GROUP 4 Flashcards
What lifestyle modifications are recommended for hypertension management?
Recommended lifestyle modifications include dietary changes, increased physical activity, stress reduction, smoking cessation, and limiting alcohol and caffeine intake
WHAT IS HYPERTENSIVE EMERGENCY AND HOW IS IT TREATED ?
Hypertensive emergency involves blood pressure >180/120 mm Hg and target organ damage. It requires IV vasodilators to reduce blood pressure by 25% within the first hour, followed by a gradual reduction over six hours.
What is hypertensive urgency, and how is it treated?
Hypertensive urgency is defined by very high blood pressure without evidence of target organ damage. It is treated with fast-acting oral agents to normalize blood pressure within 24-48 hours.
List some common antihypertensive medications.
- Diuretics: Thiazides, loop diuretics, potassium-sparing diuretics.
Calcium channel blockers.
ACE inhibitors.
Beta-blockers.
Angiotensin II antagonists.
Nondihydropyridines.
Dihydropyridines.
Vasodilators
What are key components of hypertension management through lifestyle modification?
Physical activity at least three times a week (e.g., walking), the DASH diet, reducing alcohol, caffeine, and stress, smoking cessation, and regular ophthalmology check-ups.
What is the initial medication prescribed for hypertension management, and how is it administered?
The initial medication is usually a thiazide diuretic, prescribed at a low dose and gradually increased. Additional medications may be added if needed.
COPD
COMPLICATIONS
- Cardiac Dysrhythmias
- Pneumonia
- Atelectasis
- Pneumothorax
- Bronchospasm
- Respiratory Failure
OXYGEN THERAPY MANAGEMENT
- Clear Secretions:
Ensure the patient is able to effectively clear oral, nasal, and tracheal secretions to maintain airway patency.
Equipment Setup: Set up oxygen delivery equipment, ensuring it is heated and humidified to prevent irritation of the airways.
- Monitoring:
Regularly check oxygen flow rates, the position of delivery devices, and the effectiveness of therapy using pulse oximetry and arterial blood gases (ABGs).
- Watch for signs of oxygen toxicity, absorption atelectasis, and oxygen-induced hypoventilation.
- Transporting Patients:
Provide supplemental oxygen during patient transport to ensure consistent oxygen delivery.
- Skin Care:
Monitor for skin breakdown around the delivery devices due to friction and ensure patient comfort to mitigate anxiety related to oxygen therapy.
- Patient Education:
Instruct the patient and family on the correct use of oxygen at home, emphasizing safety and proper device handling.
- Mobility Considerations:
Arrange for portable oxygen devices to facilitate patient mobility, and educate the patient on their use.
MEDICATIONS
Long-acting and Short-acting Bronchodilators:
Short-Acting: Provide rapid relief of symptoms (e.g., Albuterol).
Long-Acting: Used for maintenance therapy to improve lung function and reduce exacerbations (e.g., Salmeterol, Formoterol).
SYMPTOMS
- Chronic Cough:
- Production of Mucus:
- Chest Discomfort:
- Fatigue:
- Dyspnea:
- Shortness of Breath (SOB):
NURSING DIAGNOSES
- Impaired Gas Exchange
- Ineffective Breathing Pattern
- Ineffective Airway Clearance
- Imbalanced Nutrition
- Anxiety
- Activity Intolerance
- Potential for Pneumonia or Other Respiratory Infections
Fatigue
Deficient Knowledge
Sexual Dysfunction
Disturbed Sleep Pattern
Disturbed Thought Processes
Ineffective Coping
Ineffective Role Performance
ETIOLOGY/RISK FACTORS
Smoking: The leading cause of COPD
Alpha-1 Antitrypsin Deficiency
Air Pollution
Occupational Exposure
STAGES
Stage 1 - Mild:
May have no symptoms; airflow is 80% of normal; patients may become winded with moderate exercise.
