N3 Ex2 Oxygenation > Pneumonia > Flashcards

Pneumonia Flashcards

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1
Q

What is Pneumonia?

A

Inflammation of the lung parenchyma (Bronchioles & alveoli)

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2
Q

What is the pathophysiology of pneumonia?

A
  1. S. Pneumonia (Bacteria) aspirated into the lungs
  2. Inflammatory response is initiated
  3. Alveolar edema & exudate formation
  4. Bronchioles & alveoli fill c serous exudate, blood, fibrin & bacteria.
  5. Lung tissue consolidates (to be made solid)
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3
Q

How does pneumonia affect the patient?

A
  1. Affects the ability to ventilate properly (Inhalation & exhalation).
  2. Affects the ability of respiration (The exchange of oxygen & carbon dioxide).
  3. Affects the ability to maintain a patent airway.
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4
Q

What are some common types of pneumonia?

A
  1. Lobar Pneumonia
  2. Bronchopneumonia
  3. Interstitial Pneumonia
  4. Miliary Pneumonia
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5
Q

What is Lobar Pneumonia?

A

Affects the entire lobe of the lung

Consolidation occurs

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6
Q

What is Bronchopneumonia?

A
  1. Affects dependent portions of the lung tissue
  2. Patchy consolidation is visible bc exudate remain in the bronchi
  3. There is less edema & congestion than lobar
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7
Q

What is Interstitial Pneumonia?

A
  1. The inflammatory response involves the interstitium (alveolar walls & tissue)
  2. Does not show significant exudate
  3. Protein rich hyaline membranes line alveoli which interferes c gas exchange.
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8
Q

What is Miliary Pneumonia?

A
  1. The spread of the pathogen to the lungs via the blood stream.
  2. Discrete inflammatory lesions are visible.
  3. Seen mainly in severely immunocompromised patients.
  4. Seen in TB patients.
  5. Bc of poor immune response, damage to pleural tissue may be significant.
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9
Q

What are some complications from pneumonia?

A
  1. Atelectasis- Alveolar collapse
  2. Pleuritis- Inflammation of pleural-lining surrounding lungs.
  3. Pleural Effusion- Accumulation of excess fluid in pleural cavity.
  4. Lung Abscess- Local area of necrosis & pus formation within lungs.
    A. Sputum foul smelling
    Rupture into larger airway causes production of copious amounts of purulent sputum.
  5. Empyema- Accumulation of purulent exudate in pleural cavity.
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10
Q

How do Bacterial Pathogen cause Pneumonia?

A
  1. Circulate through the bloodstream to lungs where they damage pleural cells.
  2. The bacteria is distributed evenly throughout 1-2 lobes of a single lung called (UNILATERAL LOBAL PNEUMONIA).
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11
Q

How do Viruses cause Pneumonia?

A
  1. A virus will enter from the upper respiratory tract, infiltrating the alveoli nearest the bronchi.
  2. Invades cells, replicates, then bursts out killing cells & sending out cellular debris.
  3. This bursting causes rapid invasion of adjacent area. Viewed on x-ray as bronchopneumonia.
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12
Q

How does Aspiration Pneumonia occur?

A
  1. Aspiration of food, emesis, gastric reflux causes chemical injury & inflammatory response.
  2. This lowers pH, which causes more inflammation.
  3. This also allows for further bacterial invasion.
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13
Q

What are some GENERAL/OBSERVABLE Clinical Manifestations of Pneumonia?

A
  1. Anxiety-bc pt. can’t breath
  2. Flushed
  3. Shallow respiration
  4. Splinting affected side
  5. Confusion
  6. Disorientation
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14
Q

What are some Local Clinical Manifestations of Pneumonia?

A
  1. Cough
  2. Excessive Mucous Production
  3. SOB
  4. Dyspnea
  5. Chest Pain
  6. Hemoptysis- Bloody Sputum
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15
Q

What are some Systemic Clinical Manifestations of Pneumonia?

A
  1. Fever
  2. Diminished Appetite
  3. Malaise
  4. Cyanosis
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16
Q

What are Risk Factors for Pneumonia?

