Primary care and common infections Flashcards
What are the five principles of the primary health care approach?
o Accessibility o Public participation o Health promotion o Appropriate technology o Intersectoral cooperation
What structures are part of the URT? LRT?
URT - nasal cavity, pharynx, larynx
LRT - trachea, primary bronchi, lungs
Differentiate between influenza and the common cold for the following: A - symptom onset B - Fever C - Aches D - Chills E - Fatigue, weakness F - sneezing G - stuffy nose H - Sore throat I - chest discomfort, cough J - headache
Influenza first; CC second A - sudden onset vs. gradual B - lasts 3-4 days vs. rare C - Often severe vs. slight D - fairly common vs. uncommon E - usual vs. sometimes F - sometimes vs. common G - sometimes vs. common H - sometimes vs. common I - common and can be severe vs. mild to moderate, hacking cough J - common vs. rare
What are the presenting symptoms for croup?
Cold symptoms, fever and cough, difficulty breathing (worse at night) and loud barking cough
What are some nursing considerations for croup?
Moist and cool air
fever control
monitor breathing
What is the cause of croup?
Viral
When should patients seek treatment for croup?
start with Tylenol to see if that brings down the fever and the kid can sleep and swallow
if they have breathing issues or difficulty swallowing they should go to the ER
cyanosis - 911
What is the presentation of Streptococcal pharyngitis?
Sore throat (sudden onset), odynophagia (painful swallowing), fever, tonsillar exudate, enlarged cervical lymph nodes
What are nursing considerations for streptococcal pharyngitis?
Pain relief
medical management
infection control
What are some similarities vs. differentiating factors for strep and the common cold?
generalized aches can present in both
obvious pustules in strep
swallowing is very hard (moreso than common cold)
Ear pain in strep
How is strep diagnosed?
Rapid strep test at family doc
but can also do throat swab
Very difficult to differentiate from the common cold.
Acute sinusitis
What are presenting signs of acute sinusitis?
Pressure in the sinuses that won’t go away
purulent drainage from the nose
What are the treatments for acute sinusitis?
Abx, nasal steroids, nasal washes, or let it run its course
Bacterial infection of the epiglottis and surrounding tissue
Epiglottitis
How does epiglottitis present?
breathing through widely open mouth; saliva pooling in mouth; coughing absent but sounds like barking breathing/high pitched breathing
really bad sore throat
Why is epiglottitis a medical emergency?
b/c the throat is closing
How does bronchitis present?
Productive cough, wheezy breath sounds, malaise, SOB, chest discomfort
If we don’t give Abx for bronchitis, what might we give?
Bronchodilator and corticosteroids
pain meds
What causes pneumonia?
Infection or fluid accumulation in lungs
What are some nursing considerations for pneumonia?
Worried about aspiration, lack of mobility, DB and C
How does pneumonia present?
Fatigued and coughing all the time
Why is T3 given instead of tylenol?
Codeine is present in T3 and is a cough suppressant (don’t give too much since we want to get sputum out)
What are precautions for TB?
N95 respiratory, gown, gloves and negative pressure rough
What are symptoms of TB?
coughing (Dry), hemoptysis and night sweats
What is the Tx for Tb?
6-9 months on rifampin or isoniazid Abx
What are the differences between latent and active TB for the following: A - MTB presence B - TB test positive/negative C - CXR D - Symptoms E - Infectious status F - Defined as TB case (yes or no) G - Sputum smear/culture
Latent vs. active A - MTB present for both B - positive test for both C - normal CXR vs. lesions D - No symptoms vs. symptoms E - not infectious vs. infectious before treatment F - Not defined as TB case vs. defined as TB case G - negative vs. positive
Where are the most common areas that TB can migrate to?
kidneys, brain and spine (can also go to bones and lymph nodes)
Meningococcal disease
- Which is worse, bacterial or viral?
- Presentation?
Tx?
Bacterial > viral
Headache and sore neck
Tx with Abx
What are the two types of meningococcal disease?
Meningitis and meningoccemia
For the following descriptions, indicate whether the symptom belongs to meningoccemia, meningitis or both:
A - pale or mottled skin, purplish rash B - sensitivity to bright light C - very sleepy or vacant D - High fever E - seizures F - Unusually cold hands and feet G - severe headaches H - confused and delirious I - breathing fast and breathless
A - meningoccemia B - meningitis C - both D - both E - meningitis F - meningoccemia G - meningitis H - both I - meningoccemia
For the following descriptions, indicate whether the symptom belongs to meningoccemia, meningitis or both:
A - vomiting
B - limb, joint and muscle pain
C - stiff neck
A - both
B - meningoccemia
C - meningitis
MRSA
colonisation?
infection?
Swab nares and peri anal area for colonized
BC for infection dx
(wound swab if on skin)
community acquired strains of MRSA cause what types of infections?
skin and soft tissue
Cellulitis:
- how does one get it?
What is it?
untreated wound that is infected
Infection of the skin and soft tissue
What does cellulitis look like?
Reddened area that is well demarcated, tender, warm and swollen
How is cellulitis Dx?
blood test or wound swab
What is the treatment for cellulitis?
IV Abx, pain meds and draw line around it (surgical marker)
o Blockage, sometimes hair follicles, or debris grown so much in a gland that it coarsened
o Usually a raised bump or nodule
abscess
What is the treatment for abscesses?
o Mild – warm compress
o Moderate – excision of abscess – drain and pack + sent home with Abx
What are nursing interventions for abscesses?
o Patient teaching
o Cleansing area
o Wound/dressings
o Abx
When should someone with cellulitis get medical care immediately?
if the involved area grows rapidly
if blisters or an abscess forms
if a fever or flu-like symptoms develop