Stage 2 - Moderate:
Symptoms become noticeable; frequent stops to catch breath, coughing, wheezing; airflow is 50% to 79% of normal.
Stage 3 - Severe:
SOB worsens, frequent exacerbations requiring hospitalization; airflow is 30% to 50% of normal.
Stage 4 - Very Severe:
Low oxygen levels, constant SOB, high risk of life-threatening exacerbations; airflow is less than 30% of normal.
ASSESSMENT
General Appearance
Risk Factors
Current Problem
Weight/Diet
Respiratory Changes
Cardiac Changes:
CHRONIC BRONCHITIS
Definition:
Chronic Bronchitis is a type of Chronic Obstructive Pulmonary Disease (COPD) characterized by inflammation of the bronchi and bronchioles. It leads to persistent mucus production and airway obstruction due to long-term exposure to lung irritants such as tobacco smoke, air pollution, or hazardous airborne substances.
Pathophysiology:
- Airway Irritation (hypersecretion of mucus and inflammation)
- Ciliary Dysfunction (increasing mucus production)
- Thickened Bronchial Walls
- Mucus Plugs
- Alveolar Damage
- Irreversible Lung Changes
Signs & Symptoms:
- Persistent Cough
- Dyspnea on Exertion
- Wheezing and Crackles
- Chest Discomfort
- Fatigue and Malaise:
- Dependent Edema
- Cyanosis
- Chronic Sputum Production
- Increased Respiratory Infections
Complications:
- Bronchiectasis
- Emphysema
- Superinfections
- Lower Respiratory Tract Infection
- Respiratory Failure
- Cor Pulmonale
Diagnosis:
- Physical Examination:
Observation of prolonged expiration, use of accessory muscles for breathing, and wheezing.
- Clubbing of fingers in long-standing hypoxemia cases.
- Sputum Culture and Sensitivity:
Helps identify infectious organisms responsible for recurrent infections.
- Chest X-Ray: Hyperinflation and increased bronchial wall thickness. It also helps rule out pneumonia or lung malignancies.
- Pulmonary Function Tests (PFTs):
Shows reduced forced expiratory volume (FEV1) and forced vital capacity (FVC), indicating airway obstruction.
- Arterial Blood Gases (ABGs):
Indicates respiratory acidosis, hypoxemia, and hypercapnia in severe cases.
- Complete Blood Count (CBC):
Elevated white blood cell count (WBC) indicates infection. Chronic hypoxemia may result in polycythemia (increased red blood cells).
Treatment:
- Bronchodilators:
Relax smooth muscles around the airways, improving airflow (e.g., albuterol, salmeterol).
- Corticosteroid Therapy:
Reduces inflammation in the bronchi (e.g., prednisone). Used in acute exacerbations or severe cases. - Antibiotics:
Prescribed for bacterial infections during exacerbations. - Oxygen Therapy:
Long-term use in patients with chronic hypoxemia to maintain oxygen saturation levels. It helps prevent cor pulmonale. - Postural Drainage and Chest Percussion: Assists in clearing mucus from the airways, reducing infection risks.
- Hydration: Encourages thinning of mucus, making it easier to expectorate.
Smoking Cessation: Essential for halting disease progression and preventing further damage.
- Nutritional Support: High-protein, high-calorie diet to prevent muscle wasting. Supplements, including vitamin C, for better immune function.
- IMMUNIZATIONS: Yearly influenza vaccine and pneumonia vaccine to prevent respiratory infections.
- Environmental Modifications:
Avoiding pollutants, smoke, and allergens to reduce airway irritation.
Prognosis:
Chronic and Progressive: Chronic bronchitis is a long-term, progressive condition. Early diagnosis and consistent management can improve quality of life and slow disease progression.
Risk of Lung and Heart Failure: Severe cases may lead to lung failure or right-sided heart failure (cor pulmonale) due to increased pressure in the pulmonary arteries.
