Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Adult Health 1 Exam 3 > Pneumonia and TB > Flashcards

Pneumonia and TB Flashcards

1
Q

What is pneumonia?

A
  • Acute infection of lung parenchyma.
  • Associated with significant morbidity and mortality rates.
  • Pneumonia and influenza are eighth leading cause of death in the United States.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the etiology of pneumonia?

A

Normal defense mechanisms:
Air filtration, epiglottis closure over trachea, cough reflex, mucociliary escalator, and reflex bronchoconstriction; IgA, IgG, alveolar macrophages

Defense mechanisms become incompetent or overwhelmed
Aspiration, tracheal intubation, air pollution, smoking, viral URI, aging, chronic diseases

Table 27-1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the different classifications of pneumonia?

A
  • May be classified according to causative organism, characteristics of disease, or radiographic appearance.
  • Most effective classification:
    Community-acquired pneumonia (CAP)
    Hospital-acquired pneumonia (HAP)
  • Helps identify most likely organism and antimicrobial therapy.
    Table 27-2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is community-acquired pneumonia (CAP)?

A
  • Acute infection in patients not hospitalized or residing in a long-term care facility within 14 days of the onset of symptoms.
  • Can be treated at home or hospital depending on age, VS, mental status, comorbidities, and condition.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is hospital-acquired pneumonoa?

A
  • Occurs 48 hours or longer after hospitalization and not present at time of admission.
  • Ventilator-associated pneumonia occurs more than 48 hours after endotracheal intubation.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is empiric antibiotic therapy?

A 
- Starting treatment before definitive diagnosis based on:
Risk factors
Early versus late onset
Presentation
Underlying medical conditions
Hemodynamic stability
Most likely causative organism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the types of pneumonia?

A
  • Viral - most common, and may be mild or life-threatening.
  • Bacterial - may require hospitalization
  • Mycoplasma- atypical
  • Aspiration
  • Necrotizing
  • Opportunistic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the pathophysiology of pneumonia?

A
  • Inflammatory response
    Attraction of neutrophils
    Release of inflammatory mediators
    Accumulation of fibrinous exudates, rbc’s and bacteria.
  • Alveoli fill with fluid and debris (Consolidation)
  • Increased production of mucous (Airway obstruction)
  • Decreased gas exchange
  • Resolution of infection
    Macrophages in alveoli ingest and remove debris.
    Normal lung tissue restored.
    Gas exchange returns to normal.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the most common clinical manifestations of pneumonia?

A 
- Most common 
Cough: productive or nonproductive
Green, yellow, or rust-colored sputum
Fever, chills
Dyspnea, tachypnea
Pleuritic chest pain.
- Older or debilitated pt: confusion, stupor, or hypothermia.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What can we find in a physical examination for pneumonia?

A
  • Fine or coarse crackles.
  • With consolidation
    Bronchial breath sounds
    Egophony
    Increased fremitus
  • With pleural effusion
    Dullness to percussion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is MDR?

A

Multidrug-resistant pathogens - major problem in treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are risk factors for pneumonia?

A
  • Advanced age
  • Immunosuppression
  • History of antibiotic use
  • Prolonged mechanical ventilation
  • Atelectasis
  • Pleurisy
  • Pleural effusion
  • Bacteremia
  • Pneumothorax
  • Acute respiratory failure
  • Sepsis/septic shock
  • Lung abscess
  • Empyema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How can we diagnose pneumonia?

A
  • History and physical examination
  • Chest x-ray (Fig. 27-3)
  • Thoracentesis and/or bronchoscopy
  • Pulse oximetry
  • Arterial blood gases (ABGs)
  • Sputum gram stain, culture & sensitivity
  • Ideally before antibiotics started
  • Blood cultures
  • ## CBC with differential
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are pneumococcal vaccines?

A
  • Prevent Streptococcus pneumoniae
  • Examples: Prevnar 13 and Pneumovax 23
    Table 27-5
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do we treat pneumonia?

A
  • Prompt antibiotics
  • Response generally occurs within 48-72 hours
  • Decreased temp
  • Improved breathing
  • Decreased chest discomfort
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What supportive care do we provide for pneumonia?

A
  • Oxygen for hypoxemia
  • Analgesics for chest pain
  • Antipyretics for fever
  • Adjuvant drugs
  • Individualize rest and activity
  • There is no definitive treatment for viral pneumonia
    Antivirals: influenza and herpes
17
Q

What is the CAP drug therapy?

A

Initial empiric therapy
Gram-negative and gram-positive organisms
Likely infecting organism (Table 27-2) and risk factors for MDR organisms; varies with local and institutional prevalence and resistance patterns
Should see improvement in 3 to 5 days or need to reevaluate
Antibiotics: IV, proceed to oral when stable; at least 5 days; afebrile 48 to 72 hours

18
Q

What is the nutritional therapy for pneumonia?

A
  • Adequate hydration; monitor intake
    Prevent dehydration
    Thin and loosen secretions
    Adjust for older adults, patients with HF, or those with preexisting respiratory conditions
  • Small but frequent, high calorie, nutritious meals; monitor weight.
19
Q

What is some subjective data we can gather in a nursing assessment for pneumonia?

A
  • Functional health patterns
  • Health perception management
    Smoking, alcoholism, respiratory infection, malaise.
  • Nutritional-metabolic
    Anorexia
    Nausea
    Vomiting
    Chills
  • Activity-exercise
    Bed rest or altered mobility
    fatigue
    weakness
    dyspnea
    cough
    nasal congestion
  • Cognitive perceptual
    Pain with breathing
    Chest pain
    Sore throat
    Abdominal pain
    Headache
    muscle aches
20
Q

What are some objective findings for pneumonia?

A

fever, restlessness or lethargy, splinting affected area
Respiratory
tachypnea, asymmetric chest movements, use of accessory muscles, nasal flaring, decreased excursion, crackles, friction rub, dullness on percussion, increased tactile fremitus, sputum amount and color

21
Q

What cardiovascular issues could you find with pneumonia?

A

Tachycardia

22
Q

What neurologic changes can occur in pneumonia?

A

Changes in mental status

23
Q

What are possible diagnostic findings with pneumonia?

A

Increased WBC’s
Abnormal ABG’s
Positive sputum
Abnormal chest x-ray

24
Q

Name nursing diagnoses for pneumonia.

A 
Impaired gas exchange
Impaired breathing
Fluid imbalance
Hyperthermia
Activity intolerance
25
Q

What are the goals for a patient with pneumonia?

A 
Clear breath sounds
Normal breathing patterns
No signs of hypoxia
Normal chest x-ray
Normal WBC count
Absence of complications
26
Q

How can we promote ways to avoid pneumonia?

A

Teach hygiene, nutrition, rest, regular exercise
Cough or sneeze into elbow
*Avoid cigarette smoke
Avoid exposure to URIs; prompt treatment
Identify risk factors (Table 27-1)
Influenza and pneumococcal vaccines (Table 27-5)

27
Q

What can we teach patients for home care?

A 
Emphasize need to take full course of antibiotics
Drug-drug and drug-food interactions
Adequate rest
Adequate hydration
Avoid alcohol and smoking
Cool mist humidifier or warm bath
Chest x-ray, vaccinations
Takes several weeks (or more) to recover
28
Q

What are the expected outcomes for pneumonia?

A

Effective respiratory rate, rhythm, and depth of respirations
Lungs clear to auscultation
Absence of infection

29
Q

What is the biggest complication with TB treatment?

A

NON ADHERENCE

30
Q

What are the first-line anti-TB drugs?

A

Isoniazid

Rifampin

Adult Health 1 Exam 3 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions