1 - pneumonia Flashcards
define pneumonia
acute inflammation of the lung parenchyma
what lung structures are included in the lung parenchyma?
alveoli, alveolar ducts, bronchioles
generally, why does pneumonia occur?
mechanisms become overwhelmed by a microbial agent
patients with pneumonia tend to have which condition?
respiratory acidosis
signs and symptoms of respiratory acidosis (10)
hypoventilation, high RR shallow, low BP, pale / cyanotic, headache, drowsiness, dizziness, disorientation, muscle weakness, hyperkalemia
cause of respiratory acidosis (3)
respiratory depression
airway obstruction
pulmonary disease
three lab values disturbed in respiratory acidosis
pH decreased, CO2 increased, HCO3 decreased
normal values for pH, CO2, HCO3
ph: 7.35 - 7.45
CO2: 35 - 45 mm hg
HCO3: 22 - 26 mmol /L
symptoms of pneumonia (6)
cough
SOB
Chest discomfort
lethargy, loss of appetite
fever, chills, clammy skin
confusion (older pt)
abrupt onset
the most common bacteria causing pneumonia (4) in order
pneumococcal pneumonia
mycoplasma pneumoniae
chlamydophila pneumoniae
legionella pneumophila (legionnaire’s disease)
where could one acquire
pneumococcal pneumonia
mycoplasma pneumonia
legionella pneumophila
post viral flu / cold
crowded condition
contaminated water pools
4 non infectious causes of pneumonia
HADI:
hypersensitivity
aspiration
drug induced
infection elsewhere
predisposing factors of acquiring pneumonia
cigarette
URTI
alcohol (CNS depressant)
old age
recent flu
lung disease
corticosteroid therapy (weakened immune system )
what body dysfunctions make the body prone to infection
reduced immune system
reduced cough reflex
reduced ciliary action
bacteraemia
sepsis
IV infection
what body dysfunctions make the body prone to noninfectious pneumonia
immobility, reduced LOC
vomiting, dysphagia, severe reflux, NG, trach intubation
difference between HAP and CAP, VAP
(which one is it?)
CAP: LRTI, onset first 48h of hospitalization, no hospitalization , LTC 14 days prior
HAP: 48 h or more after hospitalization
VAP: 48-72h after endotracheal intubation
how does aspiration pneumonia occur
aspiration of the material from mouth or stomach into the trachea
how does opportunistic pneumonia occur
pt with altered immune system more susceptible to resp infection
what is HCAP (when does it occur?)
hospitalized for 2 or more days
LTC
IV antibiotics, chemo, wound care within 30 days
recent visit to hospital
clinical manifestations (signs) of pneumonia
breath sounds: diminished, crackles/rhonchi
percussion: dull
inspection: accessory muscles, effort
vitals: tachycardia, hypotension
pmhx: recent long URTI
how to diagnose pneumonia
chest xray
blood tests: CBC (wbc) chem7 (pneum -> dehydrated -> low creatinine, ABG
culture and sensitivity, gram stain
imaging: CT, scopy
as a nurse, what assessment will you conduct on a pt with pneumonia
vitals
resp assessment
neuro assessment (confusion)
pmhx of:
lung cancer, DM, COPD, malnutrition, AIDS
what treatment will you consider for a patient with pneumonia (5)
antibiotic
antipyretic
analgesics
oxygen supplementation
encourage: fluids, cals, spirometer, vaccine
complications of untreated pneumonia
sepsis
pleural effusion
metastatic infection
lung abcess
empyema
system failures
