Pneumonia + Acid -Base imbalances

Question 1

How fast do respiratory buffers work with alternations of normal acid-base balance?

Answer 1

within minutes

Question 2

How do you differentiate between community-acquired and hospital-acquired pneumonia?

Answer 2

If yes to any of these its hospital acquired:
1.) In hospital for 2+ within 90 days

2.) Resided in a nursing home or long term care facility within 90 days

3.) Received home infusion therapy within 30 days

4.) Exposed to family member with MDR organisms within 30 days

*In hospital under 48 hours

If no to any of these then its community-acquired

Question 3

How are we going to treat bacterial pneumonia?

Answer 3

With antibiotics

Question 4

What primary health promotion topics can we provide to our patientsthat relates to pneumona specidically?

Answer 4

(Primary health promotion means trying to stop/prevent individuals from getting it)

Up-to-date vaccinations – Covid, flu, pneumonia
Avoid contact with infected individuals
Social distancing
Hand washing
Proper diet, exercise

Question 5

How fast do chemical buffers work with alternations of normal acid-base balance?

Answer 5

Immediately

Question 6

What is the body’s primary defence mechanism against pneumonia?

Answer 6

Fever

Question 7

What will we see on the labs for someone who has pneumonia?

Answer 7

Increased WBC count and increased inflammatory markers

Question 8

Risk factors for pneumonia?

Answer 8

-Intubation
-Exposure
-Immunocompromised (AIDS)
-Smoking (modifiable) – comprising the lung by changing the bronchi
-Environmental pollutants
-Living conditions (homelessness)
-Substance abuse (creates chronic changes)
-Aspiration risk (swallowing assessments are important)
-Elderly, bed ridden
-Post op – ERAS protocol having patients drink fluids – use cup of water Vs straw
-Chronic illness – COPD (someone who already has a compromised lung), Asthmatics
-Dirty CPAP (dirty equiptment)
-Hygine for self and equptment I am using

Question 9

What is the most common viral pneumonia found in children?

Answer 9

RSV

Question 10

What is the earliest sign of hypoxia?

Answer 10

Confusion

Question 11

How fast do renal system buffers work with alternations of normal acid-base balance?

Answer 11

Within hours to days the kidneys respond to acid or base environment

Question 12

How do we treat a person with viral pneumonia?

Answer 12

We can give them antivirals but we primarily support them by supporting their body (nutrition, fluid, repositioning)

Question 13

What secondary health promotion topics can we provide to our patients?

Answer 13

(secondary looks at those who are more prone to catching it)

Incentive spirometer teaching, deep breathing
HOB – resting – feeding
Rapid testing
Self-isolation

Question 14

What are the 3 regulators of acid-base balance?

Answer 14

1.) Chemical buffers
2.) Respiratory system
3.) Renal system

Question 15

What are the treatment options for pneumonia?

Answer 15

Positioning: We want to have the patient sit up (best chance to expand the lungs), good side up and bad side down (affected lung down)

Fever: If it get dangerously high (we wont jump on it fast because we want to body to be able to fight infection on its own)

Fluids: Super important during pneumonia because it helps get sputum out of lungs (not given during HR, poor kidney function)

O2 Therapy: Nasal prongs at the minimum (not given to those with COPD right away)

Resp Treatments: Cupped hand, shaking ribs, getting patient to cough, suctioning any sputum out, incentive spirometer

Rest: Rest because we want them to get better and stronger, we want to do our care in bursts, visitors need to remember that they can be there all the time because the body needs to recover
-Avoid giving codeine a(cough suppressant)

Medications: Antivirals or Antibiotics

Question 16

What are the main causes of pneumonia?

Answer 16

Bacteria, Viruses, and fungi

Question 17

What is the nausea from in pneumona?

Answer 17

We have this from how we are feeling, not a symptoms of the bug, we get this because we are weak and the body is being attacked

Question 18

What is pneumonia?

Answer 18

It is inflammation of the lung alveoli from an infection

-We have a pathogen that is triggering the inflammatory response in the lungs

Question 19

What tertiary health promotion topics can we provide to our patients?

Answer 19

(Tertiary refers to dealing with those that already have this and how we can prevent it from getting worse)

> than 7 days
Fluids – fever = dehydration
Turning – mobility

Question 20

What kind of diagnostic testing do we run for pneumonia?

Answer 20

History: We want to know the smoking history, have they had or have they been around someone who has been sick, chronic illness (COPD, Asthma, etc), Onset (how long ago did it start? Right before it started what/where you? What has been your exposure) – Exam will be Resp focus

X-Ray: It will have a cloudy effect/look to it

Gram Stain +Sputum Culture: We want to get this done BEFORE we give anti biotics sensitivity: tells us what meds can kill it (ensure we actually get sputum)

CBC: Look at WBC, Inflammatory marker, ABG’s

Blood Culture: ABG

Question 21

What are the symptoms of pneumonia?

Answer 21

Productive cough, pleuritic pain

Neuro changes

Elevated labs

Unusual breath sounds

Mild to high fever

Oxygen saturation decreased

Nausea & vomiting

Increased HR & RR

Aching all over

Question 22

What are some atypical symptoms of pneumonia?

Answer 22

-We will get the dry cough due to the drying of the secretions which we don’t want

-Myalgia (achy feeling)

Question 23

What do we consider community-acquired pneumonia to be?

Answer 23

A viral infection