Mod 4: Oxygenation Flashcards
Cause of Influenza
Viral infections
Signs and symptoms of Influenza
High fever, secondary infection (bronchitis pneumonia), acute respiratory failure, ARDS
Labs for Influenza
Viral culture
Interventions for Influenza
Relief of symptoms, prevention of secondary infection, hand washing, encourage rest and hydration, encourage annual influenza vaccine for prevention.
Orders anticipated for Influenza
- Antiviral drugs if given within 24–48 hrs of onset.
- Acetaminophen or ibuprofen for headache, aches, and pains.
Cause of Bronchitis
Inflammation of the bronchi in the lower respiratory tract
Caused by viruses, air pollution, dust, inhalation of chemicals, smoking, chronic sinusitis, and asthma.
Signs and symptoms of Bronchitis
High fever, secondary infection (bronchitis, pneumonia), acute respiratory failure, and ARDS.
Labs for Bronchitis
Generally, none needed - may have a CBC or CXR to rule out an infection.
Interventions for Bronchitis
Provide symptoms relief and prevent secondary infection – cough suppressants, bronchodilator, encourage fluids, use of humidifier, avoid smoke, and good hand washing.
Orders anticipated for Bronchitis
Dextromethorphan for cough suppression
Albuterol inhaler for bronchodilation.
Causes of Pneumonia
Acute bacterial or viral infection of the lung parenchyma. Community-acquired or Hospital-acquired. Pathogens that cause pneumonia reach the lung in 3 ways:
1. Aspiration of normal flora from the nasopharynx or oropharynx. Many organisms that cause pneumonia are normal inhabitants of the pharynx in healthy adults.
2. Inhalation of microbes present in the air. Examples include Mycoplasma pneumoniae and fungal pneumonias.
3. Hematogenous spread from a primary infection elsewhere in the body. Examples are streptococci and Staphylococcus aureus from infective endocarditis.
Signs and symptoms of Pneumonia
Atelectasis, pleurisy, pleural effusion, bacteremia, pneumothorax, sepsis, and septic shock.
Labs for Pneumonia
CXR, sputum culture, pulse oximetry, CBC, and blood cultures.
Interventions for Pneumonia
Increased fluid intake (at least 3 L/day), administer IV fluids, balance between activity and rest, monitor vital signs including pulse oximetry, provide O2 therapy, physiotherapy, VTE prophylaxis, critical care management, with mechanical ventilation as needed.
Orders for Pneumonia
- IV fluids – 0.9% sodium chloride for hydration.
- O2 therapy
- Antipyretics for fever.
- Analgesics for pain.
- NSAIDS for pain and fever.
- Antibiotics to treat the infection – based on sputum culture results.
Metabolic Acidosis
pH = less than 7.35 and HC03 = less than 22
Metabolic Alkalosis
pH = more than 7.45 and HC03 = more than 26
Respiratory Acidosis
pH = less than 7.35 and PaC02 = greater than 40
Respiratory Alkalosis
pH = more than 45 and PaC02 = less than 40
Causes of Metabolic Acidosis
DKA, Renal Failure, lactic acidosis from sepsis, excessive diarrhea or liver failure
Symptoms of Metabolic Acidosis
COMA; hypovolemic shock (from osmotic diuresis) and potassium disturbances (Hyperkalemia)
Labs for Metabolic Acidosis
If DKA, glucose and potassium
If renal failure, BUN, Creat/eGFR, and potassium
If liver failure, liver enzymes, ABGs, and potassium
Interventions for Metabolic Acidosis
If DKA, administer fluids and insulin (REGULAR) IV. Assess for rapid, deep respirations (Kussmaul respirations)
If renal failure –> dialysis
Orders for Metabolic Acidosis
DKA: Regular Insulin & Fluids
Renal Failure: Dialysis & Potassium Protocol
