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NURS 3512 - Class 1-6 > Week 2 - Pneumonia > Flashcards

Week 2 - Pneumonia Flashcards

1
Q

what is pneumonia

A
  • a lower respiratory infection that causes inflammation of the alveoli & lung parenchyma caused by a microbial agent
  • and the alveoli may fill with fluid or pus
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2
Q

what are risk factors for pneumonia (11)

A

things that decrease the resp. system defence:

  • weak immune system
  • decreased consciouness (=depress the cough)
  • tracheal intubation
  • post-op pt (not coughing)
  • smoking
  • air pollution
  • COPD & asthma
  • prior infection: flu or cold
  • immobility
  • recent use of antibiotics
  • conditions that increase risk of aspiration
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3
Q

how do organisms that cause pneumonia get reach the lungs? (3)

A
  • inhalation
  • aspiration
  • hematogenous spread
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4
Q

what happens oce the germs get into the lungs

A
  • the alveolar sacs become inflamed & fill w fluid, RBCs, WBCs, and bacteria
    = sacs lose ability to inflate and deflate (which are imp. for gas exchange)
    = pt starts to experience hypoxemia bc O2 cannot transfer across capillary wall to attach to RBCs to supply body w O2 and body keeps CO2 instead
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5
Q

what are 2 types of pneumonia

A
  1. community acquired

2. hospital acquired

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6
Q

what is community acquired pneumonia

A
  • when pts obtains that germs that cause the bacteria outisde of the healthcare system
  • onset is in the community or during the first 2 days of hospitalization
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7
Q

what is hospital acquired pneumonia

A
  • pneumonia occurring 48 hr or longer after hospital admission
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8
Q

what is community acquired pneumonia often caused by (3)

A
  • conditions incurring aspiration
  • resp infection & recent use of antibiotics
  • COPD
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9
Q

what is hospital acquired pneumonia often caused by/risk factors for (2)

A
  • pts on mechanical ventilation

- bacteria

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10
Q

what are symptoms of pneumonia (10)

A 
Productive cough, Pleuritic pain
Neuro changes (fatigue, confusion r/t hypoxemia)
Elevated labs (WBC, CO2)
Unusal breath sounds (crackles)
Mild to high fever
O2 sats decreased
Nausea and vomitting
Increased HR and RR
Activity intolerance (SOB) , aching joint pain

chills

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11
Q

how might pneumonia be diagnosed (7)

A
  • history
  • physical exam
  • chest xray
  • sputum C&S
  • ABGs
  • blood cultures
  • CBC
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12
Q

what are some potential complications of pneumonia (10)

A
  • pleural effusion
  • pleurisy
  • atelectasis
  • delayed resolution from infection
  • lung abcess
  • empyema
  • pericarditis
  • meningitis
  • bacteremia
  • endocarditis
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13
Q

what is pleurisy

A
  • inflammation of the pleura
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14
Q

what is atelectasis

A
  • alveolar collapse
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15
Q

what are indications of improvement in a pt w pneumonia (3)

A
  • decreased temp
  • improved breathing
  • reduced chest pain
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16
Q

what is treatment for pneumonia (3)

A
  • antibiotics for bacterial
  • antivirals for viral pneumonia
  • treat symptoms (supportive measures)
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17
Q

what are some antibiotics used for bacterial pneumonia (4)

A
  • ceftazadime
  • vancomycin for MRSA
  • gentamicin
  • ciprofloxacin
18
Q

in uncomplicated cases, a pt usually response to anitbiotics therapy in how long

A

48-72 hrs

19
Q

how is the antibiotic chosen for bacterial pneumonia

A
  • tailored to the specific bacteria based on sputum sample
20
Q

what are some antivirals used for viral pneumonia (3)

A
  • amantadine
  • zanamivr (relenza)
  • osaltamivir (tamiflu)
21
Q

what supportive measures are used for treatment of pneumonia (7)

A
  • o2 therapy for hypoxemia
  • analgesics for chest pain
  • antipyretics for fever
  • rest
  • fluids
  • nutrition
  • positioning
22
Q

describe nutritional therapy for a pt with pneumonia (3)

A
  • fluid intake of at least 3L per day (or IV if oral intake cant be maintained)
  • at least 1500 cal per day
  • small, frequent meals (better tolerated d/t dyspnea)
23
Q

when should fluid intake be individualized? why is fluid intake imp.

