Lecture 11 Lower Respiratory Tract

Question 1

what is pneumonia

Answer 1

inflammation of lung parenchyma

inflammation of alveoli causes exudate production, which impairs O2 and CO2 diffusion

Question 2

what causes pneumonia?

Answer 2

bacteria, fungi, viruses

aspiration or altered resistance to pathogens

Question 3

what is the difference between bronchopneumonia and lobar pneumonia

Answer 3

bronchopneumonia looks patchy and lobar pneumonia causes consolidation

Question 4

what is community acquired pneumonia?

Answer 4

develops in community or within 48 hours of hospitalization

Question 5

what is healthcare-associated pneumonia?

Answer 5

occurs in non hospitalized patient who has high contact with healthcare system
usually multi-drug resistant organisms

Question 6

what is hospital acquired pneumonia?

Answer 6

develops at least 48 hours after hospital admission
often multiple organisms
ventilator-associated pneumonia occurs >48 hours after ventilation

Question 7

risk factors for pneumonia

Answer 7

immunocompromised
other heart or lung disease
immobility
smoking
age
ICU admission
altered swallowing and depressed cough

Question 8

signs and symptoms of pneumonia

Answer 8

fever, sweating, chills
severe cough
SOB
chest pain
loss of appetite
N/V, diarrhea
fatigue
weakness
purulent sputum

Question 9

diagnosing pneumonia

Answer 9

chest xray
sputum culture
blood culture
bronchoscopy

Question 10

meds for pneumonia

Answer 10

no meds for viral
IV antibiotics until patient stable enough for PO

Question 11

supportive care for pneumonia

Answer 11

hydration
O2 or intubation if necessary
antipyretics
antitussives
nasal decongestants
rest

Question 12

preventing pneumonia

Answer 12

smoking cessation
HOB >30 degrees
mobilization
assess swallowing and mental status, withhold PO if not safe
pulmonary toileting

Question 13

nursing interventions for pneumonia

Answer 13

hydration
humidity
coughing and position changes to mobilize secretions
assess effectiveness of O2 administration
semi-fowlers

Question 14

complications of pneumonia

Answer 14

sepsis
respiratory failure
pleural effusion
delirium

Question 15

what body systems are affected by tuberculosis?

Answer 15

lungs
kidneys, bones, lymph nodes

Question 16

is latent tuberculosis contagious?

Answer 16

no

Question 17

pathophysiology of tuberculosis

Answer 17

bacteria deposits in alveoli and transports to other parts of the body
immune response causes fibrosis in lung tissue

Question 18

signs and symptoms of TB

Answer 18

low grade fever
cough
bloody sputum
night sweats
fatigue
weight loss

Question 19

diagnosing TB

Answer 19

TB skin test
quantiferon
chest xray
sputum culture

Question 20

TB medications

Answer 20

isoniazid
rifampin
pyrazinamide
ethambutol

Question 21

side effects of TB medications

Answer 21

hepatotoxicity
neuritis
optic neuritis

Question 22

side effect of rifampin

Answer 22

urine and body secretions colored orange

Question 23

nursing management of TB

Answer 23

airborne precautions
promote airway clearance
improve activity
avoid alcohol
take meds on empty stomach
nutrition important because prolonged illness can cause malnutrition

Question 24

what is pleural effusion?

Answer 24

fluid in pleural space
fluid can be clear, bloody, or purulent

Question 25

symptoms of pleural effusion

Answer 25

chest pain dyspnea difficulty lying flat

Question 26

what conditions might pleural effusion be secondary to?

Answer 26

pneumonia PE cancer

Question 27

assessing and diagnosing pleural effusion

Answer 27

absent breath sounds chest xray or CT thoracentesis maybe chest tube

Question 28

respiratory failure

Answer 28

lungs fail to provide adequate oxygen and ventilation

Question 29

ABG values for respiratory failure - respiratory acidosis

Answer 29

PaO2 <60 pH <7.35 PaCO2 >50

Question 30

causes of respiratory failure

Answer 30

impaired CNS neuromuscular dysfunction muskuloskeletal dysfunction pulmonary dysfunction post-op meds and pain

Question 31

early symptoms of respiratory failure

Answer 31

restlessness fatigue headache dyspnea air hunger tachycardia increased BP

Question 32

late symptoms of respiratory failure

Answer 32

confusion lethargy tachycardia and tachypnea cyanosis respiratory arrest

Question 33

managing respiratory failure

Answer 33

correct cause intubation if necessary

Question 34

acute respiratory distress syndrome

Answer 34

severe inflammation of lungs alveolar damage pulmonary edema hypoxemia not responsive to oxygen therapy infiltrates in lungs

Question 35

managing ARDS

Answer 35

oxygen, pulmonary toileting, nebulizers enteral feeding hydration anxiety meds intubation and ventilation prone positioning