COMMUNITY BASED CARE
Home Care Management
- Ambulatory setting/home
Health Teaching
– Disease management
Health Care Resources
– Referrals to support groups
ASTHMA
COMPLICATIONS
- Pneumonia
Increased risk of respiratory infections due to airway inflammation and obstruction, leading to fluid accumulation in the lungs.
- Atelectasis
Collapse of alveoli due to mucus plugs or poor ventilation, reducing gas exchange and increasing the risk of hypoxemia.
- Hypoxemia
Low levels of oxygen in the blood resulting from airway obstruction and impaired gas exchange, leading to potential organ dysfunction.
- Respiratory Failure
Severe cases may lead to respiratory failure, requiring immediate medical intervention, including possible mechanical ventilation.
- Emphysema
Chronic inflammation can lead to structural changes in the lungs, including emphysema, characterized by the destruction of alveolar walls.
- Chronic Hypoxia
Long-term hypoxemia may lead to chronic hypoxia, affecting organ systems and resulting in complications such as pulmonary hypertension.
- Chronic Bronchitis
Chronic inflammation and mucus production can lead to chronic bronchitis, characterized by a persistent cough and increased sputum.
- Respiratory Acidosis
Build-up of carbon dioxide due to inadequate ventilation can lead to respiratory acidosis, a serious metabolic disturbance.
- Status Asthmaticus:
Warning Signs…
Cough: Persistent and worsening cough indicating airway obstruction.
Severe Obstruction: Inability to speak in full sentences, rapid breathing, and difficulty in breathing.
Respiratory Alkalosis: Initial hyperventilation leading to decreased carbon dioxide levels in the blood.
MEDICATIONS…
BRONCHODILATORS
Beta-2 Adrenergic Agonists: Promote smooth muscle relaxation in the airways.
Short-acting (e.g., Albuterol): Provides quick relief during an asthma attack.
Long-acting: More effective for ongoing control, used for prevention but does not stop an attack.
Monitoring: Assess heart rate as these may cause increased heart rate; ensure adequate hydration.
METHYLXANTHINES
Theophylline: A long-acting bronchodilator that may cause toxicity if levels build up. Used when other medications are ineffective.
ANTICHOLINERGICS
Ipratropium: An intermediate-acting bronchodilator that can cause increased heart rate as a side effect.
ANTI-INFLAMMATORY MEDS…
CORTICOSTEROIDS
Long-acting and used to reduce inflammation in the airways (e.g., Pulmicort, Flovent, Azmacort).
Side Effects: Delayed wound healing, personality changes, and fluid retention; always taper doses and rinse the mouth after use.
Mast Cell Stabilizers:
Help prevent the release of inflammatory mediators.
Antihistamines:
Reduce allergic responses contributing to asthma symptoms.
Antibiotics:
Prescribed for respiratory infections as needed.
Expectorants:
Help thin mucus for easier clearance.
DIAGNOSTIC STUDIES
History and Physical Exam: Comprehensive evaluation of symptoms and triggers.
Chest X-ray: Rule out other conditions such as pneumonia or atelectasis.
Sputum Analysis: Identify any infectious processes.
Complete Blood Count (CBC): Check for signs of infection or allergic response.
Arterial Blood Gases (ABG): Assess oxygen and carbon dioxide levels in the blood.
Pulmonary Function Tests (PFT): Measure lung function and airflow obstruction.
PATHOPHYSIOLOGY
Mast Cells: Release chemical mediators that trigger inflammation.
Vasoactive Amines: Cause dilation of blood vessels, capillary leak, and airway edema with increased secretions.
Hyperresponsiveness: Constriction of smooth muscle in the airways leads to bronchospasm.
Upper Respiratory Infections (URI): Trigger inflammatory responses and airway hyperresponsiveness.
Airflow Obstruction: Results in wheezing, poor gas exchange, and carbon dioxide retention.
CAUSES/TRIGGERS
Environmental Factors: Pollution, dust, pet dander, and household chemicals.
