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pneumonia Flashcards

1
Q

What is pneumonia?

A

Inflammation of lung parenchyma - can be caused by various microorganism

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2
Q

what is the parenchyma?

A

tissue of the lungs

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3
Q

What is the most common cause of death from infectious disease in the US?

A

Pneumonia and Flu

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4
Q

What is pneumonia classified by?

A

origin or causative agent
location
type

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5
Q

What are some types of pneumonia?

A 
Community Acquired - (CAP) bacterial and viral
Health Care - Associated (HCAP)
Hospital Acquired (HAP) usually bacterial
Ventilator -Associated pneumonia (VAP)
Aspiration pneumonia - can be CAP or HAP
Immunocompromised Host
Lobar Pneumonia
Bronchopneumonia
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6
Q
  • Occurs in a non-hospitalized pt, with extensive health care contact such as nursing home, hemodialysis, home care treatments, antibiotics/chemotherapy within 30 days.
  • May be identified in ED
  • Causative pathogens are often multi-drug resistant
  • Often difficult to treat
A

Health Care - Associated Pneumonia (HCAP)

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7
Q

Develops at home or within 48 hrs. of admission

Usually begin as common respiratory illness that progresses to pulmonary infection.

A

Community Acquired Pneumonia (CAP) bacterial and viral

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8
Q

What is the most common bacteria in people less than sixty without comorbidity and in greater than sixty with comorbidity?

A

pneumococcus (Strep)

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9
Q

Onset >48 hrs. after admission with no infection at admission

A

Hospital Acquired Pneumonia (HAP)

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10
Q

What are the common types of bacteria found in Hospital Acquired Pneumonia?

A

pseudomonas, klebsiella, E. coli, and MRSA etc.

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11
Q

Name 3 reasons why you may see HAP?

A
  • host defenses impaired
  • organisms reach lower resp. tract and overwhelms the host’s defenses
  • or highly virulent organism is present
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12
Q
  • A subtype of HAP except pt has an endotracheal tube and has been on ventilator for at least 48 hrs.
  • Most common infection in ICU
  • Prevention is Key
A

Ventilator-Associated pneumonia (VAP)

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13
Q

Most common form is bacterial infection from aspiration of bacteria that normally reside in upper airways
Can also be from gastric contents/tube feedings etc.

A

Aspiration pneumonia (Can be CAP or HAP)

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14
Q

what is commonly seen in AIDS patients or pts on chemo?

A

Pneumocystis carinii (PCP)

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15
Q

part of one or more lobes involved

A

Lobar pneumonia

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16
Q

Patchy, originates in one or more areas and extends to surrounding areas

A

Bronchopneumonia

17
Q

Which is more common Bronchopneumonia or lobar pneumonia?

A

Bronchopneumonia

18
Q

Which pneumonia is usually in adults?

A

Bacterial

19
Q

Which pneumonia is usually in children?

A

Viral

20
Q

Which pneumonia is more serious, Viral or bacterial?

A

Bacterial

21
Q

Some risk factors for pneumonia

A

Immunocompromised, smokers, COPD, cancer pts, immobility, shallow breathing patterns, rib fracture, NPO, NG Tube, NT Tube, Supine, Altered LOC, Alcohol ingestion, drug overdose, general anesthesia, advanced age, less cough reflex, resp therapy dirty equipment, asthma, inhaled steroids, transmission from healthcare providers

22
Q

What are preventive measures for pneumonia?

A 
T, C, and DB
Stop smoking
watch for aspiration and position
incentive spirometer ten times per hour while awake
Oral hygiene
Encourage to cough
watch for sedation and resp depression
prevent infections
hand washing
make sure resp equipment is clean
flu, pneumonia vaccine
23
Q

How many different strains are there of bacterial pneumonia?

A

About 23

24
Q

What changes occure with pneumonia?

A 
Hypertrophy of mucous membrane
Bronchospasm
Excess fluid
Decreased surface area
Inflammation of pleura
25
Q

What are some clinical manifestations of pneumonia?

A

Fever, chills, chest pain, tachypnea, may have upper resp infection, cough, rales, rhonchi, fatigue, orthopnea, hypoxia, cyanosis, dyspnea

26
Q

What is the CXR used for in pneumonia?

A

to look for fluid or consolidation

27
Q

Who are prone to get septic?

A

The Elderly

28
Q

What antibiotics are normally used for pneumonia if bacterial?

A

Penecillin, Vancomycin

29
Q

How long do you keep the pt on bedrest?

A

until cleared up or stable

30
Q

How many fluids to give for a pneumonia patient?

A

2500cc unless cardiac issues

31
Q

Some respiratory treatments for pneumonia

A

nebulizers
bronchodilators
chest percussion and postural drainage

32
Q

when do you d/c from hospital when have pneumonia?

A 
when stable
Temp less than or equal to 100
RR less than or equal to 24
HR less than or equal to 100
SBP greater than or equal to 90
O2 Sat greater than or equal to 90%
33
Q

What are some geriatric considerations for pneumonia?

A

May have different symptoms - general deterioration, weakness, anorexia, confusion, tachycardia, tachypnea, abdominal symptoms
take flu vaccine yearly and pneumonia vaccine

34
Q

What is the diet for a patient with pneumonia?

A

High Calorie, High Protein, Carbs, Fluids/Electrolytes, Small frequent meals

35
Q

Nursing Diagnosis for Pneumonia

A

Ineffective airway clearance RT copious secretions
Activity intolerance RT altered respiratory function
Risk fluid volume deficit RT fever and dyspnea
Altered nutrition: less than body requirements
Ineffective breathing pattern
Knowledge defiit
Fatigue RT impaired resp. funtion

36
Q

Potential complications for pneumonia

A 
Superinfection
atelectasis
pleural effusion (30% or more will develop this)
Hypotension/shock
resp failure
37
Q

Nursing interventions for Pneumonia

A 
Assessment, Documentation
Monitor for potential complications
improve airway patency
hold pillow to abdomen after abdominal surgery when coughing
promoting rest/ conserving energy
fluids high calories, protein
humidified oxygen
38
Q

Teaching for Pneumonia

A 
Smoking cessation
Gradually increase activity
breathing exercises
return for follow up visits
take all meds until gone
Oxygen at home
hand washing

Respiratory (5 decks)

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