignant cells are present; also be obtained to assess for hypersensitivity states
A
Sputum examination/studies
20
Q
Sputum examination/ studies:
Specimen is delivered to the laboratory within
a. 1 hr
b. 2 hrs
c. 3 hrs
A
B. 2 hrs
21
Q
Sputum examination/studies
What is
1. C & S
2. AFBS
A
- Sputum culture and sensitivity analysis
- Acid fast bacilli staining
22
Q
Sputum examination/studies
Procedure:
1. _______ sputum specimen is to be collected.
a. Early morning b. Early evening
- Rinse mouth with ________.
a. Juice b. Plain water - Use Sterile ________.
a. Can b. Container
A
- A. Early morning
- B. Plain water
- B. Container
23
Q
Sputum examination/studies
- Sputum specimen for C & S is collected before the __________ of antimicrobial.
- For AFB staining, collect sputum specimen for__________ mornings.
A
- First does
- Three consecutive mornings
24
Q
Are routinely used in patients w/ chronic respiratory disorders.
Evaluates lung function and dysfunction.
useful in screening clients for pulmonary disease even before the onset of signs or symptoms
A
Pulmonary Function Studies/tests
25
Assess ventilation and acid base balance; assesses oxygenation (partial pressure of arterial oxygen [Pao2]), alveolar ventilation (partial pressure of arterial carbon dioxide [Paco2), and acid-base balance.
Arterial Blood Gases
26
Arterial Blood Gases
Common site for withdrawal of blood specimen
Radial artery
27
Arterial Blood Gases
Done to assess for adequacy of collateral circulation of the hand.
Allen's test
28
Arterial Blood Gases
1. ________ pre-heparinized syringe to prevent 2. ____________ of specimen.
1.
a. 5 ml
b.10 ml
c. 15 ml
2.
a. Numb
b. Clotting
c. Bleeding
1. B. 10 ml
2. B. Clotting
29
Arterial Blood Gases
Container with ______ to prevent hemolysis of the specimen.
a. Ice
B. Hot water
A. Ice
30
Imaging Studies
Performed for clients with respiratory tract disorders to evaluate the present status of the chest and to provide a baseline for comparison with future changes.
Chest Xray
31
Imaging Studies: Chest Xray
Standard chest xray examination are performed from?
Posteroanterior and left lateral
32
Imaging studies:
An imaging method in which the lungs are scanned in successive layers by a narrow beam x-ray; the images produced provide a cross sectional view of the chest; can distinguish fine tissue density
Computed Tomogrophy
33
Imaging studies
Similar to CT except that magnetic fields & radiofrequency signals are used instead of a narrow beam x-ray.
Visualizes soft tissues.
Used to characterize pulmonary nodules.
MRI (Magnetic Resonance Imaging)
34
Imaging Studies:
Studies the lung and chest in motion.
obtaining "live" X-ray images of a living patient
Fluoroscopy
35
Imaging studies:
Commonly used to investigate thromboembolic disease of the lungs.
Involves rapid injection of a radiopaque agent.
Pulmonary Angiography
36
Imaging Studies:
A nuclear scanning test that is most commonly used to detect a blood clot.
Measure blood perfusion through the lungs
Confirm pulmonary embolism or other blood-flow abnormalities.
Lung Scan
37
Imaging Studies: Lung Scan
Remain ________ during the procedure.
a. Standing
b. Still
c. Sitting
B. Still
38
Imaging Studies:
A radiopaque medium is instilled directly into the trachea and bronchi
Bronchography
39
Imaging Studies: Bronchography
Nursing interventions before bronchogram.
- Secure consent
- Check for allergies to seafoods & iodine & anesthesia
- NPO for 6-8 hours
-Pre-op meds: atrophine SO4 & valium, topical anesthesia sprayed; followed by local anesthetic injected into larynx.
- Have oxygen & antispasmodic agents ready.
