Pneumonia & Appendicitis Flashcards
What is the pathophysiology of pneumonia ?
inflammation of the pulmonary parenchyma caused by accumulation of fluid or blood in the alveoli
- results in poor oxygenation and air exchange
What are some symptoms of pneumonia ?
- high fever
- respiratory symptoms
- irritable, restless, lethargic, malaise
- infiltrate seen on x-ray
- N/V/D or abdominal pain
- chills
- tachycardia
- dyspnea
What are some respiratory symptoms of pneumonia ?
- cough (nonproductive to productive): whitish to yellow or green sputum
- tachypnea
- rhonchi or fine crackles w/ decreased breath sounds
- dullness with percussion
- chest pain, abdominal pain with lower lobe involvement
- retractions
- nasal flaring
- pallor to cyanosis
What are some complications caused by pneumonia ?
- pneumothorax
- pleural effusion
- empyema
What is pneumothorax ?
increased air in the pleural space which increases interpleural pressure and prevents the lung from expanding fully
What is pleural effusion ?
excessive accumulation of fluid in the pleural space
What is empyema ?
collection of pus in the pleural space
Why may a chest tube be used for pneumonia complications ?
to drain air or fluid
- a closed drainage system may be inserted into the pleural space
What are some RN management of pneumonia ?
- assess for respiratory distress
- NPO (if increased RR) to reduce risk of aspiration
- IV fluids
- O2 as needed (to help decrease work of breathing)
- chest tube as needed
- chest percussion (to loosen up the sputum and make it easier to cough out)
- positioning
- suction
- antipyretics
- antibiotics
What are some prevention strategies for pneumonia ?
- pneumococcal conjugate vaccines
- prevention care bundles
What is included in a pneumonia prevention bundle ?
- HOB elevated to 30-45 degrees
- oral care with chlorhexidine
- peptic ulcer prophylaxis
- DVT prophylaxis
- spontaneous awakening trails and breathing trials
What is acute appendicitis ?
inflammation of the vermiform appendix
- most common cause of emergent abdominal surgery in children
What is the pathophysiology of appendicitis ?
obstruction of the lumen of the appendix by hardened stool, swollen lymphoid tissue, or possible parasites
- obstruction prevents mucous outflow, which increases lumenal pressure and compresses blood vessels
- ischemia causes ulceration of epithelial lining and bacteria invasion
What are clinical manifestations of appendicitis ?
- pain in right, lower quadrant
- rebound tenderness (McBurney point)
- fever & elevated WBC count
- rigid abdomen (now that the appendix has perforated)
- decreased or absent bowel sounds
- vomiting
- constipation or diarrhea
- anorexia
- tachycardia and tachypnea
- pallor
- lethargy
- irritability
- stooped posture (kind of hunched over)
What are some diagnostic tests of appendicitis ?
- CBC: elevated WBC count
- urinalysis: to rule out UTI that has referred to other parts of the body
- pregnancy test: to rule out ectopic pregnancy
- ultrasound: use first before CT
- CT scan
