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NURS 3000 > Week 2 > Flashcards

Week 2 Flashcards

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1
Q

What is pneumonia?

A

Acute inflammation of the lung parenchyma caused by a microbial angent.

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2
Q

What factors predispose pneumonia?

A

Aging, air pollution, altered consciousness, prolonged immobility, chronic diseases, debilitating illness, HIV, immunosuppressant drugs, GI feedings, malnutrition, tracheal intubation, upper RT infection.

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3
Q

How do organisms that cause pneumonia get there?

A

Aspiration, Inhalation and hematogenous spread.

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4
Q

What is community-acquired pneumonia?

A

Lower respiratory tract infection of the lung parenchyma with an onset in the community or within the first 2 days of hospitalization.

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5
Q

What is hospital acquired pneumonia?

A

Occurs 48 hrs or longer after hospital admission. Accounts for 25% of all ICU infections.

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6
Q

What is fungal pneumonia?

A

Pneumonia caused by fungi.

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7
Q

What is aspiration pneumonia?

A

Refers to the sequelae of abnormal entry of secretions or substances into the lower airway.

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8
Q

What is opportunistic pneumonia?

A

Occurs in pts with altered immune systems. Pathogens that are usually harmless can cause pneumonia in people with bad immune systems.

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9
Q

What is the most common cause of pneumonia?

A

Pneumococcal pneumonia.

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10
Q

What are the 4 stages of the disease process of pneumonia?

A

Congestion, Red hepatization, grey hepatization, and resolution.

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11
Q

What is the congestion phase of pneumonia?

A

The organism reaches the aveoli, then the body increases fluid production, where the organisms multiply and the infection spreads.

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12
Q

What is red hepatization?

A

Capillaries dialate and alveoli are filled with organisms, neutrophils, RBCs and fibrin. Lung looks red and granular.

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13
Q

What is grey hepatization?

A

Blood flow decreases, leukocytes and fibrin consolidate causing lungs to look grey.

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14
Q

What is the resolution phase of pneumonia?

A

Body heals and no complications occur.

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15
Q

What are the CM of pneumonia?

A

Rapid onset: Fever, chills, cough, purulent sputum, pleuritic chest pain, crackles in lung, increased fremitus, bronchial breath sounds.

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16
Q

What is the atypical manifestation of pneumonia?

A

Gradual onset: dry cough, headache, myalgias, fatigue, sore throat, nausea, vomiting, diarrhea.

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17
Q

What are the manifestations of viral pneumonia?

A

Chills, fever, dry nonproductive cough, extrapulmonary symptoms.

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18
Q

What are some complications of pneumonia?

A 
Pleurisy
Pleural effusion
Atelectasis
Delayed resolution
Lung Abscess
Empyema
Pericarditis
Meningitis
Endocarditis
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19
Q

What are the diagnostic tests for pneumonia?

A 
Pt Hx, physical exam
Chest Xray
Gram stain examination of sputum
Pulse oximetry and ABGs
CBC, differential, Chem 7
Blood cultures
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20
Q

What are some collaberative care measures to take with pts that have pneumonia?

A

Antibiotic treatment, O2 therapy, analgesics to relieve chest pain, rest.

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21
Q

What are the indications for a pneumococcal vaccine?

A

a) Chronic illness (lung/heart/diabetes)
b) Recovering from severe illness
c) 65 +
d) Lives in LTC

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22
Q

What are some nursing diagnosis for pneumonia?

A

Impaired gas exchange, ineffective breathing pattern, acute pain rt biological injury, activity intolerance rt respiratory condition.

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23
Q

What is sepsis?

Study These Flashcards
A

Inflammatory response to a documented or suspected infection.

24
Q

What is severe sepsis?

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A

Sepsis complicated by organ dysfunction, hypoperfusion or hypotension.

