Pneumonia Flashcards
P-vaccine
Pcv13/ prevenar 13 : all children under 5
pneumovax 23 Valentin 65 - 2 year older high risk
Pneumonia
Inflation of the pharenchymal structures of the lungs including Bronchioles and alveoli Most common cause of death from infections Vaccine - SZ peneumoniae High risk groups > 65 older Immunicompetent Functional anatomic asplenia People living in high risk areas
CDC recommends vaccination after 5 or 10 years
High risk categories
Previously vaccinated 5 years ago
Older than 65 y/o at the time of primary vaccination
Classification
Typical (bacterial) - Atypical (viral fungal) Lobar-bronchial Community vs Hospital Aerobic versus Anearobic/cavitary Opportunistic - defective immune system
Community
Aquired in community or within 48 hours of admission
Hospital
Nosocomial Onset of symptoms Post 48 of admission 3 conditions -impairs defenses orangish reaches lower respiratory tract Highly virulent organism
Typical -P
Oropharynx - Nasopharynx
Invade Alveoli Aspiration
Inhalation from environment
Loss- cough reflex, damage to collated endothelium impaired immune system predisposed to colonization and infection of lower respiratory tract
Diagnosis
H&P
CXR
Blood Culture
Sputum collection
Management
Antibiotics Hydration Antitussive Antipyretic Bed rest Oxygen (if hypoxia developes)
Intubation mechanical ventilation
Complications - pneumonia
Hypotension shock respiratory failure bacteremia - septicemia is common With all pneumonia patients - blood cultures Atectasis Pleural effusions Superinfection Bacteria may become resistant
Sputum Collections
Rinse might out with water several breaths and cough deeply 1. Gram stain 2. Cultured on culture plates 3. 1-3 bacteria growth 4. Drug sensitivity Most appropriate anti microbial drug theraphy OBTAIN BEFORE ANTIBIOTICS 48hrs c&s Mycobacterium tuberculosis 6-8 weeks
Sputum Collection
From lungs
Hold antibiotics
Nebulized warm saline /suction
First thing in the morning before eating or drinking
Sterile sputum containers / indicate in label if on antibiotics
