L1 Flashcards
Pneumonia sign and symptoms
Pleuritic chest pain which aggravated when deep breath
Rapid pulse
Soar throat
Shortness of breathe with using accessory muscles (1)scalene (2) sternocleidomastoid (3) trapezius (4)pectoralis major muscle
Medical treatment for pneumonia
Antitussive
decongestant
Antihistamine
Antibiotic treatment
Assesment of pneumonia
Vital sign, oximetry
Colour, thickness of secretion
Tachypnea, shortness of breath
Auscultate all lobes
Intervention to improve pneumonia
Oxygen with humidification
Position change
Hydration
Chest PT
Tuberculosis facts
Grow slowly
Open TB (spread faster)
Close tb (spread slower)
Sensitive to light and heat (light can kill)
AIRBORNE transmission
Diagnosis of TB
Tuberculin skin test—inject—) >10mm then positive
Chest xray—) having lesion on upper lobe
Acide fast bacillus presents on sputum culture
Physical examination: assess breathing sound
Nursing care
Promote airway clearance
1. Increase fluid intake
2. Correct positioning
Adherence to treatment
1. Treat tb as communicable disease
2. Most tb fail in treatment are because of non-regular treatment
Promote activity
1. Plan progressive acitivity schedule
2. Liquid nutritional supplement to help reaching nutrition goals
Preventing spreading of tb
1. Primary infectious control (tent)
2. Secondary infectious control (control airflow)(
(Air filter, UV)
3. Patient treatment
Pathology of COPD
Chronic inflammation will damage tissues
Scar tissue decrease elastic recoil of tissue
Risk factors of COPD
Smoking
Passive smoke
Air pollution
Genetic abnormality
Care to client with COPD
Inspection
Test-) blood gas, chest x ray
Asses for symptoms-) chronic cough? Sputum? Dyspnea?
Diagnoses of COPD
Impaired gas exchange
Impaired airway clearance
Ineffective breathing pattern
Activity intolerance
Respiratory inefficiency
Pneumonia
Pulmonary HT
Planning for COPD
Smoke cessation 戒煙
Proper use of broncodilator
Use of supplementary oxygen
Exercise training
Patient teaching of COPD
Avoid irritant or pollution
Prevent infection
Medication
Oxygen therapy caution
Concentration>21%
<50% to avoid oxygen toxicity
Chest physiotherapy
To remove bronchial secretions
1. Postural drainage—) remove secretion by gravity
2. Vibration/ percussion
3. Breathing exercise
Postural drainage management
2-4 times per day
Water or broncodilators given before drainage to loosen secretion and reduce broncospasm
Tb
Infectious disease affect lung parenchyma initially
Can infect meninges, kidneys, bones
Primary infectious disease is mycobacteria tuberculosis bacillus
Pathophysi of tb
Susceptible host inhaled mycobacteria
Travel along airway into aveoli
Deposit and duplicate
Initiate inflammatory response to host
Tb risk factors
Close contact to tuberculosis patient
Substance abuse
Special illness or treatment: diabetes, chronic renal failure, hemodialysis
S/s of tb
Low fever
Nonproductive cough
Night sweat
Fatigue
Weight loss
Treatment of COPD
Usage of antituberlosis agent for 6-12 months
Ensure organism is killed and not relapsing anymore
Medicine such as isoniazid
Chest drainage
Use to treat pleural effusion
Re expand the lung removing excessive air, fluid and blood
The chest tube can produce the negative pressure in pleural space which they usually have
