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NUR 326-Pathopharm > Tuberculosis and Pneumonia > Flashcards

Tuberculosis and Pneumonia Flashcards

1
Q

tuberculosis infection

A

-any infection caused by bacteria mycobacterium
-MTB is aerobic bacillus-rod shaped and needs lots of oxygen to grow and proliferate

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2
Q

tuberculosis

A

-characterized by granulomas in the lungs- nodular accumulations of inflammatory cells
-transmitted via humans, cattle or birds
-tubercle bacilli are transmitted in airborne droplets expelled by infected people
-slow growing organism

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3
Q

active TB manifestations

A

-fatigue/lethargy
-weight loss/anorexia
-low grade fever
-productive cough
-anxiety
-night sweats

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4
Q

TB screening and diagnosis

A

-high risk populations- IGRA
-non high risk- TB skin test
-confirm through a sputum stain and culture and look for the granulomas on chest x-ray

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5
Q

5 drugs to treat TB

A

-INH
-rifampin
-ethambutol
-pyrazinamide
-streptomycin

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6
Q

anti-tubercular drugs

A

-treat all infections caused by mycobacterium organism
-2 categories: first and second line

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7
Q

Isoniazid (INH) MOA

A

disrupts cell wall synthesis essential functions of mycobacteria

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8
Q

INH side effects

A

-peripheral neuropathy
-hepatotoxicity
-optic neuritis
-hyperglycemia

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9
Q

INH nursing implications

A

-avoid antacids
-when given with rifampin can increase CNS and hepatotoxicity
-black box warning- related to increased risk of hepatitis: often given with pyridoxine
-given PO

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10
Q

Rifampin MOA

A

inhibits protein synthesis via attacking the hydrocarbon ring structures

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11
Q

rifampin side effects

A

-hepatitis
-hematologic disorders
-red-brown discoloration of the urine and other body fluids

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12
Q

rifampin route

A

PO/IV

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13
Q

ethambutol MOA

A

diffusing into the mycobacteria and suppresses RNA synthesis, which inhibits protein synthesis

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14
Q

ethambutol side effects

A

-retrobulbar neuritis
-blindness

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15
Q

ethambutol nursing implications

A

-given PO- first line bacteriostatic
-usually used in combo with INH and rifampin
-not for children less than 13

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16
Q

pyrazinamide

A

-given PO
-bacteriostatic or bactericidal depending on drug concentration
-used in combo with other meds

17
Q

pyrazinamide side effects

A

-hepatotoxicity
-hyperuricemia

18
Q

pyrazinamide contraindications

A

-severe hepatic disease
-acute gout
-not for pregnant women in the US

19
Q

streptomycin MOA

A

-aminoglycoside: interfering with normal protein synthesis causing production of faulty proteins within the bacteria

20
Q

streptomycin side effects

A

-ototoxic
-nephrotoxic
-blood dyscrasias
-careful with people on anticoagulants: can increase bleeding

21
Q

streptomycin route

A

IM injection

22
Q

what to treat drug resistant TB with

A

-second line drugs

23
Q

pneumonia

A

defined as any type of infection of the lower respiratory system
-causes inflammation of the lung tissues, the alveolar air spaces become filled with purulent, inflammatory cells, and fibrin
-transmission occurs via inhaled infectious droplets

24
Q

pneumonia risk factors

A

-age extremes (<5, >70 or 80)
-compromised immunity
-underlying lung disease
-alcoholism
-altered LOC
-impaired swallowing
-nursing home resident
-hospitalization
-influenza

25
Q

what is hospital acquired pneumonia?

A

-developed within 48 hours AFTER admission
-has worse outcomes than community acquired

26
Q

pneumonia patho

A

-aspiration of oropharyngeal secretions most common route
-inhalation of droplets containing bacteria or other pathogens
-inflammatory reaction is stimulated within the lungs- vasodilation occurs, infection begins to spread into the resp. tract and alveoli
-goblet cells are stimulated and mucus is excreted
-alveoli attempts to open and close against the purulent exudate but many cannot

27
Q

pneumonia patho (more basic)

A

-failure of cough reflex, the mucociliary clearance mechanism, and the immune system
-failure of the mucociliary defense mechanism allows exudative fluid and inflammatory cells to invade the alveoli
note: mucociliary clearance mechanism is INEFFECTIVE in smokers

28
Q

PNA manifestations:

A

-usually preceded by URI
-proceeds to fever, chills, productive or dry cough, malaise, pleural pain, sometimes dyspnea and hemoptysis
-bacterial-productive, purulent cough
-viral-nonproductive, scanty cough
-severe: tachypnea, signs of resp distress/failure

29
Q

PNA clinical diagnosis

A

-s/s on assessment
-pulmonary consolidations: dullness to percussion, crackles, increased tactile fremitus, egophony
-diagnostic tests: chest xray, CBC, + sputum for c&s

30
Q

bacterial pneumonia

A

-gram positive: staph aureus (most common for HAP) and streptococcus pneumoniae (most common for CAP)
-gram negative: pseudomonas auruginosa, aceinetobacter, klebsiella pneumoniae

31
Q

aspiration pneumonia

A

-aspirated material from GI tract
-can be silent of abrupt
-dysphagia evaluation is crucial

32
Q

who is at risk for aspiration pneumonia?

A

-NG tube
-decreased LOC
-decreased gag reflex
-decreased gastric emptying

33
Q

viral pneumonia

A

-influenza is major risk factor
-virus alters the pulmonary immune defense and makes the lungs vulnerable to an additional bacterial infection

34
Q

s/s of viral pneumonia

A

-fever
-chills
-dyspnea on exertion
-cough

35
Q

atypical pneumonias

A

-pneumocystis carini pneumonia
-mycoplasma
-legionella
-aspergillus

36
Q

do you treat viral or bacterial pneumonia with antibiotics?

A

bacterial

37
Q

pneumonia prevention

A

-2 vaccines
1.)PCV13-prevents pneumococcal pneumonia caused by 13 strains of strep
2.)PPSV23-prevents against an additional 23 types of PNA

38
Q

what precautions are used for TB?

A

airborne

NUR 326-Pathopharm (24 decks)

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