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NS 313- Med Surg Exam 1 > Lower Respiratory > Flashcards

Lower Respiratory Flashcards

1
Q

What is pneumonia and how deadly is it?

A
  • Infection of lung parenchyma

- Significantly high morbidity and mortality rate

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2
Q

What occurs with fluid in the lugns in terms of gas exchange?

What do you do if a patient has fluid?

A
  • Fluid makes O2 getting into the lungs and CO2 getting out less effecient
  • Cough
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3
Q

What occurs in pneumonia?

A
  • Decreased cough
  • Decreased epiglotal reflexes
  • Mucociliary mechanism impaired
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4
Q

What things are you at risk for wen you have pneumonia?

A
  • Aspiration

- Infections (ex. Influenza)

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5
Q

Define…

  • Community-Acquired Pneumonia (CAP)
  • Hospital-Acquired Pneumonia (HAP)
  • Ventilator Acquired Pneumonia (VAP)
A

CAP- Not hospitalized or in long term care facility 14 days of the onset of symptoms
HAP- 48 hours or longer after hospitlization and not present at time of admission
VAP- type of HAP that occurs more than 48 hours after endotracheal intubation

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6
Q

What blood test is a good measure for inflammation?

A

ESR- Erythrocyte Sedimentation Rate

—> How quickly erythrocytes settle at the bottom of the test tube

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7
Q

What are the goals/outcomes and treating Pneumonia?

A
  • Clear breath sounds
  • Normal breathing patterns
  • No signs of hypoxia
  • Normal Chest X-Ray
  • Normal WBC count
  • Absence of complications related to pneumonia
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8
Q

What is empyma?

A

Pus

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9
Q

What test do you do to know if someone has cystic fibrosis?

A

Sweat Chloride Test

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10
Q

What are the risk factors for aspiration pneumonia?

A
  • Decrease LOC
  • Decreased Gag Reflex
  • Dysphagia
  • NG Tube
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11
Q

What does necrotizing pneumonia cause?

A

-IMMEDIATE respiratory insufficiency or failure

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12
Q

What are some signs and symptoms of pneumonia?

A
  • Cough, Fever, Chills
  • Dyspnea, Tachypnea
  • Pleuritic, Chest Pain
  • Green, Yellow, Or Rus-Colored Sputum
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13
Q

What would you find in a physical examination with someone who has pneumonia?

A
  • Fine or course crackles
  • Bronchial breath sounds
  • Egophony - Increase resonance of voice when auscultating lungs due to something in lungs
  • Increased Fremitus- put hands on the patient’s back and percuss so if you feel vibrations, it indicates fluids or a tumor
  • Dullness to percussion if pleural effusion present
  • Tachycardia
  • Confusion to Delirium
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14
Q

What is thoracentesis?

A

Thoracentesis- Temporary relief if pleuritic effusion is compromising; Needle is put between ribs into the pleural space between the lungs and the chest wall and drain fluid out

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15
Q

What’s one way to decrease the risk of pneumonia?

What’s one way to treat bacterial pneumonia and how does the patient improve?

A

-Pneumococcal Vaccine (To Prevent Streptococcus Pneumoniae)

  • Antibiotics
  • –> Decreased Temperature
  • –> Improved Breathing
  • –> Chest Discomfort
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16
Q

What are some supportive care interventions a nurse can do for a patient with pneumonia and what do they improve?

A
  • O2 for hypoxemia
  • Analgesics for chest pain
  • Antipyretics for fever
  • Individualize rest vs activity
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17
Q

What is a treatment for viral pneumonias?

A

No definitive treatment

18
Q

What is the treatment for Influenza Pneumonia?

A

Antiviral Drugs

19
Q

What should you do in terms of drug therapy with a patient with pneumonia?

A
  • Start with IV and then switch to oral therapy as soon as patient stable
  • Should see improvements in 3-5 days
20
Q

What should you do in terms of nutritional therapy with a patient with pneumonia?

A
  • Adequate hydration (may have to be IV initially)

- Thin and loosen secretions

21
Q

How should a patient with pneumonia eat and why?

A

-High calorie, small, frequent meals

Because it is easier for dyspneic patients to breath because they can’t eat and breath at the same time

22
Q

Should you monitor for weight loss in patients with penumonia?

A

Monitor for weight loss for patients with pneumonia?

23
Q

What are some nursing diagnosis you can make with a person with pneumonia and related to what?

