Lower Upper Respiratory

Question 1

discuss acute bronchitis

Answer 1

inflammation of the bronchi in the lower
respiratory tract usually caused by infection

• mostly caused by viral infections
• it is a self-limiting condition; treatment is supportive

Question 2

discuss pneumonia

Answer 2

acute inflammation of lung parenchyma (which is portion of the lung involved in gas exchange aka alveoli) caused by microbial organism

• likely to result when defence mechanisms become incompetent or overwhelmed

Question 3

what are the 3 ways organisms reach the lungs?

Answer 3

1) aspiration

2) inhalation

3) hematogenous spread from primary infection elsewhere in body

Question 4

what are the 5 types of pneumonia?

Answer 4

1) community acquired - onset in the community or during first 2 days of hospitalization

2) hospital-acquired pneumonia - occurring 48hours or longer after hospital admission

3) fungal pneumonia - not transmitted from person to person. usually occurs bc fungal infection in pt being treated with corticosteroids

4) aspiration pneumonia - abnormal entry of secretion

5) opportunistic pneumonia - bacterial and viral infections in immunocompromised pts, doesnt normally cause infection; basically body is weak in the kness and is a loser

Question 5

how does pneumonia happen? watch YouTube about the steps too

Answer 5

1) congestion

2) red hepatization

3) grey hepatization

4) resolution

Question 6

what is something we do to help manage pneumonia?

Answer 6

appropriate positioning and repositioning to prevent atelectasis

Question 7

discuss tuberculosis

Answer 7

infectious disease caused by M.tuberculosis, a gram positive acid fast bacillus

• early stages are symptoms free

Question 8

how does tuberculosis spread?

Answer 8

via airborne droplets

• pt must be in negative pressure

Question 9

what is the path for tuberculosis?

Answer 9

inhaled bacilli pass down bronchial system and implant themselves on bronchioles or alveoli then they replicate slowly and spread via lymphatic system

Question 10

how does tuberculosis heal?

Answer 10

by resolution, fibrosis and calcification

• granulation tissue surrounding lesion becomes more fibrous and form a collagenous scar around the tubercle

Question 11

what happens when tuberculosis lesions heal?

Answer 11

the infection enters a latent period.

• TB infection in this state is present but no clinical manifestations

Question 12

can you get TB again?

Answer 12

it can reactivate if the hosts defence mechanism becomes impaired

Question 13

discuss TB complications

Answer 13

military TB
- invasion of bloodstream and spread to all organs

TB pneumonia
- large amounts of bacilli go into the lungs

Pleural effusion and empyema
- caused by bacteria in pleural space

Question 14

what are the 3 testing for tuberculosis?

Answer 14

1) TB skin testing
- if pos(+) reaction, indicated TB infection present but does not tell if infection is active or latent

2) Chest study
- looking for calcification

3) bacterial studies
- Culture is MOST accurate

Question 15

what to do if you have TB?

Answer 15

• hospital is not necessary
• non-adherence is a MAJOR factor in multi drug resistance and treatment fails

Question 16

discuss TB drug therapy

Answer 16

1) directly observed therapy
- watch pts swallow drugs
- non adherence = drug resistance

2) active disease
- 4 drugs used in initial phase for max effect

3) latent TB
- treated with INH for 6-9 months

4) Vaccine
- BCG to prevent TB; will result in positive PPD REACTION

Question 17

discuss pulmonary fungal infections

Answer 17

found in clients being treated with corticosteroids
- pt doesnt need to be on isolation as it is not transmitted from person to person

• NWO blastomycosis

Question 18

what is used to treat pulmonary fungal infections?

Answer 18

IV amphotericin B

Question 19

discuss bronchiectasis

Answer 19

permanent abnormal dilation of one or more large bronchi

• almost always associated with bacterial infections

Question 20

what are nursing management for bronchiectasis?

Answer 20

antibiotics are the mainstream treatment and are often given EMPIRICALLY but attempts are made to culture the sputum

Question 21

discuss lung abscess

Answer 21

a pus containing lesion of the lung parenchyma that gives rise to a cavity

• antibiotics given for 2 - 4 months usually the primary method for treatment

Question 22

discus environmental lung disease

Answer 22

result from inhaled dust or chemicals

1) pneumoconiosis (general term for lung disease) = “DUST IN LUNGS”

symptoms may not occur until 10-15 YEARS AFTER exposure