25
What is septic shock?
Develops when hypotension cannot be reversed with fluid resuscitation and tissue perfusion abnormalities are present.
26
What organisms cause sepsis?
Gram negative and gram positive bacteria.
27
What are the general variables for diagnosis of sepsis?
- Altered mental status - Fever - increased HR - Hyperglycemia - Hypothermia - Edema/ positive fluid balance - Tachypnea
28
What are some inflammatory variables in sepsis?
- Elevated C-reactive protein - Elevated procalcitonin - Leukocytosis - Leukopenia - Normal WBC count
29
What are some organ dysfunction variables in sepsis?
- Acute oliguria - Arterial hypoxemia - Coagulation abnormalities - Hyperbilirubinemia - Absent bowel sounds - Serum creatinine increase - Thrombo-cytopenia
30
What are the 3 stages of shock?
Compensatory, Progressive, Refractory.
31
What does the body do in the compensatory stage?
Activates hormonal, neural and biochemical compensatory mechanisms, to overcome the consequences of anaerobic metabolism and maintain homeostasis.
32
How does the CV respond act in the compensatory stage of sepsis?
Body shunts blood from every part of the body except brain and heart. SNS releases epi, norepi which promotes vasoconstriction. Increase in contractility, HR and MVO2.
33
What happens to the GI system in the compensatory stage of sepsis?
Decreased blood supply, hypoactive bowel sounds.
34
What happens to the neurological system in the compensatory stage of septic shock?
- Change in LOC - Change in Glasglow Coma scale score - A and Ox4 - Restless, apprehensive, confused.
35
What happens to the renal system during the compensatory phase of septic shock?
- Increase in aldosterone (resulting in Na and H2O reabsorption) - Increase in ADH level, resulting in decrease renal blood flow. - Increase in renin level, resulting in release of angiotensin 2.
36
What happens to the respiratory system during the compensatory phase of septic shock?
- Decrease bloodflow to lungs - Hyperventilation - Increased physiological dead space - Ventilation-perfusion mismatch.
37
What are the key lab findings during the compensatory phase?
- Increase blood glucose - Decrease PaO2 - Decrease PaCO2 - Increase pH.
38
What happens to the CV during the progressive stage of septic shock?
- Increase cap refil b/c edema - decrease CO, BP, increase HR. - Dysrythmias - Myocardial ischemia - MI - Myocardial dysfunction-impaired CO- decrase peripheral perfusion- ischemia of distal extremities, diminished pulses, decrease cap refil.
39
What happens to the CV during the refractory stage of shock?
- BP inadequate to perfuse vital organs - Bradycardia, irregular rhythm - Decreased CO
40
What happens to the GI system in the progressive stage of shock?
- Erosive ulcers - GI bleeding - Translocation of GI bacteria - Impaired absorption of nutrients
41
What happens to the GI system in the refractory stage of shock?
- Ischemic gut
42
What happens to the hepatic system in the progressive stage of shock?
- Fails to metabolize drugs and waste products. - Jaundice - Increase in NH3 and lactate.
43
What happens to the hepatic system during the refractory stage of shock?
Metabolic changes from accumulation of waste products.
44
What happens to the neurological system during the progressive stage?
- Decrease cerebral blood flow - Decrease cerebral perfusion pressure - Agitation - Decreased responsiveness to stimuli
45
What happens to the neurological system in the refractory stage?
- Unresponsive - Areflexia - Pupils unreactive and dilated.
46
What happens to the renal system during the progressive stage?
- Increased BUN/creatinine ratio - Metabolic acidosis - Decreased UO - Increased urine Na - Decreased urine osmolarity and specific gravity - decreased urine K+
47
What happens to the respiratory system during the progressive stage?
- Acute respiratory distress syndrome - increased cap permeability - Pulmonary interstitial edema - Alveolar edema - decreased compliance - Diffuse infiltrates - Increase respiratory rate - Moist crackles
48
What happens to the respiratory system during the refractory stage?
- Respiratory failure - Severe refractory - Hypoxemia
49
What are the key lab findings in the progressive stage?
- Increased bleeding times - Increased liver enzymes (ALT, AST, GGT) - Thrombo-cytopenia.
50
What are the key lab findings in the refractory stage?
- Decreased blood glucose - Metabolic acidosis - Increase NH3, lactate and K+.
51
How is shock diagnosed?
ABG, Base deficit, blood cultures, BUN, Creatinine, DIC screen, D-dimer, fibrin split products, fibrinogen level, platelet count, thrombin time, lactic acid, liver enzyme panel, CBC, Chem 7, urine sample.
52
What do patients in septic shock need large amounts of ?
Fluid replacement.
53
What meds are used in septic shock?
Norepinephrine, vasopressin.
54
What are some potential nursing diagnosis for shock?
Ineffective peripheral tissue perfusion, ineffective cerebral tissue perfusion and risk for impaired liver function, anxiety rt threat of death.
55
What is the nurses role with patients in shock?
- Monitoring physical and emotional status - Planning and implementing nursing interventions and therapy - Evaluating pt response to therapy - Providing emotional support to family and pt - Collaborating with health care team.

NURS 3000 (6 decks)

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