Pulm Flashcards
Pt presents with cough d/t inflmmation of the bronchioles, bronchi and trachea. What could the pt have?
Upper RSI - Acute bronchitis
Most common organisms for bacteria infection for acute bronchitis
Streptococcus pneumoniae (CAP) Haemophilus influenzae
how to distinguish bronchitis from pneumonia?
Think PNA if…
more productive cough
Fever >100.4
infiltrates on x-ray
Decision criteria for Chest XRAY
** only if you suspect PNA
tachypnea
hypoxia
fever
abnormal lung exam
what is referred to as the 100 day cough?
Pertussis
Non pham management for bronchitis
increase fluids
humidifier
rest
smoking cessation
honey in children <1 yr
Dextromethoprhan / Guiafenesin is what kind of medication
Cough suppressant / Expectorant combo
Contraindicated in pts with parkinsons or on SSRIs
avoid in pts who have difficulty clearing secretions
Codeine/guaifenesin
Do not take MAO inhibitor, Parkinsions, SSRI
Scheduled V medication
AVOID narcotic cough suppressants in pts with COPD//Asthma
What is a cough suppressive medication
Dextromethorphan
what is medication class that this secretions?
Expectorants
Ex: Guaifenesin
What the MOA for antitussive medications and example
MOA- Topical anesthetic effect on the respiratory stretch receptors
Ex: Benzonatate (Tessalon Pearls)
SE of Benzonatate
Do not break/chew - produces local anesthesia and reduce gag refulx
dizziniess, drowsiness, visual changes
begins 15-20mins, lasts 3-8 hrs
Avoid use in pts sensitive to or taking agents with PABA d/t possible CNS effects
Caution/ contraindications to Guaifenesin
Contra: Parkinsons & SSRI usage
Caution if nephrolithiasis
not for children < 6
Name short acting bronchodilators
Albuterol
Levalbuterol
Would you give ABX for bronchitis?
No, since MOST bronchitis is viral.
If everything has been tried and pt has refractory fever or secondary infection try amoxicillin
What is an acute infection of the lung in a patient who acquired infection in the community involving the parenchyma, alveolar spaces, and intersitital tissue
Community acquired pneumonia
What is the most common agent that causes CAP?
Streptococcus Pneumoniae (Pneumococcal PNA)
Assessment findings for CAP?
productive cough Fever Dyspnea Pleuritic CP Diminished Breath sounds Consolidation on percussion - dullness Egophony E to A changes Bronchophony: Voice sounds are louder and clearer than normal
Assessment findings for CAP?
productive cough Fever Dyspnea Pleuritic CP Diminished Breath sounds Consolidation on percussion - dullness Egophony E to A changes Bronchophony: Voice sounds are louder and clearer than normal
What is required to make a diagnosis of PNA?
Chest Xray!!!
other tests: EKG to r/o Cardiac, Flu swab, possible ABG, CBC (increased WBC), Procalcitonin
Hallmark sing of bacterial PNA?
Causative agent: Pneumococcal pneumonia
Rust colored sputum!
preceded by a URI
Causative pathogen for primary atypical pneumonia?
Mycoplasma Pneumonia
Features of Mycoplasma pneumonia
systemic symptoms predominant over lung s/s
typically in pts <35yrs
Sore Throat
dry cough
Maculopapular rash!!!
may take 6 weeks w/treatment to eradicate
Viral PNA (not covid) s/s
Headache
fever
myalgia
