Pneumonia Flashcards
Pneumonia definition:
Acute infection of the lung parenchyma
What is a parenchyma?
A functional unit of an organ
Functional portion (parenchyma) of the lung is the __.
Alveoli
Name 7 risk factors for pneumonia
Age >65 Altered level of consciousness Immobility Debilitating illness Malnutrition Smoking Tracheal Intubation
Why is a patient with altered level of consciousness at risk factor for pneumonia?
They have a weakened cough and can’t expectorate their secretions
What type of pneumonia does altered LOC and weakened cough put a patient at risk for?
Aspiration pneumonia
In who does community-acquired pneumonia occur?
Patients who have not been hospitalized or lived in a long-term care facility within 14 days of first onset of symptoms
To be considered hospital-acquired pneumonia, the onset of symptoms should start at least…
48 hours after admission
If a patient is admitted with symptoms of pneumonia, can it be considered hospital-acquired?
No
A type of hospital-acquired pneumonia that often occurs in the ICU?
Ventilator-associated pneumonia (VAP)
List the four types of pneumonia .
Viral, bacterial, aspiration, opportunistic
What is the most common type of pneumonia?
Viral
Opportunistic pneumonia occurs in __ patients.
Immunocompromised
Aspiration pneumonia results from…?
Abnormal entry of material from mouth/stomach into lungs/trachea
This type of pneumonia is more serious and may require hospitalization.
Bacterial pneumonia
Viral pneumonia usually resolves in…?
3-4 days
What is the severity (virulence) of viral pneumonia?
It can be mild or self-limiting, or cause potentially life-threatening problems
Name three risk factors for aspiration pneumonia
Decreased LOC, dysphasia, and NG tubes
Nasogastric tubes must be __ to prevent aspiration pneumonia
post pyloric
Aspiration pneumonia may be __.
Silent
Pneumonia is usually preceded by an __ __ __.
upper respiratory infection
Myalgia definition
Muscle aches and pain
Malaise definition
General feeling of illness, discomfort, or lack of well-being
Common manifestation of infection in the elderly
New onset confusion
List the symptoms of pneumonia
Fever, chills, cough, malaise, myalgia, chest pain with inspiration or cough, dyspnea, fatigue, confusion (elderly)
A bacterial pneumonia cough presents as __ and __.
productive and purulent
Purulent sputum looks…
green, rusty, like red currant jelly
A viral pneumonia cough presents as __ or __ cough.
nonproductive or scanty
In severe cases of pneumonia you can have __ __ or __ __.
respiratory distress or respiratory failure
Patients with __ are the ones most often admitted to the hospital with pneumonia
comorbidities
List three diagnostic tests used to diagnose pneumonia
Chest x-ray, WBC with differential, sputum specimen for culture and sensitivity
On a chest x-ray, the provider will look for…
Infiltrates
What are infiltrates?
Haziness on a chest x ray where it should be clear
Leukocytosis is seen in patients with what type of pneumonia?
Bacterial
Leukopenia definition
Low WBC count
What does a shift to the left mean on a WBC with differential?
Increase in count of immature neutrophils
What type of leukocyte is the first to respond in an acute bacterial infection?
Neutrophils
A positive sputum culture and sensitivity will identify what two things?
The bacteria and the antibiotics it is susceptible/resistant to
If the pneumonia is viral the sputum c&s will have what result?
negative
Four things to educate your patient on for pneumonia prevention
Pneumococcal vaccine, stop smoking, adequate sleep/rest, proper nutrition
Three things for the nurse to do for patients hospitalized with pneumonia (or at risk)
1) Know who is at risk!
2) Pulmonary toilet, early ambulation
3) Standard precautions and hand hygiene
For a patient with pneumonia, you should monitor __ and __ frequently. Trend the data.
Vital signs and pulse oximetry
When monitoring the vital signs of a patient with pneumonia, if that patient has an infection they may have alterations in vital signs such as…
Fever (temperature), tachycardia (HR), hypertension (BP), and/or hypoxemia (pulse ox)
You should auscultate your patient’s lungs at the beginning of your shift to get a…?
Baseline for later comparison
What nursing intervention to keep pulse oximetry (typically) above 95%?
Supplemental oxygen if ordered
What is pulmonary toileting?
Turn, cough, deep breath, incentive spirometer
Postural drainage and percussion are examples of?
Chest physiotherapy (CPT)
Why does increased fluid intake help with pneumonia?
Helps loosen secretions
You can increase fluid intake by which two methods?
PO (if allowed) or IV
List nine nursing interventions in a patient with pneumonia or at risk for pneumonia
1) VS/Pulse ox monitoring
2) Lung auscultation
3) Supplemental oxygen
4) Pulmonary toileting/CPT
5) Increased fluid intake
6) Ambulation
7) Energy conservation
8) Drug Therapy
9) Teaching
In a patient with heart failure, increased fluid intake would be __.
Contraindicated
Energy conservation is necessary in a patient with pneumonia because they will have __ __
Activity intolerance
Drug therapy for bacterial pneumonia
Antibiotics
Drug therapy for pleuritic pain (chest pain)
Analgesics
Drug therapy for fever
Antipyretics
Pyretic means…
of or relating to fever
