T1-Ch 28: Infectious Respiratory problems

Question 1

Highly contagious acute viral respiratory infection

Answer 1

influenza

Question 2

Most influenza patients are treated at _________

Answer 2

home; pts who develop complications are hospitalized

Question 3

Patients at risk for influenza complications are: (3)

Answer 3

-older adults
-those with HF or chronic lung disorders
-immunocompromised

Question 4

S/s of influenza include rapid onset of: (6)

Answer 4

-severe headache
-muscle aches
-fever
-chills
-fatigue
-weakness

Question 5

Adults with influenza are contagious _____ hours before symptoms occur and up to ____ days following onset

Answer 5

24 hours
5 days

Question 6

Influenza _____ can cause nausea, vomiting, and diarrhea

Answer 6

B

Question 7

Antiviral medications are available to __________ of influenza and pts receive the best results if taken within ________ hours of symptom onset

Answer 7

reduce symptoms
24-28 hours

Question 8

T/F: all patients with pneumonia have excess fluid in lungs

Answer 8

True; inflammatory process

Question 9

collection of pus in the pleural cavity

Answer 9

empyema

Question 10

an abnormal solidification with lack of air spaces

Answer 10

consolidation

Question 11

S/S of pneumonia include: (7)

Answer 11

-increased RR
-dyspnea
-hypoxemia
-cough
-purulent/blood-tinged/rusty sputum
-fever
-pleuritic chest discomfort

Question 12

Risk factors for community-acquired pneumonia (6)

Answer 12

-Older adults
-No pneumococcal vaccination within the last 5 years
-No influenza vaccination within one year
-Recent exposure to respiratory viral or influenza infection
-Tobacco or alcohol use
-Exposure to high amounts of secondhand smoke

Question 13

Risk factors for health-care acquired pneumonia (10)

Answer 13

-Older adults
-Chronic lung disease
-Presence of gram-negative colonization of the mouth, throat, and stomach
-Altered level of consciousness
-Recent aspiration event
-Presence of endotracheal, tracheostomy, or nasogastric tube
-Poor nutritional status
-Reduced immunity
-Use of drugs that increase gastric pH or alkaline tube feedings
-Mechanical ventialtion

Question 14

pneumonia contracted outside a health care setting

Answer 14

community acquired pneumonia

Question 15

Onset/diagnosis of pneumonia occurring less than 48 hrs after admission based on risk factors
OR
Patient is living in a facility/has been receiving care from outpatient facility

Answer 15

Health-Care Associated pneumonia

Question 16

onset/diagnosis of pneumonia greater than 48 hrs after admission to a hospital

Answer 16

hospital acquired pneumonia

Question 17

onset/diagnosis of pneumonia within 48-72 hrs after endotracheal intubation

Answer 17

ventilator associated pneumonia

Question 18

community-acquired pneumonia management (2)

Answer 18

-antibiotics based on multiple patient and environmental factors
-therapy lasting min of 5 days

Question 19

Health-Care Associated pneumonia management (2)

Answer 19

-may have multi drug-resistant organisms
-hand hygiene is critical

Question 20

hospital acquired pneumonia management (2)

Answer 20

-encourage pulmonary hygiene and early ambulation
-assess risk for aspiration and monitor for early signs of sepsis

Question 21

ventilator associated pneumonia management (7)

Answer 21

Ventilator bundle order set
-Elevate HOB 30 degrees
-Daily sedation
-DVT prophylaxis
-Oral care regimen
-Stress ulcer prophylaxis
-Suctioning
-Hand hygiene

Question 22

highly communicable disease caused by infection with mycobacterium

Answer 22

Tuberculosis

Question 23

Initial TB infection is seen more often in the _____ lobes

Answer 23

upper

Question 24

TB patients can by asymptomatic of ______

Answer 24

years or decades

Question 25

___________ is a reactivation of the disease in a previously infected person

Answer 25

secondary TB

Question 26

Secondary TB is more common in:

Answer 26

older adults

Question 27

Greatest risk for development of TB: (7)

Answer 27

-Those in constant, frequent contact with an untreated infected person -Those who have reduced immunity or HIV disease -Adults who live in crowded areas (long term care, prisons, homeless shelters, mental health facilities) -Older homeless adults -Users of injection drugs or alcohol -Lower socioeconomic groups -Foreign immigrants from less affluent countries

Question 28

TB cues (8)

Answer 28

-persistent cough -unintended weight loss -anorexia -night sweats -hemoptysis -SOB -fever -chills

Question 29

TB Vaccination

Answer 29

Calmette-Guerin vaccine (BCG)

Question 30

anyone who has received a BCG vaccination will show a positive TB skin test for _____ years following

Answer 30

10 years

Question 31

TB treatment

Answer 31

-Isoniazid, Rifampin, Pyrazinamide, and Ethambutol for first 8 weeks -Rifampin and Isoniazid daily or twice a week for following 18 weeks

Question 32

Inflammation of the mucous membrane of one or more of the sinuses, usually seen with rhinitis, especially the common cold

Answer 32

Rhinosinusitis

Question 33

rhinitis

Answer 33

stuffy nose

Question 34

Anything that inhibits sinus drainage can lead to rhino sinusitis, including: (7)

Answer 34

-deviated nasal septum -nasal polyps or tumors -inhaled air pollutants -cocaine -allergies -facial trauma -dental infections

Question 35

Rhinosinusitis is most commonly caused by _______ and develops in the ____ and ____ sinuses

Answer 35

-viral infection -maxillary and frontal sinuses

Question 36

Complications of Rhinosinusitis include: (3)

Answer 36

-cellulitis -abscess -meningitis

Question 37

S/s of rhinosinusitis: (10)

Answer 37

-pain in cheeks/head -purulent nasal drainage -postnasal drip -sore throat -fever -erythema -swelling -fatigue -dental pain -ear pressure

Question 38

drug therapy for rhinosinusitis include: (4)

Answer 38

-decongestants -antihistamines -intranasal steroid spray -antipyretics and analgesics may be supplemented

Question 39

Steps for incentive spirometry use (6)

Answer 39

1. Have patient sit up if possible 2. Exhale fully and place the mouthpiece in his or her mouth 3. Take a long, slow, deep breath, raining the piston as high as possible 4. Hold breath for 2-4 seconds before slowly exhaling 5. Evaluate the technique and record the volume of air inspired 6. Teach the patient to perform 5-10 breaths per session every hour while awake