40
Imaging Studies: Bronchography
Nursing Interventions after:
- Side lying position
- NPO until cough and gag reflexes return
- Cough & deep breathe client
- Low grade fever common
41
Endoscopic Procedures:
The direct inspection & observation of the larynx, trachea & bronchi through a flexible or rigid bronchoscope.
Bronchoscopy
42
Endoscopic Procedures: Bronchoscopy
Diagnostic use:
- to collect secretions
- to determine location of pathogenic process & collect specimen for biopsy.
43
Endoscopic Procedures: Bronchoscopy
Therapeutic uses:
- remove foreign object
- excise lesions
44
Endoscopic Procedures: Bronchoscopy
Nursing interventions prior to bronchoscopy:
- Informed consent/permit needed
- Atrophine S04 & valium pre-op;topical anesthesia sprayed followed by local anesthesia injected into larynx
- NPO 6-8 hrs
- Remove dentures, prostheses, contact lenses.
45
Endoscopic Procedures: Bronchoscopy
Nursing Interventions after:
- check for return of cough & gag reflexes before giving fluid.
- watch for cyanosis, hypotension, tachycardia, arrhytmias, hemoptysis,dyspnea. These signs & symptoms indicate perforation of bronchial tree.
46
Endoscopic Procedures:
A diagnostic procedure in w/c the pleural cavity is examined with an endoscope
Thorascopy
47
Endoscopic Procedures:
Aspiration of fluid or air from the pleural space
Used for diamosis or treatment and involves the pleural fluid or air from the pleural space.
Thoracentesis
48
Endoscopic Procedures: Thoracentesis
Nursing Interventions before thoracentesis
- secure consent take initial V/S
- position: upright leaning on over bed table
- instruct to remain still, avoid coughing during insertion of needle
- pressure sensation is felt on insertion of needle
49
Endoscopic Procedures: Thoracentesis
Nursing Interventions after:
- Turn on the unaffected side to prevent leakage of fluid in the thoracic cavity
- Bed rest until VS is stabie
- Check for the expectoration of blood. Notify physician
- Monitor VS
50
Endoscopic Procedures:
Performed to obtain tissue for histologic analysis, culture & cytologic examination.
Biopsy of Lungs
51
Endoscopic Procedures: Biopsy of Lungs
_________ are used to make a definite diagnosis regarding the type of malignancy, infection, inflammation or lung disease
Tissue samples
52
Endoscopic Procedures: Biopsy of Lungs
_________ are used to make a definite diagnosis regarding the type of malignancy, infection, inflammation or lung disease
Tissue samples
53
Endoscopic Procedures: Biopsy of Lungs
Biopsy procedures:
- Transbronchoscopic biopsy - done during bronchoscopy
- Percutaneous needle biopsy - areas not accessible by bronchoscopy
- Open lung biopsy
54
Endoscopic Procedures:
Removes lymph node tissue to be looked at under a microscope for signs of infection or a disease.
To assess metastasis of cancer.
