Brainscape's Knowledge GenomeTM

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


See full index

n233 final > pneumonia/dyspnea > Flashcards

pneumonia/dyspnea Flashcards

1
Q

what is dyspnea

A

laboured or difficulty breathing
shortness of breath, feeling your not getting enough air
SUBJECTIVE experience

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

risk factors for dyspnea?

A 
SMOKING
exposure to second hand smoke
family history of lung disease
genetic make up
allergens and environmental pollutants 
recreational and occupational exposure
poor nutrition 
inadequate exercise
substance abuse 
stress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

diagnostic tests for dyspnea?

A 
o2 sat 
hgb, RBC, WBC, ABGs
chest x-ray
CT chest 
throat or sputum cultures
possibly bronchoscopy
PFTs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

nursing interventions for dyspnea

A 
multiple strategies 
decrease anxiety
treat (if possible) underlying pathology
oxygen may be helpful
patient position 
pursed lip breathing 
meds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is pneumonia?

A

inflammation of lung parenchyma caused by various microorganisms
-leading cause of death from infection, 5th leading cause of death worldwide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

causes of pneumonia?

A 
bacteria
mycobacteria
chlamydial 
mycoplasma 
fungi
parasites
viruses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

community-acquired pneumonia?

A 
develops in community or within 48 hrs of admission 
-STREPOTOCOCCUS PNEMONIAE (most common)
haemophilus influenza
pseudomonas aeurignosa
legionella
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

hospital-acquired pneumonia (nosocomial)?

A 
onset of symptoms more than 48 hrs after admission
-most lethal of infetions 
-eneterobcater species
e coli 
h influenzae 
staphylococcus auerus (MRSA)
pseudomonas aeruginosa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

why do hospitalized pts develop pneumonia?

A
  • host defences impaired,
  • inoculums or organisms reach lower resp tract
  • HIGHLY virulent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how to prevent HAP?

A 
frequent oral hygiene 
isolation of pts with known pneumonia
reposition, early ambulation
nutritious diet 
deep breathing and cough 
clean equipment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

pneumonia in the immunocompromised ptient?

A

immunocompromised due to a variety of factors
-could be caused by CAP o HAP organisms
commonly acquire pneumonia from organisms of low virulence
-pneumocystis pneumonia and other fungal pneuonia
TB (mycobacterium tuberculosis)

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

aspiration pneumonia?

A

resulting from entry of endogenous or exogenous substances into lower airway
-most common form of aspiration of bacteria that normally live in upper airway, substances other than bacteria can aspirate and cause pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

diagnostic findings associated with pneumonia?

A

-history of resp tract infection
-physical exam reveals: fever, chills, rigors, pleuritics chest pain worsened by coughing and deep breathing, may have flushed cheeks and circumoral cyanosis, cyanotic nail beds
-tachypnea (24-45), SOB, acessory muscle use
-some have URTI symptoms (running nose etc)
rash, pharyngitis
-mucoid or mucopurulent sputum may be evident after a few days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

diagnostics for pneumonia?

A 
chest x-ray
CBC (elevated WBCs, leukcytes)
sputum sample for c and s 
blood cultures (bacteremia common) 
ABGs 
oxygen sats
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

medical management of pneumonia?

A

-causative agents
-prompt administration of abx
prompt administration of antibiotic is KEY
length of treatment depends on causative agent
hydration
symptoms can be treated with supportive meds
bed rest
oxygen therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

nursing assessments of pneumonia?

A 
fever, chills, night sweats
pleuritic-type pain
fatigue
tachypnea (use of accessory muscles)
coughing, purulent sputum
bradycardia 
assess oldeer pt for unusual behaviour, altered mental status, dehydration, fatigue, HF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

nursing assessments after diagnosis?

A 
-head to toe: changes in physical assessment
watch for changes in temp, pulse, 02 sats
-amount odour and color of secretions
-degree of tachypnea and dyspnea 
-changes on chest x-ray
-fatigue
-fluid balance
-oral intake of fluid 
-effect of meds
-pt understanding of treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

considerations for older adults?

A
  • difficult to treat, higher mortality rate

- symptoms in elderly: general deterioration, weakness, abd symptoms, anorexia, tachycardia, confusion, tachypne

19
Q

pediatric considerations?

