Pneumonia Flashcards
(28 cards)
what is pneumonia
inflammation of the lung parenchyma from bacteria, mycobacteria, fungi, viruses
classifications
- CAP
- HAP
- HCAP
- VAP
causative agents
- s. pneumoniae- younger people without comorbid illnesses
- h. influenzae: older adults or those with comorbid illnesses
underlying diseases and disorder risk factors
- heart failure
- COPD
- Diabetes
- AIDS
- Cystic Fibrosis
risk factors
- smoking
- immunocompromised systems
- prolonged immobility; supine position
- NPO status
- alcohol
- older adults
- respiratory therapy
- transmission of organisms from health care providers
streptococcal clinical manifestations
- sudden onset of chills
- fever
- pleuritic chest pain (pain with inspiration)
- tachypnea
- respiratory distress
viral, mycoplasma, or legionella clinical manifestations
relative bradycardia (fever with a low heart rate)
other clinical maifestations
- respiratory tract infection
- headache
- low grade fever
- pleuritic pain
- myalgia
- rash
- pharyngitis
- orthopnea
- crackles
- increased tactile fremitus
- purulent sputum
assessment and diagnosis
- history
- physical exam
- chest x ray
- blood culture
- sputum examination
- bronchoscopy
questions to ask in history assessment
- recent viral infections
- comorbid conditions
- history of asthma
- sputum: amount, consistency, odor, color
- SOB
- cough: frequency, severity
focus during physical assessment
- inspect and auscultate chest
- O2 stat
- oxygen
- vital signs
- changes in mental status
- fatigue
- edema
- dehydration
- concomitant heart failure (especially in older adults)
purpose of chest x-ray
- show pattern of organism
- shows rate of perfusion
purpose of blood culture
-detect and identify type of microorganism and treatment needed
how to receive sputum culture
rinse mouth out with water, take deep breath, and cough
indication of infection in CBC
- elevation in blood cells
- presence of bands (immature wbc)
purpose for O2 stat and ABG testing
assess for hypoxemia, hypercapnia, or acidosis
purpose of bronchoscopy
- view respiratory structures
- retain biopsies and fluid samples
preoperative bronchoscopy nursing interventions
- make sure informed consent is signed
- patient NPO
- IV access
Intraoperative bronchoscopy nursing interventions
- frequent VS monitoring
- oxygen monitoring
- keeping surgeon updated on patient
postoperative bronchoscopy nursing internventions
- keep pt on oxygen for next 2-4 hours
- wait for gag reflux
- monitor oxygen levels
- chest x-ray
preoperative thoracentesis nursing interventions
- informed consent
- make sure patient has someone to drive them home
intraoperative thoracentesis nursing interventions
-assist pt with leaning forward with elbows over the table with feet supported
postoperative thoracentesis nursing interventions
- monitoring dressing closely
- monitor s/s of pneumothorax: uneven respirations, diminished breath sounds on one side, dyspnea, SOB, anxiety
- monitor for infections for the next few days
nursing interventions to improve airway patency
- TCDB
- suctioning
- humidification
- change position every two hours
- incentive spirometer
- rest
- maintain nutrition: small frequent meals and fluid with electrolyte
