Module 2 - Pneumonia

Question 1

Types of Pneumonia

Answer 1

Typical
Atypical
Hospital Acquired Pneumonia (HAI)
Community Acquired Pneumonia (CAI)
Ventilator Associated Pneumonia
Aspiration Pneumonia
Immunocompromised Pneumonia

Question 2

Hospital Acquired Pneumonia

Answer 2

Pneumonia that develops >48 hours after admission into hospital

Question 3

Community Acquired Pneumonia

Answer 3

Pneumonia that develops in the community or <48 hours after admission into hospital

Question 4

Respiratory Defenses

Answer 4

Cough Reflex
Mucociliary Blanket
Respiratory macrophages
Respiratory antibodies

Question 5

Signs & Symptoms of Typical Pneumonia

Answer 5

fever
malaise
chills
fever
productive cough - green/brown/yellow mucus  
SOB
chest pain
hemoptysis

Question 6

Respiratory Defenses

Answer 6

Cough reflex
Mucociliary blanket
Antibodies (IgA)
Alveolar macrophages

Question 7

Community-acquired Pneumonia

Answer 7

Pt has been out of hospital for 2 weeks

Diagnosis within 48 hrs of admission

Question 8

Hospital-Acquired Pneumonia

Answer 8

Pt diagnosed after 48 hrs of admission

More likely to be associated with antibiotic-resistant bacteria

Question 9

Aspiration Pneumonia

Answer 9

occurs when fluids/foreign matter is aspirated from upper airway –> lungs

Question 10

Populations at risk for Aspiration Pneumonia

Answer 10

dysphagic patients
stroke patients
patients with decreased LOC (sedation, drugs, alcohol)

Question 11

Walking Pneumonia

Answer 11

Mild case of CAP

does not require bedrest or hospitalization

Question 12

Risk Factors

Answer 12

Surgery --> decreased DB+C
Immobility
Dysphagia 
Neurological/Cognitive impairment (stroke, dementia)
Immunocompromised 
Alcohol
Smoking
Diabetes
Heart Failure
Age (>65)
COPD

Question 13

Complications of Pneumonia

Answer 13

hypoxemia
life-threatening low blood pressure
lung abscess
lung injury -> acute respiratory distress syndrome 
sepsis

Question 14

Consolidation

Answer 14

accumulation of fluid, debris and particles in the alveoli

Question 15

Pneumonia

Answer 15

infection leading to inflammation of the lung parenchyma

Question 16

Lobar Pneumonia

Answer 16

Entire lobe of lung is affected

Question 17

Bronchopneumonia

Answer 17

patchy infection. part of the airway + parts of parenchyma are affected

Question 18

Atypical Pneumonia Location

Answer 18

Affects the alveolar septum and interstitium of lungs

Question 19

Typical Pneumonia Location

Answer 19

Affects the alveoli

Question 20

Stages of Typical Pneumonia

Answer 20

Consolidation
Red Hepatization
Gray Hepatization
Resolution

Question 21

SaO2

Answer 21

oxygen saturation of arterial blood. measured directly by an ABG or indirectly by pulse oximetry

Question 22

SpO2

Answer 22

oxygen saturation of available hemoglobin in arterial blood. indirectly measures SaO2

Question 23

PaO2

Answer 23

partial pressure of oxygen in blood plasma. measured by an ABG

Question 24

Immunocompromised Pneumonia

Answer 24

microbes that may not cause pneumonia in healthy individuals cause pneumonia in IMC pts because of increased susceptibility

Question 25

Atypical Pneumonia S/S

Answer 25

dry cough | low grade fever

Question 26

Parenchyma

Answer 26

functional tissue of an organ

Question 27

Typical Pneumonia Agents

Answer 27

bacteria | viral (influenza)

Question 28

Atypical Pneumonia Agents

Answer 28

mycoplasma | viruses

Question 29

Mycoplasma

Answer 29

type of bacteria lacking a cell wall

Question 30

HA Pneumonia Risk Factors

Answer 30

``` Intubation/Venatilator Immunocompromised Status Chronic Lung Disease Immobility Dysphagia Airway instrument (endotracheal tube/tracheotomy) ```

Question 31

Types of Immunocompromised Status

Answer 31

Low Humoral Immunity Low cellular Immunit Neutropenia/Impaired granulocyte function

Question 32

Normal Lung Sounds

Answer 32

Bronchial Bronchovesicular Vesicular

Question 33

Bronchial sounds

Answer 33

loc: trachea (abnormal if heard elsewhere) loud expiration harsh, hollow, tubular

Question 34

Bronchovesicular sounds

Answer 34

loc: major bronchi moderate heard on inspiration/expiration mixed sound

Question 35

Vesicular

Answer 35

loc: peripheral lung fields soft inspiration rustling sound

Question 36

Diagnostic Tests

Answer 36

``` ABG - acidosis CBC - elevated WBC Blood culture - bacteremia Chest X-ray - consolidation, edema Sputum Culture & Sensitivity (id bacteria & antibiotic) ```

Question 37

Abnormal Respiratory Data

Answer 37

``` Chest pain Dyspnea Increased WOB Abnormal lung sounds SpO2 <92 or 88 Cyanosis Pale, cold, clammy (decreased CWMS) ```

Question 38

Respiratory interventions (9)

Answer 38

``` Raise HOB DB+C Incentive spirometer Bronchodilators Oxygen therapy Fluid intake (dilute secretions) Pain treatment Oral care Promote Mobility ```

Question 39

Determinants of gas exchange

Answer 39

``` Alveolar Diffusion Distance Ventilation Pulmonary Perfusion Composition of Air Gas Transport ```

Question 40

Factors increasing metabolic demand

Answer 40

Physical Activity Stress Fever