Infection & Inflammatory Respiratory Diseases Flashcards
parenchyma
functional tissue of an organ
excludes connective tissue
nosocomial infection
infection acquired in hospital
granuloma
small area of inflammation
ghon complex
lesion in lung formed from TB
pneumonia
acute lung injury where an inflammatory process affects the parenchyma of the lungs
causes of pneumonia
- bacterial
- viral
- fungal
- inhalation of toxic or caustic chemicals, smoke, dusts or gases via airborne transmission
- aspiration of food, fluids, vomitus
risk factors of pneumonia
- age
- chronic bronchitis
- poorly controlled diabetes
- uremia
- dehydration
- malnutrition
- confinement to an extended stay facility/hospital
- intubation/surgery, etc.
pathogenesis of pneumonia
- full scale inflammatory and immune responses with damaging side effects to the lung tissue
- damage type II cells that produce surfactant
community acquired pneumonia
- people with limited or no contact with medical institutions or setting
- remains a common and serious clinical problem
- hospital acquired pneumonia
- high mortality rate
- 40% hospital deaths, 90% older than 65
- common complication of the flu
S&S of pneumonia
- sudden and sharp pleuritic chest pain aggravated by chest movement and accompanied by a hacking, productive cough
- innappropriate dyspnea
- tachypnea –> decreased chest excursion –> decreased tidal volume –> increased respiratory rate
- cyanosis
- headache
- fatigue
- fever and chills
- aches and myalgias
- altered mental status
pneumonia medical management
antibiotic
vaccine
chest PT
PT implications for pneumonia
- wash hands
- deep breathing, coughing, airway clearance
- hydration
- early ambulation
- proper positioning
- out of bed activities
influenza
viral infection
symptoms of influenza
fever chills muscle aches cough congestion runny nose HA fatigue
treatment influenza
rest and fluids
OTC anti-inflammatory meds
PT implications and influenza
- be conscious of fatigue
- ease back into therapy
- check resting HR
- skeletal muscle altered from the infection
tuberculosis
- disease caused by bacteria mycobacterium TB
- primarily in the lungs
- can be in the vertebral column, CNS or heart
what is multi drug resistant strains regarding TB
TB caused by bacteria that do not respond to isoniazid and refampicin
transmission of TB
- airborne
- unpasteurized milk
- inhalation of infected airborne particles or droplets by an infected person
what is active TB
bacteria is inside a granuloma and becomes active when that breaks up and is now circulating through the body
progression of primary TB can lead to what
- pt’s not knowing they have TB because the granuloma is sealed off due to cell-mediated immunity from macrophages
what is a secondary infection in TB
the ghon complex becomes reactivated, high infectious state, forms cavity that is not reachable from immune cells
clinical manifestations of TB
- asymptomatic
- 2-12 wks
- highest risk for active infxn is in the first two years
symptoms of Tb
- productive cough
- weight loss
- anorexia
- fever
- night sweats
- fatigue
- malaise
- hemoptysis
PT implications for TB
- protect yourself
- clean equipment
- notice S&S
- thorough chest assessment
- postural deviations
- gait
- strength
- balance
- functional mobility
- exercise
- observe med list
- negative air pressure rooms
- PT EDUCATION
if someone has TB, will they always show a positive test for the rest of their lives?
yes
HEPA filter mask
trap 99.97% airborne particles 0.3 microns or larger
N95 Mask
filter particles 1 micron in size > 95%
PAPR
power air purifying respirator
for a chest expansion assessment where does the tape measure go around
at or about the level of 4th intercostal - nipple level or just below
chest expansion assessment
measure a deep max inspiration and a max expiration - take the difference
childrens amount of expansion
2 cm
young males amount of expansion
5-8 cm
emphysemia amount of expansion
< 1 cm
equal chest expansion
- place fingertips of both hands on either side of lower ribs, thumbs meet at midline, ask pt to breathe deep
- posteriorly at the level of and parallel to the 10th rib
- if one thumb is closer to midline, diminished expansion on that side