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A
  1. Cigarette Smoking
    A. Injures airway tissue
    B. Decreases cilia actions
    C. The Chemicals Numb Coughing Reflex
  2. Alcohol
    A. Interferes c actions of Macrophages
  3. Drug Abuse
    A. Higher risk for infections @ injection sites, spreading through blood stream to lungs.
  4. Age >65
  5. Chronic Cardiac, Respiratory, DM Diseases.
17
Q

What are some Opportunistic Risk Factors for Pneumonia?

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A
  1. Significantly in immunocompromised ppl. such as HIV/AIDS & Cancer pt.’s on chemotherapy.
  2. Seen on X-ray as patchy throughout the lungs.
  3. Alveoli thicken bc of edema & fill c protein rich fluid.
  4. Has an abrupt onset.
18
Q

What are some Risk Factors for Aspiration Pneumonia?

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A
  1. Emergency Surgery
  2. Obstetric Procedures
  3. Depressed Cough
  4. Impaired Gag Reflex
  5. Impaired Swallowing
19
Q

What are some Therapies for Pneumonia?

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A 
1. PREVENTION
     A. ID susceptible pop. -Age & Debilitated
     B. Early ID of Organism
     C. Immunization-->Pneumococcal Vaccination
2. Symptomatic Therapy & Supportive Care
     A. Increase Fluid Intake
     B. Incentive Spirometer
3. Oxygen Therapy
     A. Depends on degree of hypoxia
4. Chest Physiotherapy
     A. Percussion
     B. Vibration
     C. Postural Drainage
5. Thorocenthesis
20
Q

What are some Pharmacological Therapies for Pneumonia?

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A 
1. Antibiotics
     A. p +gram stain & x-ray
     B. Broad Spectrum:
          a. Claramyocin
          b. Erythromycin
          c. Penicillin
          d. 2nd/3rd Gen Cephalosporin
          e. Fluroquinolone
2. Anti-Inflammatory
     A. Bronchodilators
     B. Sympathomimetic
          a. Methyl Xanthine's--Aminophylline
3. Agents to Break-Up Mucus
     A. Acetycystein (Mucomyst) 
     B. Potassium Iodide
     C. Guaifenesin
21
Q

What are some main Priority RN Dx?

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A
  1. Ineffective Airway Clearance
  2. Ineffective Breathing Pattern
  3. Activity Intolerance
  4. Anxiety
  5. Imbalanced Nutrition: Less than body requirements
  6. Hyperthermia
  7. Disturbed Sleep Pattern
22
Q

RN Dx: Ineffective Airway Clearance

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A
  1. R/T decreased functionality of cilia due to damage & inflammation Secondary to pneumonia
  2. Implementation:
    A. Place in Fowler or High-Fowler Position.
    B. Assist to Cough, Deep Breath, & Use Devices.
    C. Encourage Increased Fluid Intake to 2,500–3,000mL.
23
Q

Home Care for Pt. c Pneumonia

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A
  1. Take medication as Prescribed, even if feeling better.
  2. Recommendations for limiting activities.
  3. Adequate fluid intake to keep mucus thinned.
  4. Maintain adequate nutritional intake
  5. Avoid smoking & 2nd hand smoke.
  6. Report manifestations to MD.
24
Q

What are some Diagnostic Studies for Pneumonia?

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A
  1. Hx & Physical
  2. C x R
  3. Gram stain of Sputum
  4. Sputum Culture & Sensitivity
  5. Pulse Oximetry &/or ABG
  6. CBC c Diff
  7. Chemistries
  8. Blood Cultures
  9. Bronchoscopy-Flexable Scope
25
Define Hospital-Acquired Pneumonia:
1. Occurring 48 Hours p Admission & NOT Intubated @ Time of Admission. 2. 2nd most common nosocomial infection 3. Endotrachial Intubation is a Major Risk Factor!!!
26
What Season are ppl. most susceptible to Community-Acquired Pneumonia?
Mid-Winter | Smoking is a Major Risk Factor as well.
N3 Ex2 Oxygenation
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