Lymph node biopsy
55
Common Respiratory Interventions
- oxygen theraphy
- tracheobronchial suctioning
- bronchial hygiene measures
- chest physiotheraphy
- incentive spirometry
- closed chest drainage ( thoracostomy tube)
56
Common Respiratory Interventions:
Bronchial hygiene measures:
- Suctioning: oropharyngeal, nasopharyngeal
- Steam inhalation
- Aerosol inhalation
- Medimist inhalation
57
Common Respiratory Interventions:
Chest Physiotherapy (CPT):
- postural drainage
- percussion
- vibration
58
Common Respiratory Interventions:
Incentive Spirometry:
- Enhance deep inhalation
59
Common Respiratory Interventions:
Closed Chest Drainage (Thoracostomy tube)
Purposes:
- To remove air and/or fluids from the pleural space
- To reestablish negative pressure and reexpand the lungs
Types:
a. Two botle system
b. Two bottle system
c. Three bottle system
60
RESPIRATORY DISORDERS:
Infection of the mucous membrane
Sinusitis
61
RESPIRATORY DISORDERS: Sinusitis
Causes:
- URTI (Upper respiratory tract infection) / cold
- Cigarette smoking
- Allergic rhinitis
62
RESPIRATORY DISORDERS: Sinusitis
Assessment:
- Pain
-Maxillary: cheek, upper teeth
- Frontal: above eyebrows
- Ethmoid: in & around the eyes
- Sphenoid: behind the eye, occiput, top of the head
- General malaise
- Stuffy nose
- Headache
- Post-nasal drip
- fever
63
RESPIRATORY DISORDERS: Sinusitis
Surgical Management:
- Functional Endoscopic Sinus Surgery (FESS)
- Caldwell-Luc Surgery (Radical Antrum Surgery)
a. Do not chew on affected side
b. Caution with oral hygiene to prevent trauma of incision
c. Do not wear dentures for 10 days
d. Do not blow nose for 2 weeks after removal of packing
e. Avoid sneezing for 2 weeks after surgery
- Ethmoidectomy - surgical procedure in which tissue from the ethmoid sinus cavity is removed. The procedure is usually used to treat chronic sinusitis.
- Sphenoidotomy/ethmoidotomy-
Osteoplastic flap surgery for frontal sinusitis
64
RESPIRATORY DISORDERS:
A group of disorders characterized by inflammation & imitation of the mucous membranes of the nose.
Can coexist with other respiratory disorders, such as asthma.
Maybe acute or chronic, nonallergic or allergic.
Rhinitis
65
RESPIRATORY DISORDERS: Rhinitis
Seasonal rhinitis occurs during (1)_________ and perennial rhinitis occurs (2)___________.
1. Pollen season
2. Throughout the year
66
RESPIRATORY DISORDERS: Rhinitis
Causes:
- Changes in temperature or humidity
- Odors
- Infection
- Age
- Systemic disease
- Use of OTC drugs & prescribed nasal decongestants
- Presence of a foreign body
- Allergic rhinitis
- Exposure to allergens: food, medications, particles in the outdoor & indoor environment
67
RESPIRATORY DISORDERS: Rhinitis
Clinical Manifestations:
- Rhinorrhea (excessive nasal drainage, runny nose)
- Nasal congestion, nasal discharge (purulent w/ bacterial rhinitis)
- Sneezing
- Pruritus of the nose, roof of the mouth, throat, eyes & ears
- Headache
68
RESPIRATORY DISORDERS: Rhinitis
Medical Management:
- Antihistamines & corticosteroid nasal sprays
- Oral decongestant agents - nasal obstruction
69
RESPIRATORY DISORDERS: Rhinitis
Nursing Management:
- Instruct patient w/ allergic rhinitis to avoid or reduce exposure to allergens & irritants
- Patient education is essential when assisting the patient in the use of all medications
Instruct patient about the importance of controlling the environment at home and at work
• For infectious rhinitis, emphasized hand hygiene technique w/ the patient as a measure to prevent transmission of organisms.
• In elderly and other high risk populations, the nurse reviews the value of receiving an
influenza vaccination each year to achieve immunity.
70
RESPIRATORY DISORDERS:
Sudden and life threatening deterioration of the gas exchange function of the lungs and indicates failure of the lungs to provide adequate oxygenation or ventilation for the blood.
Defined as a decrease in arterial oxygen tension (Pa02) to less than 50 mmEg (hypoxemia) and an increase in arterial carbon dioxide tension (PaCO2) to greater than So mmHg (hypercapnia), w/ an arterial pH of less than 7.35.
