Brainscape's Knowledge GenomeTM

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


See full index

MED SURG > TOPIC 3 - pneumonia and TB > Flashcards

TOPIC 3 - pneumonia and TB Flashcards

1
Q

pathophysiology of pneumonia

A

Inflammation, characterized by an increase in blood flow and vascular permeability, activates neutrophils to engulf and kill the offending organisms.

As a result, the inflammatory process attracts more neutrophils, edema of the airways occurs, and fluid leaks from the capillaries and tissues into alveoli.

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

manifestations of pnuemonia

A

cough, fever, chills, dyspnea, tachypnea, pleuritic chest pain, sputum (green, yellow, rust color)

diaphoresis, anorexia, fatigue, myalgia, headache

auscultate - fine or coarse crackles / consolidation - bronchial, egophony breath sounds

palpations - increased fremitus, dullness during percussion

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

older adult symptoms of pneumonia

A

confusion or stupor related to hypoxia
hypothermia (rather than fever)

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

symptoms of acute exacerbation

A

increased resp rate, use of accessory muscles, decreasing LOC, restless

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

complications of pneumonia

A

atelectasis, pleurisy, pleural effusion, bacteremia, pneumothorax, meningitis, acute resp failure, sepsis, lung abscess, emphysema

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

diagnosis related to pneumonia

A

impaired gas exchange
ineffective breathing pattern
acute pain
activity intolerance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

interventions for acute exacerbation

A

oxygen therapy
prompt initiation of antibiotics
hydration
nutritional support
breathing exercise
early ambulation
therapeutic positioning
pain management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

adjunctive therapy for pneumonia

A

cough suppressants,
mucolytics,
bronchodilators,
corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

tuberculosis

A

gram positive, acid fast bacillus that is spread via airborne droplets

microorganisms lodge in lungs = pneumonitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

multi-drug resistant Tb vs extensively drug resistant

A

multi-drug = resistance to 2 of the most potent first line anti-TB drugs (isoniazid and rifampin)

extensively drug resistant = resistant to any fluoroquinolone plus any injectable antibiotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

symptoms of TB

A

Initial dry cough that becomes productive that frequently becomes productive with mucoid or mucopurulent sputum.
Fatigue
Malaise
Anorexia
weight loss
low-grade fever
night sweats

can also present acutely as -
High fever
Chills, generalized flulike symptoms
Pleuritic pain
Productive cough
Crackles and/or adventitious breath sounds

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

risk factors for TB

A

Homeless
Residents of inner-city neighborhoods
Foreign-born persons
Living or working in institutions (includes health care workers)
IV injecting drug users
Poverty, poor access to health care
Social and occupational history to determine risk factors for transmission of TB

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

TB infections outside the lungs

A

TB in the spine can lead to destruction of intervertebral disc
CNS Tb can cause severe bacterial meningitis
Abdominal TB can lead to peritonitis

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

diagnostic studies for TB

A

bacteriologic studies - consecutive sputum samples obtained on 3 different days, examined for AFB, results can take up to 8 weeks

if patient has productive cough - early morning is the ideal time to collect sputum specimens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

manifestations of TB

A

fatigue, weight loss, lethargy, anorexia, low grade fever in afternoon, cough with purulent sputum, night sweats and anxiety, dyspnea, chest pain, and hemoptysis

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

TB skin test

A

also know as the matoux test
uses PPD injected ID
assess for induration in 48-72 hours
presence of induration at injection site indicates development of antibodies secondary to exposure to TB

17
Q

TB skin test results

A

positive if greater than 15 mm induration in low risk individuals
positive if greater than 5 mm in immunocompromised patients

18
Q

5 or more mm is positive for

A

HIV infected
close contact with infected person
person who have abnormal xrays
persons who inject drugs

19
Q

10 mm or more is considered positive for

A

foreign born
HIV negative but who inject drugs
low income medically underserved
residents of long term care
person with medical conditions
children younger than 4 without other risks
staff of long term care

20
Q

IGRA tests

A

detects t cells in response to myobacterium tb
includes quantiferon-TB and T-spotTB
rapid results
more expensive

21
Q

chest x ray test

A

cannot make diagnosis soley on x ray
may appear normal in a patient with TB

upper lobe infiltrates, cavity infiltrates, lymph involvement and pleural pericardial effusion suggest TB

22
Q

nursing diagnosis related to TB

A

ineffective breathing pattern (related to decrease lung capacity)
ineffective airway clearance (related to increased secretions)
risk for infection (related to cough and sputum)
noncompliance and ineffective health management (related to lack of knowledge or motivation)

23
Q

first line drugs

A

ethambutol
isoniazid
pyrazinamide
rifamycin
rifampin
rifapentine
streptomycin

24
Q

ethambutol

A

Adverse effects: headache, malaise, dizziness, confusion, optic neuritis, N &V, diarrhea, anorexia

25
Q

isoniazid

A

Most widely used anti-tubercular

Contraindicated in hepatic dysfunction
Adverse effects: hepatotoxicity, peripheral neuropathy, visual disturbances, hyperglycemia

26
Q

pyrazinamide

A

Adverse effects: hepatoxicity, N &V, diarrhea, anorexia, dysuria, itching, photosensitivity, anemia

27
Q

rifamycin

A

Most used to treat mycobacterium avium complex disorders
Can turn body fluids red-orange-brown

28
Q

rifampin

A

Broad spectrum bacteriocidal drug
Adverse effects: GI upset, skin eruptions, hepatitis, thrombocytopenia, discoloration of sweat ,tears,urine (Usually orangish-red color)

29
Q

rifapentine

A

Derivative of rifampin with longer action

30
Q

streptomycin

A

Aminoglycoside
Available for injection only

31
Q

treatment for patients with PPD, ghons complex, and sputum

A

adults - isoniazid for 6 months
children - INH or other antibiotic for 9 months
HIV and INH for 12 months

32
Q

treatment for active disease and sputum culture

A

multidrug therapy for 12-18 months
(isoniazid, rifampin, pyrazinamide, ethanbutol, stremptomycin)

may return to community when sputum is negative

33
Q

multidrug resistant tuberculosis

A

develops when therapy is terminated early
bacteria become resistant to usual regimen
therapeutic regimen adjusted based on C&S
very expensive

34
Q

vaccine for TB

A

bacile-calmette-guerin vaccine to prevent TB

given to infants in parts of the world where there is high prevalence of TB

not recommended in US because of low risk

BCG vaccine can result in false positive TST

35
Q

how long will a patient stay infectious

A

2 weeks after starting treatment is sputum is positive

36
Q

implementation of care for TB

A

airborne isolation - single occupancy room with 6 to 12 airflow exchanges/hour, HEPA masks

receive medical workup and appropriate drug therapy

if in ambulatory care - go home even if cultures are positive, monthly sputum culture

MED SURG (30 decks)

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