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kol- Med Surg 320 Spring > Pneumonia > Flashcards

Pneumonia Flashcards

1
Q

What is pneumonia and where does it occur

A

Excess fluid in lungs from INFLAMMATORY process.

Occurs in the interstitial space, alveoli, and bronchioles

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2
Q

causes of inflammation leading to pneumonia?

A

infectious organism or inhaling irritating agents

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3
Q

Pneumonia from an ________ process will have more formation of exudate

A

infectious

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4
Q

What does pneumonia result in?

A

reduces gas exchange

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5
Q

Pathophysiology of pneumonia

A

Pathogens enter airway (infectious or irritating agent).
If an infectious organism, it will multiply.

Immune Response: WBC arrive.
Causes capillary leak, edema, and exudate formation.

Exudate collects in and around alveoli.
Alveolar walls thicken and lungs stiffen (from fibrin and edema).
Diffusion is impaired– reducing gas exchange.

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6
Q

Who has highest risk of pneumonia?

A

Rate is higher among older adults (>65), nursing home
patients, hospital patients, and patients with
neurological, dysphagia, or ventilated patients.

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7
Q

which is more common- community acquired or hospital acquired pneumonia?

A

community acquired

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8
Q

what is most common cause of sepsis

A

community acquired pneumonia

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9
Q

2 types of pneumonia based on location in lung:

A

Lobar Pneumonia: Consolidation in a segment or lobe (aspiration)
Bronchopneumonia: Scattered patches around bronchi

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10
Q

3 main types of pneumonia

A

Community acquired
Healthcare acquired
Ventilator acquired

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11
Q

definition of community acquire pneumonia? 2 common pathogens causing it?

A

pneumonia that is acquired outside the hospital.
-The most commonly pathogens are Streptococcus
pneumoniae, Haemophilus influenzae

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12
Q

what can occur as complication of influenza?

A

pneumonia

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13
Q

Hospital-acquired pneumonia (HAP/HCAP) is defined

as

A

…. a pneumonia that was not incubating at the time of hospital admission and that presents 2 or more
days after hospitalization.

(Pneumonia that presents sooner should be regarded as community­ acquired pneumonia.)

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14
Q

define ventilator associate pneumonia?

A

a lung infection that develops in a

person who is on a ventilator.

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15
Q

infectious causes of pneumonia- name the 3 weird ones

A

Bacteria
Viruses
Mycoplasmas
Fungi

Weird:
Rickettsiae -ticks/fleas
Protozoa
Helminths- wormies

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16
Q

Non infectious causes of pneumonia

A

Toxic gases
Chemical fumes
Smoke
Aspiration (water/fluid, food, saliva, vomit)

17
Q

Risk factors for developing pneumonia ?

A

Age 
Unvaccinated
Unvaccinated or Pneumococcal Vaccine > 5 years ago
 Unvaccinated against influenza  Chronic health issues
 Chronic lung disease  Immunocompromised  Tobacco Use and smoke (including vaping)  Recent respiratory illness (viral or flu) exposure  ETOH  Altered level of consciousness  Aspiration risk  Endotracheal tube, tracheostomy, nasogastric tube  Poor nutritional status

18
Q

Risk factors for developing pneumonia ?

A
  • Age
  • Unvaccinated
  • –> Unvaccinated or Pneumococcal Vaccine > 5 years ago
  • —> Unvaccinated against influenza  Chronic health issues
  • Chronic lung disease
  • Immunocompromised
  • Tobacco Use and smoke (including vaping)
  • Recent respiratory illness (viral or flu) exposure
  • ETOH
  • Altered level of consciousness
  • Aspiration risk
  • Endotracheal tube, tracheostomy, nasogastric tube
  • Poor nutritional status
19
Q

Prevention for pneumonia

A

Vaccination –> only protects from INFECTIOUS agent
Avoid crowded areas
Clean respiratory equipment
Avoid indoor pollutants (i.e dust, smoke, aerosols) Balanced Diet
Adequate fluid intake (unless on fluid restriction) Adequate sleep
Tobacco Cessation, including vaping
Handwashing
Incentive Spirometry

20
Q

Nursing Interventions for Prevention of pneumonia

what kind of water should you put in GI tube?

A 
Pulmonary hygiene (cough, turn, deep breathe)  Mobility  
Handwashing 
Incentive Spirometry 
Sterile H2O in GI tubes 
 Aspiration precautions 
 Ventilator bundle 
Patient Education
Evaluate vaccine status/needs
21
Q

vaccination for pneumonia? 2 types when we do it?

A
  1. Prevnar Pneumococcal Conjugate Vaccine (PCV 13)

6-12 months later

2.Pneumovax Pneumococcal Polysaccharide Vaccine (PPSV 23)

For persons 65+ OR Adults 19-64 who have risk factors.  CDC recommends to be vaccinated with both, FIRST with with Prevnar then 12 months later with Pneumovax.  Don’t forget annual flu vaccine.

**renew pneumovax every 5 years

22
Q

Pneumonia complications

A
  • Sepsis (Bloodstream infection with system wide
    inflammation)
  • Empyema (Exudate in the pleural cavity)
  • Pleural Effusion
  • Lung Abscess/ Necrosis
  • Death
23
Q

what is an empyema?

A

exudate in pleural cavity

24
Q

objective assessment signs of pneumonia?

A 
Chest pain/discomfort (pleuritic)
 Headache
 Dyspnea
 Myalgia
 Chills
 Anxious

*note no fever

25
Q

Generalized Appearance of pneumonia assessment

A

 Flushed cheeks
 Anxious appearance
 Fever (may not be present)

26
Q

Cardiac assesment for pneumonia

A

 Tachycardia

 Dysrhythmias

27
Q

Respiratory assessment for pneumonia

A

Respiratory

  • -Breathing pattern : Shallow , Labored, Accessory Muscles , Chest Expansion, Rate
  • -Positioning: Tripod or Orthopnea (shortness of breath lying down)
  • Cough (may or may not be present)
  • –> Productive: Assess color, amount, consistency, and odor.
  • -Adventitious breath sounds: Crackles (fluid), Diminished, Wheezing, Bronchial, Hypoxia
28
Q

Labs for pneumonia?

A

ABG
 Sputum Culture and Sensitivity
 BMP, CBC, Lactate
 Possibly: Blood cultures, viral panel

29
Q

indepedent sputum collection- how much sputum ya need?

A
  • do not touch inside of container or lid
  • stand on side of pt
  • several deep beraths then cough
  • -> do not let pt clear throat and put saliva in
  • need 10-15 ml
30
Q

assisted sputum collection

A
  • sterile
  • use sputum trap
  • insert tube into nose, suction out while coughing
31
Q

nurisng interventions for pneumonia?

A
  • Oxygen Therapy
  • Incentive Spirometry (Improves inspiratory muscles, preventing atelectasi)
  • Pulmonary hygiene
  • Encourage fluids, unless on fluid restriction
  • Aspiration assessment and prevention
  • Hand hygiene
  • Oral care
  • Mobility
  • Medications: Bronchodilators, Steroids, Expectorants, Anti Infectives (non-viral cause), consider resistance.
  • –Ventilated patients:
  • —> Vent Bundle (HOB >30, oral care every 2 hr with CHG, PUD prop, DVT prop, suctioning, sedation wean…)
32
Q

vent bundle?

A

Vent Bundle (HOB >30, oral care every 2 hr with CHG, PUD prop, DVT prop, suctioning, sedation wean…)

kol- Med Surg 320 Spring (43 decks)

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