Lifestyle Choices: Smoking and consumption of fatty foods.
Genetics: Family history and ethnic background can increase susceptibility.
Infections: Bacterial and viral infections, particularly respiratory viruses.
Age and Gender: Asthma can affect individuals of all ages but is more common in children and can vary with gender.
SYMPTOMS
Labored Breathing: Difficulty breathing characterized by shortness of breath (SOB).
Frequent Coughing: Often worse at night or early in the morning.
Wheezing: High-pitched whistling sound during expiration.
Chest Tightness or Pain: Discomfort or pressure in the chest.
Feeling Tired: Fatigue due to increased effort in breathing.
Gastroesophageal Reflux: Acid reflux can exacerbate asthma symptoms.
Allergic Symptoms: Itchy eyes, runny nose, and sneezing.
Common Cold Symptoms: Increased mucus production and nasal congestion.
INCIDENCE
Prevalence: Affects approximately 5 million children under 18 years old, making it one of the most common childhood diagnoses.
ASTHMA IS CHARACTERIZED BY…
Airflow obstruction
Inflammation
Hyperresponsiveness
Chronic airway limitation
EMPHYSEMA
DEFINITION…
Emphysema is a chronic lung condition classified under Chronic Obstructive Pulmonary Disease (COPD).
It is characterized by:
- Over-distention of the alveoli: This results in the destruction of the alveolar walls and loss of elasticity, which leads to difficulty in breathing.
- Hyperinflation of the lungs: Air becomes trapped in the lungs due to the collapse of small airways during exhalation, leading to increased lung volume but reduced effective gas exchange.
PATHOPHYSIOLOGY…
- Destruction of Alveolar Walls:
The primary pathological feature of emphysema is the breakdown of the elastin and collagen fibers in the alveolar walls, caused by inflammatory processes and exposure to irritants.
This breakdown results in enlarged air spaces (blebs) and a decreased surface area for gas exchange, reducing oxygen supply to the bloodstream.
- Loss of Lung Elasticity:
The damaged alveoli lose their elastic recoil, which is essential for normal expiration. Consequently, air becomes trapped in the lungs, leading to hyperinflation.
- Increased Ventilatory Dead Space:
The alveoli may fill with air, but due to their collapse, gas exchange does not occur effectively. This results in hypoxemia (low oxygen levels) and hypercapnia (increased carbon dioxide levels).
- Development of Bullae:
The formation of large air-filled spaces within the lungs can occur, which may lead to spontaneous pneumothorax (collapse of the lung).
ETIOLOGY…
Emphysema is primarily caused by:
- Cigarette Smoking: The leading cause; toxic substances in cigarette smoke lead to inflammation and damage to lung tissues.
- Alpha-1 Antitrypsin Deficiency: A genetic disorder where insufficient levels of the protein lead to unchecked lung tissue damage.
- Environmental Irritants: Prolonged exposure to pollutants, occupational dust, and chemical fumes can contribute to the disease.
- Genetic Factors: Family history of respiratory diseases may increase susceptibility.
CLASSIFICATIONS…
Panlobular Emphysema:
Involves destruction of the entire alveolus, leading to uniform enlargement.
Typically associated with alpha-1 antitrypsin deficiency.
Centrilobular Emphysema:
Characterized by the breakdown of the walls of the bronchioles while sparing the distal alveoli.
Most commonly seen in smokers and leads to chronic hypoxemia, hypercapnia, and polycythemia.
SYMPTOMS…
Shortness of Breath (SOB): Initially during exertion, but can progress to rest.
Wheezing: Due to airway obstruction.
Chronic Cough: Often persistent with or without sputum production.
Chest Pain: May be experienced due to lung stretching or inflammation.
Sputum Production: Varies in color and amount; may be present.
Bluish Fingertips and Lips (Cyanosis): Indicates inadequate oxygenation.