Acute Respiratory Failure (ARD)
71
RESPIRATORY DISORDERS: Acute Respiratory Failure
Causes:
Ventilator failure mechanisms leading to ARD include:
- Impaired function of the Central Nervous System
- Neuromuscular dysfunction ( myasthenia gravis, Guillain - Barre syndrome, amyotropic lateral sclerosis, spinal cord trauma)
- Musculosleletal dysfunction
- Pulmonary dysfucnction
72
RESPIRATORY DISORDERS: Acute Respiratory Failure
Causes:
Oxygenation failure mechanisms leading to ARD include:
- Pneumonia
-ARDs
-Heart failure
- pulmonary embolism
- restrictive lung disease
- COPD
73
RESPIRATORY DISORDERS: Acute Respiratory Failure
Early signs:
Restlessness,
fatigue,
headache,
dyspnea,
air hunger,
tachycardia and HPN
74
RESPIRATORY DISORDERS: Acute Respiratory Failure
As hypoxemia progresses, more obvious signs present:
Confusion,
lethargy,
tachycardia,
tachypnea,
central cyanosis,
diaphoresis &
finally respiratory arrest
Use of accessory muscles, decreased breath sounds
75
RESPIRATORY DISORDERS: Acute Respiratory Failure
Medical Management:
- assist with intubation and maintaining mechanical ventilation
- assess the patient’s respiratory status by monitoring the level of responsiveness, ABGs, pulse oximetry & VS
- assess the entire respiratory system and implements strategies to prevent complications.
- assess the patient’s understanding of the management strategies that are used and initiatives some form of communication to enable the patient to express concerns and needs to the health care team.
76
RESPIRATORY DISORDERS:
A severe form of acute lung injury.
Acute Respiratory Distress Syndrome
77
RESPIRATORY DISORDERS: Acute Respiratory Distress Syndrome
Etiologic factors/causes:
- Aspiration (gastric secretions, drowning)
- Drug ingestion & overdose
- Polonged inhalaion of high consentration boxygen, smoke, or corrosives
substances
- Localized infection (bacterial, fungal, viral pneumonia)
- Metabolic disorders (pancreatitis, uremia)
- Shock (any cause)
- Trauma (pulmonary contusion, multiple fractures, head injury)
- Major surgery
- Fat or air embolism
- Systemic sepsis
- 02 toxicity
78
RESPIRATORY DISORDERS: Acute Respiratory Distress Syndrome
Clinical Manifestations:
- Increase RR
- fine crackles
- dyspnea
- retractions
- central cyanosis
- dry cough
-fever
- alteration in LOC
- ABG’s : decrease Pa02
increase PaCO2
79
RESPIRATORY DISORDERS: Acute Respiratory Distress Syndrome
Helpful in distinguishing ARDS from hemodynamic pulmonary edema.
Plasma brain natriuretic peptide (BNP)
80
RESPIRATORY DISORDERS: Acute Respiratory Distress Syndrome
May be used if the BNP is not conclusive
Transthoracic Echocardiography
81
RESPIRATORY DISORDERS: Acute Respiratory Distress Syndrome
The definitive method to distinguish between hemodynamic ( heart failure) and permeability edema
Pulmonary artery catheterization
82
RESPIRATORY DISORDERS: Acute Respiratory Distress Syndrome
Medical Management:
- Intubation & mechanical ventilation
- Circulatory support, adequate fluid volume and nutritional support
- Supplemental oxygen
Monitor ABGs, pulse oximetry & bedside pulmonary function testing.
- PEEP (Posive End Expiratory pressure)
- Inotropic or vasopressor agents may be required
- Pulmonary artery pressure catheters
- Adequate nutritional support
83
RESPIRATORY DISORDERS: Acute Respiratory Distress Syndrome
Medical management:
Critical part in the testiment of ARDS.
PEEP ( Positive End Expiratory pressure)
84
RESPIRATORY DISORDERS: Acute Respiratory Distress Syndrome
Medical Management:
Used to monitor the patient's fluid status & the severe &progressive pulmonary HPN sometimes observed in ARDS.
