Pneumonia

Question 1

description of pneumonia

Answer 1

inflammation of lower respiratory tract

can be caused by infectious agents

Question 2

organisms that cause pneumonia reach lungs by

Answer 2

aspiration, inhalation, hematogenous spread

Question 3

generally classified by caustive agents

Answer 3

bacterial, viral, fungal, chemical

Question 4

may be acquired…

Answer 4

in community or in hospital (ie/ ventilator associated)

Question 5

age range of contracting pneumonia

Answer 5

affects people of all ages

esp > 65 y/o or <2 y/o

Question 6

high risk individuals for pneumonia..

Answer 6

• accumulated lung secretions (asthma, COPD, SCA)
• cigarette smokers
• immobility
• immunosuppressed
• depressed gag and or cough
• sedated
• neuromuscular disorder
• nasogastric or orogastric intubate
• hospitalized pt

Question 7

s/s of pneumonia

Answer 7

• tachypnea (shallow resp)
• abrupt fever, shaking, chills
• productive cough with pleuritic pain
• rapid, bounding pulse
• pain and dullness to percussion over affected lung
• bronchial breath sounds/ crackles
• tactile fremitus

Question 8

s/s of older adults

Answer 8

confusion, anorexia, increased RR, tachycardia,

Question 9

what is tactile fremitus

Answer 9

feel chest vibrations when pt says “99”

is heard d/t solid tissue conducts sound in pneumonia pt

Question 10

describe bronchial breath sounds

Answer 10

• heard over areas of density or consolidation
• sound wave easily transmitted over consolidation
• sound of E changes to E in lungs (egophony)

Question 11

and increased temp….

Answer 11

increases metabolism and demand for O2

Question 12

fever can cause

Answer 12

dehydration d/t fluid loss (diaphoresis)

Question 13

also high risk for pneumonia if…

Answer 13

-altered LOC
-brain injury
-decreased or absent gag/cough reflex
-aspirating suseptibility
-drug overdose
-stroke pt
immunocompromised

Question 14

examples of macrolides

Answer 14

clarithromycin, azithromycin, erythromycin

Question 15

when taking abx report what

Answer 15

D and abd pain

Question 16

dx/labs of pneumonia

Answer 16

• chest x ray (infiltrates with consolidaiton or pleural effusion)
• elevated WBC
• ABG indicate hypoxemia
• drop Oz sat (<90%)

Question 17

intervention for pneumonia

Answer 17

-assess sputum for volume, color, consistency, clarity and odor (if pseudomonas)
-assist to cough productively (deep breathe every 2 hr, humidity, suction airway, chest physiotherapy)
-provide fluid to liquify secretions (3L)
-assess lung sounds, rate, depth, pattern, RR
-monitor ABGs
-encourage flu vaccine
give abx, rest, monitor temp and fluid status

Question 18

monitor these abx for allergic rxn

Answer 18

penicillin (observe 30 min after, give on empty stomach)

semisynthetic (monitor for superinfection)

Question 19

tetracycline

Answer 19

abx
decreases BC
no sunlight
no milk or antacids

Question 20

aminogycosides

Answer 20

monitor renal function, peak and trough
monitor ototoxicity (headache, dizzy, tinnitus)

Question 21

other abx given

Answer 21

macrolides, monobactam (renal function and heart), cephalosporins

Question 22

pneumonia prevention in older adults

Answer 22

• annual flu vaccine
• pneumococcal vaccine >65 yo
• avoid infection and pollutants
• no smoking

Question 23

pneumonia prevention in immunocompromised

Answer 23

• annual flu vaccine, pneumonia vaccine
• avoid infection
• nutrition
• fluid intake
• balance activity and rest

Question 24

pneumonia prevention in comatose and immobile

Answer 24

• elevate HOB 30 for feeding and 1 hr after

- turn frequently

Question 25

cerebral hypoxia

Answer 25

brain not recieving enough O2

early signs: irritability and restlessness

Question 26

why is hydration important for pneumonia pt

Answer 26

• thins out mucus trapped in bronchioles/alveoli (expectoration)
• essential if pt has fever
• important cuz 300-400 mL fluid lost daily with evaporation