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What is the initial empiric therapy for CAP based on?

-likely infecting organism and risk factors for MDR organisms
-varies with local patterns of antibiotic resistance
-improvement within 3-5 days or need to reevaluate
-antibiotics: IV, proceed to oral when stable at least 5 days, afebrile (no fever) 48-72 hours


What is the total treatment time for patients with CAP and what needs to be emphasized?

-treatment a minimum of 5 days
-afebrile for 48 to 72 hours
-emphasize importance of completing the full course of antibiotic treatment


Explain pneumonia nutritional therapy.

-prevent dehydration (increase fluid to 3L/day
-thin and loose secretions (hydration)
-adjust for older adults and those with preexisting conditions and heart failure
-high calorie, small, frequent meals
-monitor for weight loss


What are the possible diagnostic findings?

increased WBC's
abnormal ABG's
positive sputum
abnormal chest X ray


What is the nursing diagnosis?

-impaired gas exchange
-ineffective breathing pattern
-acute pain
-activity intolerance
-ineffective airway clearance
-fatigue and activity intolerance
-risk for deficit fluid volume (fever and rapid RR)
-imbalanced nutrition
-deficient knowledge about treatment and prevention
-impaired gas exchange ineffective breathing pattern
-acute pain
-activity intolerance


What are some patient teaching topics?

avoid cigarette smoke
identify risk factors


How much hydration should the nurse encourage?

2-3L/day unless contraindicated
-loosens pulmonary secretions


At what degree should the patient be at to prevent aspiration?

30 degrees


Pneumonia prevention

-proper position to prevent aspiration
-reposition every 2 hours
-strict adherence to ventilator bundle to prevent VAP


What type of technique should be used when doing tracheal suctioning?

sterile technique


Explain respiratory techniques.

-high fowlers (with tray table in front to lean on)
-oxygen therapy as ordered
-breathing exercises
-early ambulation
-therapeutic positioning
-pain management
-slow deep breathing, turning, coughing, (airway clearance)
-monitor for respiratory muscle fatigue
-incentive spiraometer
-collaboration with respiratory therapy


How to teach patient about pain.

-Nurse should perform pain assessment (location, characteristics, onset/duration, frequency, quality, intensity, severity)
-encourage patient to monitor own pain and interven appropriately (prepare for discharge)
-teach nonpharmacologic techniques before, after, during, or along with other pain measures.
-start pain measures before it becomes unmanageable
-medicate before painful activity


What are the expected outcomes for a person with pneumonia?

-normal rate, rhythm, and depth of respiration
-lungs clear to auscultation
-reports pain control
-SpO2 > or equal to 95
-clear sputum from airway