Lecture 11 Lower Respiratory Tract Flashcards
what is pneumonia
inflammation of lung parenchyma
inflammation of alveoli causes exudate production, which impairs O2 and CO2 diffusion
what causes pneumonia?
bacteria, fungi, viruses
aspiration or altered resistance to pathogens
what is the difference between bronchopneumonia and lobar pneumonia
bronchopneumonia looks patchy and lobar pneumonia causes consolidation
what is community acquired pneumonia?
develops in community or within 48 hours of hospitalization
what is healthcare-associated pneumonia?
occurs in non hospitalized patient who has high contact with healthcare system
usually multi-drug resistant organisms
what is hospital acquired pneumonia?
develops at least 48 hours after hospital admission
often multiple organisms
ventilator-associated pneumonia occurs >48 hours after ventilation
risk factors for pneumonia
immunocompromised
other heart or lung disease
immobility
smoking
age
ICU admission
altered swallowing and depressed cough
signs and symptoms of pneumonia
fever, sweating, chills
severe cough
SOB
chest pain
loss of appetite
N/V, diarrhea
fatigue
weakness
purulent sputum
diagnosing pneumonia
chest xray
sputum culture
blood culture
bronchoscopy
meds for pneumonia
no meds for viral
IV antibiotics until patient stable enough for PO
supportive care for pneumonia
hydration
O2 or intubation if necessary
antipyretics
antitussives
nasal decongestants
rest
preventing pneumonia
smoking cessation
HOB >30 degrees
mobilization
assess swallowing and mental status, withhold PO if not safe
pulmonary toileting
nursing interventions for pneumonia
hydration
humidity
coughing and position changes to mobilize secretions
assess effectiveness of O2 administration
semi-fowlers
complications of pneumonia
sepsis
respiratory failure
pleural effusion
delirium
what body systems are affected by tuberculosis?
lungs
kidneys, bones, lymph nodes
is latent tuberculosis contagious?
no
pathophysiology of tuberculosis
bacteria deposits in alveoli and transports to other parts of the body
immune response causes fibrosis in lung tissue
signs and symptoms of TB
low grade fever
cough
bloody sputum
night sweats
fatigue
weight loss
diagnosing TB
TB skin test
quantiferon
chest xray
sputum culture
TB medications
isoniazid
rifampin
pyrazinamide
ethambutol
side effects of TB medications
hepatotoxicity
neuritis
optic neuritis
side effect of rifampin
urine and body secretions colored orange
nursing management of TB
airborne precautions
promote airway clearance
improve activity
avoid alcohol
take meds on empty stomach
nutrition important because prolonged illness can cause malnutrition
what is pleural effusion?
fluid in pleural space
fluid can be clear, bloody, or purulent
symptoms of pleural effusion
chest pain
dyspnea
difficulty lying flat
what conditions might pleural effusion be secondary to?
pneumonia
PE
cancer
assessing and diagnosing pleural effusion
absent breath sounds
chest xray or CT
thoracentesis
maybe chest tube
respiratory failure
lungs fail to provide adequate oxygen and ventilation
ABG values for respiratory failure - respiratory acidosis
PaO2 <60
pH <7.35
PaCO2 >50
causes of respiratory failure
impaired CNS
neuromuscular dysfunction
muskuloskeletal dysfunction
pulmonary dysfunction
post-op meds and pain
early symptoms of respiratory failure
restlessness
fatigue
headache
dyspnea
air hunger
tachycardia
increased BP
late symptoms of respiratory failure
confusion
lethargy
tachycardia and tachypnea
cyanosis
respiratory arrest
managing respiratory failure
correct cause
intubation if necessary
acute respiratory distress syndrome
severe inflammation of lungs
alveolar damage
pulmonary edema
hypoxemia not responsive to oxygen therapy
infiltrates in lungs
managing ARDS
oxygen, pulmonary toileting, nebulizers
enteral feeding
hydration
anxiety meds
intubation and ventilation
prone positioning