Pulmonary artery pressure catheters
85
RESPIRATORY DISORDERS: Acute Respiratory Distress Syndrome
Medical Management:
Adequate nutrional support
- Patients w/ ARDS require 35-45 kcal/kg/day to meet caloric requirements
- Enteral feeding
- Parenteral nutrition
86
RESPIRATORY DISORDERS: Acute Respiratory Distress Syndrome
Nursing Management:
- Close monitoring in the ICU by the nurse
- 02 thearpy (increase flow 8-10 L/m)
- Position: semi to high Fowler's
- Increase fluid intake (balance with diuretics due to pulmonary edema)
- Meticulous eye care
- Frequent assessment of the patient's status is necessary to evaluate the effectiveness of treatment.
- Turn patient frequently to improve ventilation & perfusion in the lungs & enhance secretion drainage
- Reduce patient's anxiety
- Provide rest
- anticipate the patients needs regarding comfort and pain
- check the patients position to ensure comfortability
87
RESPIRATORY DISORDERS:
Inflammation of the bronchi usually caused by a viral infection.
Acute Bronchitis
88
RESPIRATORY DISORDERS: Acute Bronchitis
Causes:
- bacterial & viral infection
- chemical irritants
- cigarette smoking
89
RESPIRATORY DISORDERS: Acute Bronchitis
Clinical manifestations:
- wheezing
- coughing with green or yellow color sputum
- shortness of breath
- fever w/ chills (infection)
- body malaise
- muscle aches
- sore throat
- nasal congestion
90
RESPIRATORY DISORDERS: Acute Bronchitis
Diagnostic findings:
- Chest x-ray
- Pulmonary function tests
- ABGs analysis
91
RESPIRATORY DISORDERS: Acute Bronchitis
Treatments:
The goal of treatment for bronchitis is to relieve symptoms and ease breathing
- Paracetamol, ibuprofen for fever, body aches and headaches
- Increase fluids
- Rest
- Breathing in warm moist air
92
RESPIRATORY DISORDERS:
Inflammation of the lung parenchyma caused by various microorganisms, including bacteria, mycobacteria, fungi & viruses.
Pneumonia
93
RESPIRATORY DISORDERS: pneumonia
Risk Factors:
- Conditions that produce mucus or bronchial obstruction & interfere w/ normal lung drainage ( cancer, cigarette smoking, COPD)
- Immunosuppressed patients
- Smoking
- Prolonged immobility & shallow breathing pattern
- Depressed cough reflex (due to medications, debilitated state or weak respiratory muscles), aspiration of foreign material into the lung during a period of unconsciousness or abnormal swallowing mechanism
- NPO status, placement of nasogastric, orogastric or endotracheal tube
- Supine positioning in patients unable to protect their airway
- Antibiotic therapy (in very ill people)
- Alcohol intoxication
- General anesthetic, sedative, or opiod preparations (promote respiratory depression)
- Advanced age
- Respiratory therapy w/ improperly cleaned equipment
- Transmission of organisms from health care providers
94
RESPIRATORY DISORDERS: pneumonia
Classifacations:
- A. Community Acquired Pneumonia (CAP)
- B. Hospital Acquired Pneumonia (HAP)/Nosocomial Pneumonia
- C. Pneumonia in Immunocompromised host
- D. Aspiration pneumonia
95
RESPIRATORY DISORDERS: pneumonia
Classification:
Occurs either in the community setting or within the first 48 hours after hospitalization or institutionalization.