A

IMMUNIZATIONS (2) pneumococcal conjugate and pneumococcal polysaccharide vaccine

  • antipyretics
  • promote oxygenation
  • susceptible to secondary bacterial infections
  • fluids
  • rest
20
Q

patho of pneumonia…

A
  • upper airway characteristics usually prevent infectious particles from reaching normally sterile lower resp tract
  • arises from normally present flora from pt whose resistance has been altered or from aspiration of flora in oropharynx, may also be due to blood borne organisms
  • affects in ventilation and diffusion
  • inflammation
  • decrease alveolar oxygen, hypoventilation… hypoxemia
21
Q

substantial portion of one of more lobes=

A

lobar pneumonia

22
Q

bronchopneumonia=

A

patchy pneumonia more commmon than lobal

23
Q

severe pneumonia symptom?

A

cheeks flushed, lips and nail beds demonstrate central cyanosis

24
Q

orthopnea as a manifestation of pneumonia?

A

shortness of breath when reclining, may prefer to sit upright or lean forward

25
Q

possible only sign of pneumoonia in COPD patients?

A

purulent sputum or slight changes in resp symptoms

26
Q

sputum examination?

A

rinse mouth with water to minimize contamination
breathe deeply several times
cough deeply
expectorate raised sputum into sterile container

27
Q

vancomycin for…

A

MRSA

28
Q

atypical pneumonia=

A

10-21 days

29
Q

viral pneumonia treatment?

A

same as abcterial (primarily supportive, antihistamines, antipyretics, hydration, decongestion, bed rest. NO antimicrobial)

30
Q

why may diagnosis of pneumonia go missed in elderly?

A

less likely to exhibit classic symptoms, may be seen as normal aging
-general deteriration, abdominal symptoms, weakness, anorexia, confusion
VACCINATION recommended

31
Q

complication: shock and resp failure

A 
hypotension, shock, resp failure (occurs usually in pt late ot be treated)
aggressive therapy (hemodynamic and ventilatory support) vasopressor, cortciosteroids, intubation
32
Q

complication: atelectasis and pleural effusion

A

obstruction of bronchus by accumulated secretions

  • pleural effusions associated with bacterial pneumonia
  • chest tube to drain, antibiotics, sometimes surgical management
33
Q

emphyema=

A

thick purulent fluid accumulates in pleural space, often with fibrin development

34
Q

complication: superinfection

A
  • may occur with admin of very large doses of antibiotics
  • bacteria may become resistent to antibiotic therapy
  • if pt improves and fever diminishes after initial, but then rise in temp with increasing cough—> pneumonia spread, superinfection likely
35
Q

nursing interventions for pneumonia?

A
  • improve airway patency, remove secretions
  • hydration things and loosen pulmonary secretions
  • humidity, loosen secretions
  • incentive spirometer
  • effective directed cough (deep inspiratory manoeuvre, glottic closure, explosive expiration)
  • chest pysio (percussion and postural drainage) indicated with sputum retention, hx of pul problems
  • after each position change, deep breath and cough
  • nasotrachal suctioning if pt cannot breathe deeply and cough
36
Q

other PRIME nursing care for pneumonia

A

-promote rest and conserve energy (bed rest, semi-fowlers, changing freq)
-promote fluid intake (increased resp rate= fluid loss) at least 2 L a day
maintaining nutrition (decreased appetite, enriched drinks or shakes)
-promoting pt knowledge (purpose and meaning of treatment, simple, may need to repeat)

37
Q

monitoring and managing complications?

A

should respond to treatment within 24-28 hrs of antibiotics

  • monitor vitals for shock and resp failure, report deterioarting status, assist in admin IV
  • thoracentesis to remove fluid for atelectasis and pleural effusion, maybe chest tube
  • confusion, changes in cognition (may be dt hypoxemia, fever, sleep deprivation, sepsis, underlying comorbidities
38
Q

most common way to describe SOB from patients?

A

breathlessness

39
Q

prevalence for dyspnea?

A

cancer, COPD, end-stage renal, neurological disease

common in patients with advanced life-threatening illness

40
Q

is dyspnea a simple symptom?

A

no it is a complex set of interactions between physical, psychological and emotional factors further modulated by individuals experience and fears

41
Q

sensation of breathlessness is felt when…

A

higher cortical centers perceive what the resp system can provide as inadequate or unsustainable to meet bodys requirements, may feel a threat to survival

42
Q

non-pharmacological threatment of dyspnea?

A

pulm rehabilitation, exercise, NMEs, forward positioning, walking aid, breathing retraining/blow as you go pursed lip breathing

  • facial cooling
  • acupuncture, anxiety reducing things
  • clinic??
43
Q

pharmacological treatment of dyspnea?

A
  • opioids low dose morphine, now recommended
  • oxygen, improves survival and quality of life
  • anxiolytics for anxiety

n233 final (11 decks)

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