Respiratory Disorders - Pneumonia

Question 1

Respiratory Disorders - Pneumonia

What is pneumonia?

Answer 1

It is the inflammation of the bronchioles and alveoli. The inflammation may affect on or both lungs (unilateral or bilateral)

Question 2

Respiratory Disorders - Pneumonia

What does typical pneumonia result from? What is the most common pathogen causing infectious pneumonia?

Answer 2

Bacterial infection of the alveoli.

Streptococcus penumoniae (pneumococcal pneumonia)

Question 3

Respiratory Disorders - Pneumonia

What is mycoplasma? Describe the s/s. How is it treated?

Answer 3

It is also referred to as “walking pneumonia”. It is caused by tiny organisms similar to those of bacterial and viral.

Onset of s/s is gradual and more mild. It responds well to antibiotics

Question 4

Respiratory Disorders - Pneumonia

What are the signs and symptoms of pneumonia?

Answer 4

• Chills
• Elevated Temperature
• Peluritic pain
• Tachypnea
• Rhonchi and wheezes
• Use of accessory muscles for breathing
• Mental status changes
• Sputum collection.

Question 5

Respiratory Disorders - Pneumonia

How would the nurse manage a client with pneumonia?

Answer 5

• Encourage Rest
• Increase fluids - for hydration and expelling mucus
• Provide high calorie, high-protein diet with small freq. meals.
• Administer oxygen (as prescribed)
• Administer antibiotics for mycoplasia and bacterial pneumonia.
• Monitor respiratory status
• Monitor for labored respirations, cyanosis, and cold and clammy skin.

Question 6

Respiratory Disorders - Pneumonia

What type of diet is suggested for a client with pneumonia?

Answer 6

High calorie, High-protein diet with small frequent meals.

Question 7

Respiratory Disorders - Pneumonia

When would antibiotics be administered to a client with pneumonia?

Answer 7

If the client has mycoplasia (walking pneumonia) or bacterial pneumonia.

Question 8

Respiratory Disorders - Pneumonia

Describe the symptoms of typical pneumonia.

Answer 8

Typical pneumonia is bacterial. S/S are usually a productive cough that produces rust colored or purulent sputum, chest pain (aching, sharp, localized), diminished breath sounds, fine crackles heard over the affected area.

Question 9

Respiratory Disorders - Pneumonia

Describe the symptoms of atypical pneumonia.

Answer 9

This is nonbacterial. S/S will be a nonproductive dry, hacking cough that may last up to 6 weeks. The cough is usually worse at night.

Question 10

Respiratory Disorders - Pneumonia

What is the primary test used to establish the diagnosis of pneumonia?

Answer 10

Chest x-ray helps identify the extent and pattern of lung involvement. Fluid, consolidated lung tissue, and atelectasis (areas of alveolar collapse) can be identified.

Question 11

Respiratory Disorders - Pneumonia

What must be obtained before initiation of antibiotic therapy?

Answer 11

Sputum specimen or culture.

Question 12

Respiratory Disorders - Pneumonia

When assessing for pneumonia, what are some subjective data the nurse can collect?

Answer 12

• Complaints of chest pain
• SOB or difficulty breathing
• Cough

Question 13

Respiratory Disorders - Pneumonia

What medications would the nurse expect to be ordered for the treatment of pneumonia

Answer 13

Antibiotics
Bronchodilators - to help dilate the bronchioles (improve ventilation and reduce bronchospasms)
Expectorant (Guaifenesin) - to help liquify the mucus

Question 14

Respiratory Disorders - Pneumonia (ATI Med Surge Book - Ch 21)

Which of the following clients have an increased risk for pneumonia? Select all that apply. A client who has:

A. Dysphagia
B. AIDS
C. been vaccinated for pneumococcus and influenza 6 months ago.
D. a closed heard injury and is receive mechanical ventilation.
E. myasthenia gravis

Answer 14

A. Dysphagia
B. AIDS
D. a closed heard injury and is receive mechanical ventilation.
E. myasthenia gravis

Rationale:
A client who has difficulty swallowing, or dysphagia, has an increased risk of aspiration, which increases the risk of pneumonia. Mechanical ventilation is invasive and increases the risk of respiratory infections. A client who has myasthenia gravis has generalized weakness and will have difficulty clearing secretions from the airway.

Question 15

Respiratory Disorders - Pneumonia (ATI Med Surge Book - Ch 21)

A nurse working in an outpatient clinic observes an older adult female client who reports chills and chest pain that worsens with inspiration. Her husband states that his wife wok up this morning and did not recognize him or know where she was. Which of the following actions should the nurse take first?

A. Obtain baseline vital signs and oxygen saturation.
B. Collect a sputum culture and send to the lab.
C. Complete the health history from the client.
D. Provide a pneumococcal vaccination.

Answer 15

A. Obtain baseline vital signs and oxygen saturation.

Rationale:
Using the nursing process, data collection is the first action the nurse should take and therefore the nurse should obtain baseline vital signs and oxygen saturation. While all the other actions should be taken, they are not the priority action.

Question 16

Respiratory Disorders - Pneumonia (ATI Med Surge Book - Ch 21)

A nurse is caring for a client with the following vital signs: Temperature 99.1º F, respiratory rate 30/min, blood pressure 130/76 mm Hg, pulse 110 beats/min, and SaO2 91% on room air. Which of the following prescribed interventions is the nurse’s priority action?

A. Start antibiotics.
B. Begin oxygen therapy
C. Collect a sputum culture.
D. Administer antipyretic medication

Answer 16

B. Begin oxygen therapy

Rationale:
The client’s respiratory and heart rates are elevated, and the oxygen saturation is 91% on room air. These signs indicate that oxygenation meds are not being met. Therefore, according to the ABC priority setting framework, providing oxygen is the highest priority. After starting oxygen, it is important to obtain the sputum specimen before starting the antibiotics and administering an antipyretic.

Question 17

Respiratory Disorders - Pneumonia (ATI Med Surge Book - Ch 21)

A nurse is reviewing the plan of care for a client who has pneumonia and who is receiving oxygen by face mask. Which of the following interventions are appropriate? Select all the apply.

A. Provide low-caloric foods
B. Increase fluid intake to 2 to 3 L/day.
C. Offer rest periods with physical activity.
D. Monitor skin around the mouth and nose for breakdown.
E. Encourage deep breathing and coughing.

Answer 17

B. Increase fluid intake to 2 to 3 L/day.
C. Offer rest periods with physical activity.
D. Monitor skin around the mouth and nose for breakdown.
E. Encourage deep breathing and coughing.

Rationale:
The nurse should offer the client foods that are high in calories. Clients with pneumonia tend to burn calories rapidly and need more calories to conserve energy.