Community Acquired Pneumonia (CAP)
96
RESPIRATORY DISORDERS: pneumonia
Classification: Community Acquired Pneumonia (CAP)
*Causative agents for CAP that requires hospitalization:
- S. pneumonia
- H. influenza
97
RESPIRATORY DISORDERS: pneumonia
Classification: Community Acquired Pneumonia (CAP)
Causative agents for CAP that requires hospitalization:
*Most common cause of CAP in people younger than 60 years of age; gram positive organism that resides naturally in the upper respiratory tract
S. pneumonia
98
RESPIRATORY DISORDERS: pneumonia
Classification: Community Acquired Pneumonia (CAP)
Causative agents for CAP that requires hospitalization:
* cause a type of CAP that frequently affects elderly people & those w/ comorbid illnesses (COPD, alcoholism, DM)
H. influenza
99
RESPIRATORY DISORDERS: pneumonia
Classification:
* The onset of pneumonia symptoms more than 48 hours after admission in patients with no evidence of infection at the time of admission
Hospital Acquired Pneumonia (HAP)/Nosocomial Pneumonia
100
RESPIRATORY DISORDERS: pneumonia
Classification: Hospital Acquired Pneumonia (HAP)/Nosocomial Pneumonia
*Common organism/ causative agents
- enterobacter species,
- escherechia coli,
- H. influenza,
- Klebsiella species,
- proteus,
- Serratia marcescens,
- P aeruginosa,
- S. aureus,
- S. pneumonia
101
RESPIRATORY DISORDERS: pneumonia
Classification: Hospital Acquired Pneumonia (HAP)/Nosocomial Pneumonia
Predisposing Factors:
- Sever acute or chronic illness
- Supine positioning & aspiration
- Coma
- Malnutrition
- Prolonged hospitalization
- Hypotension
- Metabolic disorders
102
RESPIRATORY DISORDERS: pneumonia
Classification:
* Occurs with the use of corticosteroids or other immunosuppressive agents, chemotherapy, nutritional depletion, use of broad spectrumantimicrobial agents, AIDS, genetic immune disorders & long term advanced life-support technology (mechanical ventilation)
Pneumonia in Immunocompromised host
103
RESPIRATORY DISORDERS: pneumonia
Classification: Pneumonia in Immunocompromised host
*causative agents:
- pneumocytis pneumonia
- fungal pneumonias
- mycobacterium tuberculosis
104
RESPIRATORY DISORDERS: pneumonia
Classification:
Refers to the pulmonary consequences resulting from entry of endogenous or exogenous substances into the lower airway.
Aspiration pneumonia
105
RESPIRATORY DISORDERS: pneumonia
Classification: Aspiration pneumonia
* Most common form of aspiration pneumonia is _____________ from aspiration of bacteria that normally reside in the upper airway
Bacterial infection
106
RESPIRATORY DISORDERS: pneumonia
Classification: Aspiration pneumonia
*assessment and diagnostic findings
- Physical exam
- Chest x-ray
- Blood culture
- Sputum exam
- Bronchoscopy
107
RESPIRATORY DISORDERS: pneumonia
* Medical Management
- Pharmacologic therapy
- Warm moist inhalations
- Red rest
Oxygen therapy — hypoxemia
Monitor ABGs, pulse oximetry, sputum, chest x-ray, temperature
Incentive spirometry
108
RESPIRATORY DISORDERS: pneumonia
Medical Management:
* Pharmacologic therapy
- Antibiotics: azithromycin, clarithromycin or erythromycin
- Flouroquinolone ( moxifloxacin, gemifloxacin or levofloxacin) -
outpatients w/ CAP who have cardiopulmonary disease
- Antihistamines - for sneezing & rhinorrhea
109
RESPIRATORY DISORDERS: pneumonia
* Nursing Diagnoses:
- Ineffective airway clearance R/T copious tracheobronchial secretions
- Activity intolerance R/T impaired respiratory function
- Risk for fluid volume deficit R/T fever and rapid RR
- Imbalanced nutrition: less than body requirements
- Knowledge deficit about the treatment regimen & preventive health measures
110
RESPIRATORY DISORDERS: pneumonia
* Nursing Management
- Improving airway patency
-Promoting Rest and Conserving Energy
- Promoting fluid intake
- maintaing nutrition
- promoting patient’s knowledge
- monitoring and managing potential complications
- promoting home care and community based