A
  • if pt on fluid restriction ex. heart failure

- fever –> dehydration & lose water thru breathing

24
Q

why is high cal important for treatment of pneumonia

A
  • to provide energy for increased metabolic processes
25
Q

how should a pt with pneumonia be positioned? why?

A
  • with the good lung down

- allows maximal lung expansion & gas exchange

26
Q

list nursing care interventions for a pt w pneumonia (7)

A
  • promote vaccinations
  • teach pt to practice good health habits
  • prevent aspiration
  • early ambulation post-op
  • turning
  • DB&C
  • incentive spirometry
27
Q

what vaccines can we promote that will help prevent pneumonia (2)

A
  • influenza

- pneumococcal

28
Q

what “good health habits” should we teach the pt to do? why? (4)

A
  • proper diet
  • hygeine
  • adequate rest
  • regular exercise

can all help maintain natural resistance to organisms

29
Q

what positions & interventions can help prevent aspiration (3)

A
  • HOB elevated during meals & TB
  • if decreased LOC, monitor for inability to swallow secretions
  • lateral side lying in decreased LOC
30
Q

how often should pts be turned w pneumonia or to prevent pneumonia if decreased LOC? why (2)?

A
  • turn & reposition every 2 hr

- facilitates lung expansion & discourages pooling of secretions

31
Q

why is early ambulation post-op important to prevent pneumonia (4)

A
  • to facilitate deep breathing at frequent intervals
  • facilitate lung expansion
  • discourage pooling of secretions
  • augment bronchial hygeine
32
Q

what should a nurse be careful to avoid overmedication of to avoid pneumonia (2)? why (2)?

A
  • sedatives and narcotics
  • can cause a depressed cough reflex
  • & accumulation of fluid in lungs
33
Q

why is turning, DB&C, and incentive spirometry important for a pt with pneumonia (3)

A
  • increases lung vol
  • mobilize secretions
  • prevents atelectasis
34
Q

a nursing diagnosis r/t pneumonia is impaired gas exchange r/t to fluid and exudate accumulation in alveoli. what are 2 categories of nursing interventions for this

A
  • resp monitoring

- o2 therapy

35
Q

what resp monitoring can be done r/t imapired gas exchange (5)

A
  • auscultate breath sounds
  • monitopr rate, rhythmn, depth, effort of resp
  • monitor for increased restlessness, anxiety, air hunger
  • monitor pts ability to cough effectively
  • monitor pts resp secretions
36
Q

describe o2 therapy for impaired gas exchange (6)

A
  • admin supp o2 as ordered
  • set up o2 equipment and admin thru humidified system
  • monitor effectiveness of o2 therapy (pulse ox, ABGs)
  • monitor for skin breakdown from friction of O2 device
  • monitor pts anxiety r/t need for O2 therapy
  • periodically check O2 delivery device to ensure the prescribed conc is being delivered
37
Q

a nursing diagnosis r/t pneumonia is ineffective breathing pattern. what 2 categories of nursing interventions can be done for this. (7)

A

ventilation assistance

  • monitor resp and O2 status
  • position to maximize resp efforts
  • encourage DB&C, turning
  • monitor for resp muscle fatigue
  • auscultate breath sounds
  • assist w incentive spirometer
  • admin meds that promote airway patency
38
Q

how can we position a pt w pneumonia to maximize resp efforts (3)

A
  • elevate HOB
  • provide overbed table for pt to lean on
  • good lung down
39
Q

a nursing diagnosis r/t pneumonia is ineffective airway clearance. what nursing interventions can be done for this (5)

A
  • monitor rate, rhythm, depth, and effort of resp
  • auscultate breath sounds
  • assist pt to sitting position w head slightly flexed, shoulders relaxed, knees flexed to improve resp status
  • encourage use of incentive spirometry
  • provide systemic fluid hydration to liquify secretions
40
Q

a nursing diagnosis r/t pneumonia is acute pain. what nursing interventions can be done for this (5)

A
  • perform comprehensive assessment of pain
  • encourage pt to monitor own pain and intervene appropriately
  • teach use of nonpharmacologic techniques
  • use pain control measures before pain becomes severe
  • medicate before an activity to increase participation, but evaluate hazard of sedation

NURS 3512 - Class 1-6 (47 decks)

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