Care of Patients with Infectious Respiratory Problems Flashcards
Rhinitis:
Inflammation of nasal mucosa
“Hay fever” or “allergies”
Manifestations- allergic rhinitis
Headache
Nasal irritation and congestion
Sneezing and rhinorrhea
Manifestations – viral / bacterial rhinitis
Same as allergic rhinitis
Also systemic – sore/ dry throat, low-grade fever, malaise
Interventions of Rhinitis
Antihistamines, leukotriene inhibitors, mast cell stabilizers
Decongestants
Antipyretics
Antibiotics
Supportive therapy
Complementary and alternative therapy – vitamin C, zinc
Sinusitis:
Inflammation of sinus mucous membranes
Usually caused by Streptococcus pneumoniae, Haemophilus influenzae, Diplococcus, Bacteroides
Manifestations of Sinusitis:
Pain Purulent nasal drainage Fever Erythema Swelling Fatigue Dental pain Ear pressure
Nonsurgical management of Sinusitis:
Broad-spectrum antibiotics Analgesics (pain and fever) Decongestants Steam humidification Hot/wet packs over sinus area Nasal saline irrigations Increased fluids
Pharyngitis:
Sore throat is common inflammation of pharyngeal mucous membranes
Odynophagia, dysphagia, fever, hyperemia
Viral versus Bacterial
Strep throat can lead to serious medical complications!
Screen with Rapid Antigen Test (RAT)
Results in 15 minutes
-Epiglottitis is rare complication
Tonsillitis :
Inflammation/infection of tonsils and lymphatic tissues
Contagious airborne infection, usually bacterial
Antibiotics for 7-10 days
Surgical intervention
Peritonsillar Abscess (PTA)
-Complication of acute tonsillitis
-Manifestations:
Pus causing one-sided swelling with deviation of the uvula
Trismus and difficulty breathing
Bad breath, swollen lymph nodes
Peritonsillar Abscess (PTA): Treatment
Percutaneous needle aspiration of abscess
Antibiotics
Laryngitis
Inflammation of mucous membranes lining the larynx; possible edema of vocal cords
Signs & symptoms of Laryngitis:
Acute hoarseness, dry cough, difficulty swallowing, temporary voice loss (aphonia)
Laryngitis Treatment focused on relief and prevention:
Voice rest, steam inhalation, increased fluid intake, throat lozenges
Reduce use of tobacco and alcohol
Influenza
Highly contagious acute viral respiratory infection
Influenza Signs& Symptoms
Severe headache, muscle ache, fever, chills, fatigue, weakness, anorexia
Influenza: Vaccination is advisable
Who?
People older 50 yearly vaccines because they are at risk
Influenza: Antiviral agents may be effective if
started within 24-48 hours of symptoms
Pandemic Influenza:
“Spanish Influenza”
Mostly prevalent among animals and birds; virus can mutate, becoming infectious to humans
Example: H1N1 (swine flu)
Pandemic Influenza: Treatment
Strict isolation precautions
Antiviral drugs
-Oseltamivir (Tamiflu), zanamivir (Relenza)
Pneumonia:
- Excess fluid in lungs resulting from inflammatory process
- Inflammation triggered by infectious organisms, inhalation of irritants
- Inflammation occurs in interstitial spaces, alveoli
- WBC’s to infection site
Pneumonia S&S:
Reduces gas exchange, leads to hypoxia
Septicemia
Atelectasis- alveolar collapse
Risk for Pneumonia:
Community-acquired infectious pneumonia
Nosocomial or Health care-acquired
Pneumonia: Community-acquired infectious pneumonia:
Older adult; never received vaccine or >5 years
Did not receive influenza previous year
Chronic health problems
Exposure to influenza or respiratory viral
Tobacco use/ secondhand, alcohol
Pneumonia: Nosocomial
Older adult, chronic lung disease
Gram-negative colonization (mouth, throat, stomach)
Altered LOC, recent aspiration, poor nutrition
Presence of ET tube, NG, Trach
Immunocompromised, mechanical ventilation (VAP)
Clinical Manifestations of Pneumonia:
Increased respiratory rate- dehydration Dyspnea Hypoxemia Cough Purulent Vital signs Lung sounds Myalgia Tripod position
Interventions of Pneumonia:
Hand washing Sterile water for NG Aspiration precautions Oxygen Incentive spirometry Smoking education
Lab assessments for Pneumonia:
Gram stain, culture and sensitivity of sputum CBC ABGs Serum BUN Electrolytes Creatinine
Imaging & Diagnostic Assessment fir Pneumonia:
Chest x-ray
Pulse oximetry
Transtracheal aspiration
Bronchoscopy
Pneumonia: Community-Based Care
Home care management Teaching for self-management Health care resources Prevention -Immunization of appropriate persons
Pulmonary Tuberculosis:
Highly communicable; caused by Mycobacterium tuberculosis
Transmitted via aerosolization
Secondary TB
Increased incidence secondary to HIV infection
Manifestation of TB
Progressive fatigue Lethargy Nausea Anorexia Weight loss Irregular menses Low-grade fever, night sweats Cough, mucopurulent sputum, blood streaks
Diagnostic assessment of TB:
Manifestation of signs/symptoms
NAA (Nucleic acid amplification) test (results in 2 hr)
Sputum smear for acid-fast bacillus
Sputum culture confirms it
Tuberculin (Mantoux) test – PPD (Purified Protein derivative) given intradermally in forearm: if +, then chest x-ray
Induration of 10 mm or greater diameter = Positive for exposure
PPD Skin test
Positive reaction does not mean that active disease is present, but does indicate exposure to TB or dormant disease
Interventions of TB:
Combination drug therapy with strict adherence:
Isoniazid
Rifampin
Pyrazinamide
Ethambutol
Negative sputum culture = No longer infectious
Notes on TB medications
INH- empty stomach, avoid ETOH, dark urine yellow skin = liver toxicity
Rifampin – red/ orange urine, additional contraceptive, ETOH, liver toxicity
PZA – water, sunscreen, ETOH, liver toxicity
EMB – ETOH, vision changes, water
Pertussis:
Respiratory infection – Bordetella pertussis
Contagious, respiratory droplets
Childhood to adult
When Pertussis occurs:
Catarrhal stage- Common cold- mild cough
Paroxysmal- Severe coughing ‘fits’- “whooping” cough
Recovery - Can last for months
Diagnosis for Pertussis
Sputum cultures
Greatest risk for developing TB:
contact with untreated, HIV, crowded areas prisoners, shelters, mental health, homeless, drug abusers, lower socioeconomic, foreign
TB is the most common
-bacterial infection
2nd TB reactivated when defenses lowered especially older adults or HIV
Acid-base bacilli AFB
Active TB transmitted by
cough, laugh, sneeze, whistle, sings= droplets are airborne
