PNA Case Flashcards
how to differentiate compensated vs uncompensated respiratory/metabolic abnormalities
pH normal = compensated
normal range for pH
7.35 - 7.45
PaCO2 nl range
45-35
HCO3 nl range
22-26
what 2 organisms account for the majority of CAP
strep pneumo
mycoplasma
besides strep pneumo and mycoplasma, 3 other pathogens that cause CAP
h.flu
chlamydia pna
legionella
DOC for strep pneumo CAP
doxycycline
3 alternative DOC’s for strep pneumo CAP
3rd gen cephalosporins
macrolides
fluoroquinolones
what are three third gen cephalosporins
ceftriaxone
ceftazidime
cefdinir
what are the 2 respiratory fluoroquinolones
levofloxacin
moxifloxacin
3 DOC for mycoplasma CAP
doxycycline
erythromycin
levofloxacin
2 DOC for h.flu CAP
macrolides
levo/moxi
2 DOC for chlamydia pna
macrolides
levo
3 DOC for legionella
macrolides
levo
doxycycline
how do you decide if a pt should be on PO vs IV abx for CAP
bio availability of DOC
ex no difference btw PO vs IV fluoroquinolones
2 indications to switch CAP pt from IV to PO
stable w. nl vs x 24 hr
no resp distress
what is considered nl vs for switching to PO abx
afebrile
rr 24 or less
HR 100 or less
SBP 90 or higher
SpO2 > 90
t/f: all pt’s hospitalized for CAP should be on IV abx
f!
CURB 65
2 common oral abx to d/c CAP pt with
3rd gen cephalosporins
fluoroquinolones
PCP f/u for hospitalized CAP pt
after completion of abx course -> 5-7 days
what should be done shortly prior to hospital d/c for CAP pt
repeat CXR
best rec for fever/body aches related to CAP
alternate APAP 1 gm w. IBU 600 mg q 4 hr
5 indications for emergent care w. CAP
cp
dyspnea
fever >102
leg swelling
calf pain