Frequent Respiratory Infections: Increased susceptibility due to compromised lung function.
COMPLICATIONS…
Hypoxemia and Acidosis: Insufficient oxygen supply leading to respiratory failure.
Cardiac Dysrhythmias: Abnormal heart rhythms due to hypoxia or strain on the heart.
Pneumonia: Increased risk of lung infections due to impaired mucociliary clearance.
Atelectasis: Partial or complete collapse of a lung segment due to air trapping and mucus accumulation.
Pneumothorax: Air leaks into the pleural space, causing lung collapse, particularly in cases with blebs.
Cardiac Failure (Cor Pulmonale): Strain on the right side of the heart due to chronic lung disease and hypoxemia.
Respiratory Failure: Severe reduction in the lungs’ ability to perform gas exchange.
DIAGNOSIS…
Pulmonary Function Tests (PFTs): Show reduced forced expiratory volume (FEV1) and FEV1/FVC ratio.
Chest X-Ray: May show hyperinflation, flattened diaphragm, and decreased vascular markings.
CT Scan: Can identify the extent and type of emphysema more accurately.
Arterial Blood Gases: Measure oxygen and carbon dioxide levels, indicating respiratory failure.
MANAGEMENT/TREATMENT…
Bronchodilators: Help relax and open the airways.
Corticosteroids: Reduce inflammation in the airways.
Oxygen Therapy: Supplemental oxygen for patients with low blood oxygen levels.
Antibiotics: For respiratory infections as needed.
Pulmonary Rehabilitation: Exercise training, nutrition advice, and education for better lung health.
Smoking Cessation: The most crucial step to slow disease progression.
Vaccinations: Yearly influenza vaccine and pneumonia vaccine to prevent infections.
NURSING INTERVENTIONS…
Airway Clearance Techniques: Encourage deep breathing exercises and use of inhalers.
Education: Teach patients about disease management, smoking cessation, and medication adherence.
Monitor Vital Signs: Pay attention to respiratory rate, heart rate, and oxygen saturation levels.
Nutritional Support: Encourage a diet high in protein and calories to maintain strength.
TUBERCULOSIS
TB Definition:
A reportable, communicable, and inflammatory destructive disease spread through inhalation of infected droplet nuclei.
Most Common Site:
Pulmonary (lungs)
Extrapulmonary Sites: TB bacilli can spread to bones, spine, kidneys, reproductive organs, CNS, and larynx.
Causative Organism:
Mycobacterium tuberculosis (tubercle bacilli)
Characteristics:
Aerobic (requires oxygen)
Acid-fast bacillus
Reproduces slowly in the body
Does not reproduce outside the body
Destroyed by heat, sunlight, pasteurization
Risk Factors:
- Close and prolonged contact with an individual who has untreated TB
Immune dysfunction or immunosuppressive therapy (e.g., HIV, oncology patients)
- Alcoholism, Homelessness, and Poverty
- Elderly populations
- Children under 3 years old
- Living or working in crowded environments (e.g., prisons, long-term care facilities)
- Certain geographic areas with higher incidence rates
- Men have double the rate compared to women
Transmission:
Spread: Airborne via inhalation of droplet nuclei when a person with active TB coughs, sneezes, or laughs.
Coughing is the most important means of spreading the infection.
Requires close, prolonged contact for transmission.
Sensitization:
Primary Infection: The first exposure leads to sensitization of the immune system within 2-10 weeks.
Manifested by a positive tuberculin skin test (TST)
Sensitivity is typically maintained for life, even without active disease.
Pathophysiology:
Initial Inhalation: Infected droplets deposit in the lungs.
Inflammatory Reaction: The body initiates an immune response, attempting to phagocytize the bacteria and wall off the infection, forming a Ghon tubercle.
Latent TB: Most bacilli remain dormant, walled off by the immune system in a resting stage. There are no symptoms, and it is not contagious.
