Ch. 25 Flashcards
pneumonia
- common resp disorder with many causes
- excess of fluid in the lungs from an inflammatory process
- inflammation triggered by infectious organisms and inhalation of irritants
3 types pf PNA
- community-acquired pneumonia (CAP)
- hospital-acquired pneumonia (HAP) or nosocomial
- ventilator associated pneumonia (VAP)
infectious causes of PNA
Organisms such as bacteria, viruses, mycoplasmas, fungi, rickettsiae, protozoa, helminths(worms)
infectious PNA categories
- CAP
- VAP
- HAP
PNA develops when
Immunity cannot overcome the invading organisms
PNA incidence and prevalence
- Top cause of death- 50,000 deaths annually in US from pneumonia
- 2019-1.3 million people sought emergency care
- Higher among older adults, nursing home residents, hospitalized patients, patients with neurologic or swallowing problems, patients on ventilators
- CAP > HAP
which is more common CAP or HAP?
CAP
PNA health promotion and maintenance
- Vaccinations
- Avoid crowded places during flu season
- Cough, turn, move, deep breathe
- Clean respiratory equipment
- Avoid pollutants, Stop smoking
- Hand hygiene
- Get rest and sleep
- Eat healthy diet
- Drink 3L of water daily (unless fluids are restricted)
VAP incidence
increasing
VAP onset
24-48 hours of being placed on mechanical vent
ventilator bundles to reduce the incidence of VAP
- hand hygiene
- oral care
- head of bed elevated
- suctioning
PNA: auscultation findings
- crackles or wheezes
- diminished breath sounds
PNA: palpation findings
- increased fremitus over the area
PNA: percussion findings
- dullness over the area
PNA: nail bed assessment
assess nail beds for cyanosis
PNA lab assessment
- Gram stain, culture, and sensitivity testing of sputum
- CBC
- Arterial blood gas level
- Serum blood urea nitrogen/creatinine levels
- Electrolytes
PNA imaging assessment
- CXR
- pulse oximetry
- bronchoscopy
PNA: patient problems
- Decreased gas exchange
- Potential for airway obstruction
- Potential for sepsis
PNA: solutions and goals
- Improving gas exchange
- Preventing airway obstruction
- Preventing sepsis
PNA interventions
- Clear secretions/maintain airway patency
- Restrict smoking
- Coughing and deep breathing
- Oxygen
- Monitor for anxiety
- Monitor for skin breakdown
- Medications
PNA medications
- Antibiotics (early treatment improves morbidity and mortality and reduces complications)
- Analgesics
- Mucolytics
- Bronchodilators
community-based care for PNA
- home care management
- health teaching
- health care resources
PNA: evaluation of outcomes (pt goals)
- Attains or maintains adequate gas exchange (O2 sat >95%)
- Maintains patent airway
- Is free from infection
- Returns to pre-pneumonia health status
