Unit 6 Lecture Flashcards
Flu can cause:
Otitis
Viral or bacterial Pneumonia
Bronchitis
Flu spreading
Up to 6 ft in any direction
Plus surfaces
Bacterial pneumonia
More common with chronic conditions or older adults
Flu timeline
Exposed 1-5 days before symptoms
Infectious for a day before symptoms
Infectious for 5-7 days after
Flu symptoms (NVD FEARS)
NVD Fever Extreme fatigue Aches Runny nose Sore throat
Live virus vaccines
Ages 2-49
Assessments for flu
WBC are normal/low
Chest x to rule out pneumonia
Antivirals
Prevents spread by Inhibit enzymes to prevent entry to cell
Takes a couple days to work
Antivirals
Reduce duration and severity
Mivir and virin
Relenza
Zanamivir > 7 for treatment > 5 for prevention No resp issues Inhaled powder 5 days
Tamiflu
Oseltamivir
Pill or liquid
Treatment > 2 weeks
Prevention > 1 year
Health care acquired pneumonia
20-50% mortality rate
Acquired in hospital
Susceptible PT and stronger bacteria
Ventilator increases risk
Lobar
Isolated to one lobe and solid are on X-ray
Usually younger PT
Usually seek treatment early
Follows viral/flu
Bronchopneumonia
Low grade fever Cough Crackles Patchy X-ray Hospital correlation
Walking pneumonia
Not debilitating with mild symptoms
May not need meds
Pneumonia causes
Bacteria
Virus
Non-pathogens (chemicals, smoke, aspirations)
Susceptible to pneumonia
Diminished swallowing/gag reflex
Immunosupressed
Smoker/drinker
Children/elderly
Pneumonia in children
More susceptible
Fever can lead to seizure
Retractions and nasal flaring
Exhausted or restless
Old people pneumonia symptoms
Mental confusion
Weakness/fatigue
Loss of appetite
Fever/cough absent
Pneumonia diagnostic tests (CAB SOX)
Culture ABG Blood work Serology if culture is negative O2 X-Ray
Meds for Pneumonia (classes)
Specific and BS Antibiotics Bronchodilators/sympathomimetics Expectorants IV fluids Pain meds Antipyretic
Pneumonia home care (TREAT)
Tobacco avoidance Rest Eat All meds Talk to Doc if worse
Penicillin lab effects
Lower RBC/WBC/PLT/K
Interfere with ACE inhibitors
Penicillins goods
Safe for all
IM/IV
Absorbed well
Doesn’t cross blood/brain barrier
Anaphylaxis interventions
Stop
ABC
Antihistamine/steroids
Cephalosporins instructions
W/ Food
No alcohol
Store in fridge
Penicillin s/e
Organisms are more resistant
Risk for Anaphylaxis
K Blood
Interfere with ACE inhibitors
Cephalosporins bads
Increased bleeding
Thrombophlebitis/pain
Carbapenems
Penems
IV
Cephalosporins prefixes
Cef/Ceph
Cephalosporins bads
Increased bleeding
Thrombophlebitis/pain
Macrolides Instructions
Oral/IV
Empty stomach
No juice
Tastes metallic
Macrolide assessments
Weight loss Renal/Hepato Increases coumadin effect Rash Prolonged QT
Ketolides instructions
Food or not
Not for liver disorder
Tetracycline
\+/- Static PO Contraceptive decrease Not for pregnant
Carbapenem different bad
Seizure
Tetracycline s/e
Teeth discolor especially in <8
Photosensitive
Colitis
Decreases Contraceptive
Amino glycosides monitoring
Hearing
Peak/trough
I/O
Nephro/hepato/neuro
Peak
Measures rate of absorption
Drawn 30 min after completed infusion
Peak is high, prob toxic
Peak is low, not therapeutic
Aminoglycosides monitoring
Hearing
Peak/trough
I/O
Nephro/hepato/neuro
Tetracycline
PO
Not for pregnant
Tetracycline gi
Not within 2hrs of dairy, antacids, iron
Decreases effect
Doxy or mino need food
Sulfonamide instructions
No alcohol, mouthwash, aftershave
No 1st trimester
Sulfonamide monitoring
I/O
Flu symptoms/infection
Bruising/bleeding
Sulfonamide s/e
Crystals in red brown urine
Metal Taste
Aplastic/hemolytic anemia
Steven Johnson syndrome- flu like then purple skin lesions, blisters
Sulfonamide med avoidance
Thiazides (check)
Aspirin
Blood meds
Trough
Lowest concentration
Measures rate of elimination
High- prob toxic because not clearing
Immediately before next infusion
Flouroquinolones s/e
Photo Cns Sleep dis heart Brown orange urine Levoquin-GLU may bottom out
Fungal contraindications
Liver, kidney
Glycopeptides Instructions
+ only
Oral IV
Rotate sites
1-2 hour
Glycopeptide value monitor
Blood decreases
Antifungals
Superficial infections
Diflucan
Flagyl
Impairs DNA of weak bacteria
Treats: GI, vaginosis, skin, lower resp
Med need to look ups
Charts
Nursing interventions
Key meds
Aminoglycoside concerns
Avoid benzo/anesthetics
Safety measures
Urine Output
Flagyl s/e
Drunk symptoms
Dark urine
Anorexia
S-E for all meds
GI
HA
Supers
Penicillin Instructions
1 hr before/2 hr after meals
Vanc S/E
Hearing loss Shock Red Man SJ syndrome Nephro Anxiety/Memory
Vanc Instructions
Serum levels 1-2 after and right before
1-2 hours IV
Monitor Glycopeptide SE
Ketolide Indications
Serious resp infections
Community acquired pneumonia
Macrolide Indications
STD
Allergy to Penicillins
Soft Tissue
Carbapenems indications
The broadest/Hospital Aq infection
Last resort
Penicillin indications
+/-
STD
Proph
Cephalosporins indications
+/-
BL resistent
Postop/Pelvic
Min
Aminoglycoside indications RUNG
-/Some + SERIOUS infections Resp Urinary Nervous GI
Glycopeptide indications
\+ Resp Staph MRSA Bone Nothing else works
Antifungal administration
PO/IV/Vaginal/Topical
Monitor Urine
No alcohol
Flouroquinolones indications BS GAP
Bone infection STIS Gastrointeritis Antrhax Pneumonia
Sulfonamide indications BE MO
Burns
Eye Proph
Meningitis
Otitis Media
Flouroquinolone instructions
PO Absorbed well Food or not antacids decrease Fe, Ca, Mg, Zn No children, baby, breasting, preg