Active TB: The bacilli multiply when resistance decreases (due to factors like stress, immunosuppressive drugs, or inadequate treatment), leading to active disease, which is contagious and potentially fatal if untreated.
General Symptoms:
Fatigue
Malaise
Anorexia
Weight loss
Pulmonary Symptoms:
Persistent, productive chronic cough (lasting 3+ weeks)
Hemoptysis (coughing up blood) in advanced stages
Night sweats
Low-grade fever, often in the late afternoon or evening
Dyspnea (shortness of breath)
Extrapulmonary Symptoms: May vary depending on the organ system affected (e.g., bone pain, CNS symptoms)
Diagnosis:
Tuberculin Skin Test (TST) or PPD Test:
Administration: Inject intradermally; read area of induration (not redness) 48-72 hours later.
Positive: ≥10mm induration (or ≥5mm for HIV-positive individuals)
Doubtful: 5-9mm (may require retesting)
Contraindications: Prior Bacille Calmette-Guérin (BCG) vaccine may cause false-positive.
QuantiFERON-TB Gold Test:
Results within 24-36 hours, unaffected by prior BCG vaccination.
Sputum Culture: Required for definitive diagnosis.
3 sputum specimens collected on consecutive days to identify tubercle bacilli.
Chest X-ray: May show nonspecific findings such as nodules or infiltrates but is not diagnostic on its own.
Management:
Medications: Treatment requires 6-12 months of multiple drug therapy to prevent resistance.
First-line drugs:
Isoniazid (INH) and Rifampin: Primary antibiotics
Pyrazinamide (PZA): Active TB cases
Ethambutol (Myambutol): May be added for drug-resistant TB
Resistance:
Primary Resistance: Resistance to first-line agents in individuals with no previous treatment.
Secondary (Acquired) Resistance: Resistance develops during treatment.
Multi-drug Resistance (MDR-TB): Resistance to two or more first-line drugs (INH and rifampin).
Isolation: Respiratory isolation until sputum tests are negative to prevent transmission.
Mask-wearing is essential to prevent spread while on treatment.
Bed Rest: Recommended until symptoms subside, often treated on an outpatient basis.
Nursing Interventions:
Airway Clearance: Encourage coughing, deep breathing, and expectoration of sputum.
Education:
Importance of drug regimen compliance (completing the full course of treatment)
Preventing spread to others (e.g., mask use, avoiding crowded places until non-infectious)
No special precautions are needed for personal items (e.g., bed linens, utensils)
Monitor for Drug Side Effects: Particularly hepatotoxicity with INH and Rifampin (AST/ALT levels should be monitored).
Follow-Up: Essential for monitoring adherence to treatment and detecting complications.
Nutrition:
Diet: High-protein, high-calorie, and high-calcium diet to support healing.
Supplements: Iron and Vitamin B6 are often recommended due to medication-induced deficiencies.
Follow-Up and Prevention:
Contact Tracing: Identifying individuals who may have been exposed for INH prophylaxis.
Living Arrangements: Ensure proper ventilation and minimize exposure to others.
Lab Monitoring: Regular tests for liver function (AST, ALT) to monitor for drug-induced hepatotoxicity.
Public Health Nursing: Ongoing education and social support to ensure compliance and manage lifestyle changes.
TB Converter: A person with a newly positive tuberculin skin test (conversion from negative to positive) is at high risk for developing TB and may need INH preventive therapy. However, a positive skin test alone does not indicate active disease.
PNEUMONIA
DEFINITION
Pneumonia is an inflammation of the lungs caused by various infectious agents, leading to the obstruction of bronchioles, increased exudate production, and decreased gas exchange. It can result in significant morbidity and mortality, particularly among vulnerable populations.
TYPES
Inflammation of the Lungs
- Can be caused by bacterial, viral, or fungal infections.
- The inflammatory response leads to fluid accumulation and impaired gas exchange.