A
  • Impaired gas exchange- related to fluid and exudate accumulation within the alveoli and surrounding lung tissue
  • Ineffective breathing pattern- related to inflammation and chest discomfort
  • Acute pain- related to inflammation and ineffective pain management
  • Activity Intolerance -related to chest discomfort, Inflammation, SOB, and personalized weakness
24
Q

What are some nursing implementations that can help AT RISK patients from developing pneumonia?

A
  • Reposition every 2 hours
  • Strict medical asepsis
  • Strict Ventilator bundle to theirs only
  • Elevate HOB 30 degrees and have them sit up for all meals
  • Assess for Gag Reflex
  • Incentive Spirometry
  • Mobilize Secretions
  • Skin Checks Frequently
  • Oral Hygiene and Suctioning
  • Avoid unecessary antibiotic use

-Perform Swallow Study for Elderly Patients (ultrasound After Swallowing)

25
Q

What are some important/urgent nursing implementations that can be done during pneumonia acute care (they already have it)

A
  • Frequent assessment with Oximetry
  • PROMPT initiation of antibiotics (unless viral)
  • O2 as needed
26
Q

What are some people you can work with in an interprofessional collaboration and what do they do?

A
  • Respiratory Therapists- Oxygen Therapy

- Physical Therapists- Postural Drainage and Chest Percussion

27
Q

What do humidifiers do?

What don’t they do?

A
  • Facilitates the ease of breathing

- Doesn’t mobilize and/or get rid of secretions

28
Q

What should you see during an evaluation for someone cleared of pneumonia?

A
  • SpO2 Greater than or equal to 95%
  • Clear of Sputum inAirway
  • Effective Respiratory Rate, HR, and Depth of Respirations
  • No Adventitious Breath Sounds
  • Lungs Clear to Ausculatation
29
Q

What should you see and hear if you auscultate and percuss someone with pleural effusion?

A
  • Localized Decreased Breath Sounds

- Dullness to Percussion

30
Q

What is used for outpatient treatment of penumonia?

A

Erythromycin

31
Q

What does TB create in your lungs, when do they occur, and what do they do when they occur?

A
  • Creates craters called Ghon complexes in your lungs
  • Eats Alveoli
  • When Ghon Complexes are Released
32
Q

What are some populations that are vulnerable to TB?

A
  • Homeless
  • Living or Working In Institutions (includes health care workers)
  • IV Drug Users
  • Foreign Born Persons
  • Povery
  • Immunosurpressed
33
Q

What are some diagnostic tests that can be done to determine TB?

A
  • Tuberculin Skin Test
  • Sputum Culture and Sensitivity
  • Sputum for AFB
  • Chest X-Ray
34
Q

How long does it take to clear TB?

A

6-9 months

35
Q

What criteria does TB need in order to be considered Multidrug-Resistant Tuberculosis (MDR-TB)?

A

Resistance to at least 2 potent first line anti-TB drugs

-Specifically Rifampin and Isoniazid

36
Q

What criteria does TB need in order to be considered Extensively Drug Resistant TB (XDR-TB)?

A

Resistant to any Fluoroquinolone + Any Injectable Antibiotic

Most Resistant to Treatment

37
Q

Describe Primary, Latent, and Active TB infections?

A

Primary- Initial Infection and Inflammation begins

Latent TB- No signs or symptoms but infected

Active TB- Reactivation post Primary; Signs and symptoms show

38
Q

What is a somewhat unique symptom of TB?

A

Night Sweats

39
Q

What are the classes of TB Infections?

A

Classes
0 = No exposure or History
1 = Exposure and No History (-PPD)
2 = Latent TB and no Symptoms (+PPD skin test)
3 = TB Clinically Active (+ bacteriological studies or both a +PPD and X-Ray Evidence)
4 = History of TB but not clinically active (+PPD)
5 = TB suspect (diagnoasis pending and stay in this category for 3 months)

40
Q

What does a +PPD skin test indicate?
What doesn’t it indicate?
What constitutes as a +PpD test?

A
  • Indicates Infection
  • Doesn’t indicate whether it’s latent or active causing illness
  • Reactions greater than or equal to 15 mm considered positive in normal patients
41
Q

What is considered a +PPD test in an immunocompromised patient?

A

Reactions greater than or equal to 5mm

NS 313- Med Surg Exam 1 (10 decks)

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