Week 10 - Pneumonia

Question 1

What is pneumonia? (2)

Answer 1

• infection in the lungs, causing excess fluid in the lungs from inflammatory response
• exudate develops, inflamed alveolar walls

Question 2

What is the etiology of pneumonia?

Answer 2

• organisms from environment, invasive devices, equipment, supplies

Question 3

What are the risk factors of getting pneumonia? (7)

Answer 3

• older adult
• unvaccinated
• Chronic disease
• Smoking
• altered LOC
• Dysphagia
• Reduced immunity

Question 4

What are the clinical manifestations of pneumonia in terms of the CNS? (2)

Answer 4

• anxious
• headache

Question 5

What are the clinical manifestations of pneumonia in terms of the CVS and Respiratory Tract? (10)

Answer 5

• Chest pain or discomfort
• tachycardia
• Severe chest muscle weakness
• Cough
• Dyspnea
• Hemoptysis (coughing blood)
• Sputum production
• varied breath sounds
• Chest expansion diminished
• Hypotensive

Question 6

What are the clinical manifestations of pneumonia in terms physical appearance and inflammation response? (5)

Answer 6

• Flushed cheeks
• Myalgia (muscle pain and aches)
• Chills
• Fever
• Tripod position

Question 7

What do the lab tests of the following show, which can correlate to a diagnosis of pneumonia?

a) C&S
b) CBC
c) ABGs
d) Imaging

Answer 7

Positive sputum C&S
CBC - Elevated WBC
ABGs

Imaging:
- Xray

Question 8

What ways can help clinically manage pneumonia? (3)

Answer 8

1. Improved gas exchange
   - Oxygen therapy
2. Preventing airway obstruction
3. Preventing Sepsis - Anti-infectives

Question 9

How can we prevent airway obstruction? (3, 4)

Answer 9

1. deep breathe and cough every 2 hours
2. Hydration
3. Drug therapy
   - Bronchodilators when bronchospasm present
   - Glucocorticoids (COPD getting pneumonia)

Question 10

What is the standard physicians order for SpO2? How about for COPD IF they are a CO2 retainer?

Answer 10

Standard - >94%
COPD - Keep SpO2 88-92%

Question 11

When is SpO2 Prescribed for? (3)

Answer 11

1. Hypoxemia
   - hypoxia
   - conditions that increase need for oxygen therapy

Question 12

What should we use in terms of inspired oxygen (FiO2) to not cause harmful side effects?

Answer 12

Uses lowest fraction of inspired oxygen (FiO2) to have acceptable blood oxygen level without causing harmful side effects

Question 13

What does oxygen do to PaO2?

Answer 13

O2 improves PaO2 but does not cure the cause

Question 14

What should you consider when titrating oxygen flow rates?

Answer 14

• does the patient’s supplemental O2 need to be increased or decreased to stay within the ordered parameters?

Question 15

How can you promote oxygen safety when it comes to combustion, humidity, and skin assessment?

Answer 15

1. Combustion -educate smokers who have oxygen therapy
2. Humidity - if receiving 4L/min or more
3. Skin Assessment - ears, back of neck, face

Question 16

Why is oxygen toxic? (4)

Answer 16

• with high levels, nitrogen is diluted, causing alveoli collapse
• related to concentration of oxygen delivered, duration of therapy and degree of lung disease present
• excess oxygen therapy can cause stress on cells, leading to cell damage and death
• reason why we titrate O2 therapy when >94%