Pneumonitis
- Inflammation of lung tissue not always due to infection (can be due to chemical irritants, allergens, etc.).
Bronchopneumonia
- A form of pneumonia characterized by inflammation that primarily affects the bronchi and surrounding alveoli.
- Can be caused by bacterial infections, often following viral respiratory infections.
Community-Acquired Pneumonia (CAP)
- Acquired outside of a healthcare setting. (Examples include Legionnaires’ disease and infections from Streptococcus pneumoniae)
Hospital-Acquired Pneumonia (HAP)
- Occurs in patients hospitalized for at least 48 hours. (More likely caused by resistant bacteria (e.g., Pseudomonas aeruginosa, Acinetobacter).
Aspiration Pneumonia
- Results from the inhalation of food, liquid, or vomit into the lungs.
- Common in individuals with impaired swallowing or altered consciousness.
INCIDENCE
Prevalence: Third leading cause of death among individuals over 85 years old.
Age Factor: Increased incidence in those over 64 years of age.
Mortality Rate: Can be as high as 50% in cases caused by Pseudomonas or Acinetobacter, especially in the presence of complications or in patients with significant comorbidities (e.g., flu).
ETIOLOGY/RISK FACTORS
Infectious Agents:
Influenza virus: Common cause of viral pneumonia.
Bacteria: Streptococcus pneumoniae, Staphylococcus aureus, and others.
Risk Factors:
Impaired immune function (elderly, chronic diseases).
Prolonged immobility.
Smoking.
Altered level of consciousness (LOC).
Ineffective cough reflex.
Recent hospitalization or use of respiratory equipment.
Symptoms of Pneumonia
Common Symptoms:
Cough (may be productive)
Fever and chills
Tachycardia (increased heart rate)
Tachypnea (increased respiratory rate)
Dyspnea (shortness of breath)
Pleuritic chest pain (sharp pain during breathing)
Malaise (general discomfort)
Decreased breath sounds on auscultation
Sputum Characteristics:
Green/yellow sputum: Suggestive of Streptococcal infection.
Yellow/bloody sputum: Indicative of Staphylococcal infection.
DIAGNOSTIC ASSESSMENT
History and Physical Examination: Assessing symptoms, risk factors, and clinical signs.
Nutrition Assessment: Evaluating nutritional status and needs.
Chest X-ray: Helps visualize lung inflammation or consolidation.
Blood Culture: Identifies pathogens in the bloodstream.
Sputum Culture: Determines the causative agent of pneumonia.
Arterial Blood Gas (ABG): Assesses oxygenation and acid-base status.
Capillary Blood Gas (CBG): Less common, may provide similar information as ABG.
Bronchoscopy: Direct visualization and possible sampling of the lower respiratory tract.
Pulse Oximetry: Monitors oxygen saturation levels.
NURSING DIAGNOSES
Impaired Gas Exchange: Due to fluid in the alveoli and inflammation.
Ineffective Airway Clearance: Related to excessive secretions and weak cough.
Deficient Fluid Volume: May occur due to fever and reduced intake.
Sleep Pattern Disturbance: Resulting from respiratory distress.
Pain: Due to pleuritic involvement or muscle strain from coughing.
Injury: High Risk: Related to altered LOC or fatigue.
Activity Intolerance: Due to fatigue and dyspnea.
COMPLICATIONS
Atelectasis: Collapse of lung tissue due to fluid or mucus obstruction.
Pleural Effusion: Accumulation of fluid in the pleural space.
Lung Abscess: Localized collection of pus within the lung tissue.
Pleurisy: Inflammation of the pleura, causing sharp pain during breathing.
Pericarditis: Inflammation of the pericardium, potentially leading to chest pain.
Endocarditis: Infection of the heart valves that can occur in severe cases.
Superinfection: Secondary infection following initial pneumonia.
Hypotension: Drop in blood pressure due to severe infection.
Shock: Potentially life-threatening condition resulting from sepsis or respiratory failure.
