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NURS 572 > Week 2 Chapter 47 > Flashcards

Week 2 Chapter 47 Flashcards

1
Q

How does PNA develop?

A

when an organisms invades the lung’s parenchyma and the host’s defenses are depressed

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2
Q

What are the origins of PNA?

A

bacterial, viral, fungal, rickettsial, and parasitic
inflammatory processes
inhalation of toxic substances

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3
Q

S/S of PNA

A

cough, dyspnea, sputum production, fever, abnormal breath sounds (crackles)

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4
Q

the need for initial ________ to evaluate for _________ because of variability of PNA clinical presentations

A
  1. chest xray
  2. new or progressive infiltrates
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5
Q

What organisms is the most common cause for bacterial PNA?

A

strep pneumoniae

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6
Q

What is the goal of treatment for PNA?

A
  1. for patients to return to their original respiratory status before the illness
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7
Q

How do you know if a patient is responding well to a treatment

A

patient should respond to empiric therapy by showing improved clinical condition within 48-72 hours and the resolution of symptoms within 5-7 days

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8
Q

Severe CAP is defined as having one major criteria or three or more minor criteria which are

A
  1. septic shock needing vasopressors
  2. resp failure needing mechanical ventilation
  3. resp rate >30
  4. PaO2/FiO2 ratio <250
  5. multi lobar infiltrates
  6. confusion/AMS
  7. uremia
  8. leukopenia
  9. thrombocytopenia
  10. hypothermia
  11. hopytension requiring fluids resuscitation
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9
Q

what tools do clinicians use to determine prognosis and locations CAP treatment?

A

PSI and CURB-65

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10
Q

PSI considers

A

age, comorbidity, physical examination findings, and results of diagnostic testings such as ABGs and chest X-rays

is more invasive but more sensitive in predicting mortality

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11
Q

What are the most common pathogen in nursing home acquired PNA?

A

strep pneumoniae, h influenzae, k pneumoniae, p aeruginosa, and MRSA

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12
Q

CURB-65 considers

A

confusion, BUN, RR, BP, and age

less invasive

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13
Q

Treatment guidelines for inpatient/nursing home PNA are

A

beta lactam plus macrolides OR resp fluoroquinolone for non severe PNA

beta lactam plus macrolide or beta lactam plus fluoroquinolone for severe PNA

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14
Q

Why are pregnant women more predisposed for PNA?

A

physiological changes that occurs such as alterations in T lymphocyte function, increased O2 consumption, reductions in functional residual capacity, and increased risk of aspiration

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15
Q

What treatments for PNA are safe for prego?

A
  1. macrolides (erythromycin and azithromycin are first choice)
    clarithyromycin is another option but risk of fetal harm has not been ruled out
  2. do not use doxycycline or fluoroquinolones
  3. beta lactam plus macrolides should be used with women who has comorbidities or recent antibiotic use
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16
Q

What vaccines are recommended for prego women for prevent viral infections causing PNA?

A
  1. MMR BEFORE prego since it is contraindicated in prego women
  2. Hep B can be during prego
  3. flu and COVID can be during prego
  4. pneumococcal
17
Q

What are indications for hospitalization in children beyond infancy?

A
  1. mod-severe resp distress
  2. failure to respond to oral antibiotics
  3. lobar consolidation in more than one lobe
  4. immunosuppression
  5. empyema
  6. abscess or pneumatocele
  7. underlying cardiopulmonary disease
18
Q

What is the most common cause of bacterial infection in children of all ages?

A

strep pneumoniae

19
Q

Symptoms of infants with chlamydial PNA are

A
  1. repetitive taccato cough and tachypnea
  2. cervical adenopathy
  3. rales
  4. wheezing is rare
  5. hyperinflation and bilateral diffuse infiltrates on chest X-ray
  6. nasal stuffiness and otitis media
20
Q

treatment for chlamydial PNA is

A
  1. macrolides
22
Q

Diagnosis for children with bacterial PNA are

A
  1. usually occurs secondary to a viral infection
  2. blood cultures unless patient is outpatient, improving, and are immunized
  3. sputum aspiriate
  4. chest xray (lobar consolidation
  5. CBC only if PNA is severe
  6. if pneumatoceles are shown on chestxray, most likely staph PNA
23
Q

Treatment for bacterial PNA in children

A
  1. amoxicillin
  2. ampicillin for IV
  3. cef for PNC resistance
  4. vanco for life threatening situations
  5. clindamycin or levofloxacin if resistance for PNC/allergy to beta lactams
24
Q

What is the most common cause of PNA in school aged children and young adults

A
  1. mycoplasma pneumoniae
25
Q

S/S of mycoplasma pneumoniae

A
  1. upper resp symtoms
  2. fever, malaise, headache, chills
  3. wheezing
  4. maculopapular rash
26
Q

treatment for mycoplasma pneumoniae

A

macrolides

27
Q

How to determine if it is viral or bacterial PNA?

A

pro cal and c reactive protein
although not sensitive enough to be used as an independent biomarker and continued research is needed

NURS 572 (3 decks)

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