PULM Flashcards
Who is the flu vaccine definitely indicated for?
Everyone… but definitely those 65+ and those that work in a nursing home
If a pt has influenza what Tx can we offer?
WITHIN 48 hours offer Oseltamivir (better in elderly than Zanamivir)
What lung disease is in the top 10 causes of death, in the elderly?
Pneumonia!
What are some RF to getting pneumonia?
dementia, seizures, HF, COPD, inactivity, disorders of swallowing, hospitalization
How do pneumonia sxs present in a healthy person?
productive cough, fever, malaise
How do pneumonia sxs present in the elderly?
grumpy, tired (fatigued), loss of appetite, N/V/D
What might you find on PE with pneumonia?
crackles, wheeze, dullness to percussion, egophony (99)
Increased respiratory rate (>28)
How does the pneumonia vaccine schedule work?
?
What might be one of the first indications a pt has COPD?
low SPO2
If a patient is SOB, fatigued, with a significant cough and you get spirometry done and their FVC is about 80% of normal – what diagnosis do you think of?
COPD (mild)
**Normal lungs can expire AT LEAST 80% of their volume in 6 seconds or less
If the FVC reading was between 50-80% what does that indicate?
Moderate COPD
A pt with moderate COPD (70% FVC) and they were hospitalized last week for a COPD exacerbation – how do you treat them?
They most likely have been on short-acting & long-acting
**MUST ADD ICS – if a pt has had an acute exacerbation (or severe COPD)
At what point would we consider long-term O2 treatment?
PaO2 <55% for majority of day + SaO2 <88%
What should we always discuss with COPD (nearing end stage) pts?
end of life care wishes
What are 4 RF for tuberculosis?
Corticosteroid use (>15mg), DM, malignancy, kidney failure
