flue & others
why do you need a anual vaccine
because the virus undergoes mutations every year = new strains=no immunity
what are the isolation precautions for someone with suspected or comfirmed TB?
AIRBORNE ISOLATION:
-SINGLE OCUPANCY ROOM
-NEGATIVE PRESSURE VENTILATION
-HIGH EFFICIENCY PARTICULATE AIR MASKS,(N95) EMPLYEES ONLY
what are the 3 ways organisms reach lungs, and cause pneumonia
aspiration
inhalation
hematogenous spread
how does the pathophysiology of an acute asthma attack correlates with the manifestations of the disease.
The main pathophysiological process of acute asthma attack is inflammation. Exposure to allergens or irritants triggers the inflammatory cascade involving a variety of inflammatory cells. Inflammation leads to bronchoconstriction, hyperreactivity, and edema/ excess mucus production of airways leads to limited airflow, especially airflow OUT of the lungs. Causing wheezing, coughing, dyspnea and chest tightness
what is the major risk factors for COPD?
cigarette smooking
what is the name of the airway clearence device by COPD patients?
Acapella
what is the difference between active TB and latent TB?
-Active TB is symptomatic disease where the patient will experience coughing, chest pain, fatigue, fever and weight loss, for long periods of time.Active TB is also spread via airborne droplets, that can be suspended in air for minutes to hours. Latent TB is asymptomatic, noninfectious, but may develop into active TB later, therefore it is important to treat to prevent active TB, that will include a 3-9 months of drug therapy.
what is the pathophysiology for aspiration pnemumonia, and what are ways that we can prevent it?
p: when foreign material ( food, liquid, vomit) from mouth or stomach enters the lungs leading to inflammation and infection.
prevention: head of bed 30, assit with meals, monitor reflux and gastrci residuals, early mobilization, twice oral hygiene and spech therapy cnsult
what is "silent chest"?
ominous sign that there is a Severe airway obstruction or impending respiratory failure; may be life-threatening!
No breath sounds = no air moving in or out of the lungs = no gas exchange = no oxygen to tissues and brain = death!
what are some breathing technic used by COPS patients?
-pursed-lip breathing
-diaphragmatic breathing
-hiff coughing
-postural drainage
-percussion
why would some people get a false positive on their skin test?
- pt has received the BCG vaccine
-latent TB
what is the gold standart test to diagnose TB?
sputum culture
-Three consecutive sputum samples at 8 to 24 hours intervals; need at least one early morning specimen
what is the pathophysiology for oportistic pnemumonia, and what are ways that we can prevent it?
p: pneumonia that occurs in immunocompromised patients
prevent: refraim from crowded spaces, get vaccinations, strict hand washing hygiene
what are the "rescue mediactions" fro acute asthama attacks, what is the pathaphisology, side effects and important information of this med?
Short-acting β-Adrenergic agonists (SABAs)
Example: albuterol
Stimulate β2 receptors in bronchioles to produce bronchodilation
Most effective for relieving acute bronchospasm with acute attack
Onset: minutes and duration: 4 to 8 hours
Too frequent use results in tremors, anxiety, tachycardia, palpitations, and nausea
Not for long-term use
what is the drug therapy for pts with COPD?
the same meds as asthma
-Bronchodilators like β2-Adrenergic agonists (short and long acting), anticholinergics (short and long acting), methylxanthines, inhaled corticosteroids
when is the peak transmission for pts with influenza?
a day before onset of symptoms and can continue for 5-7 days after a person first becomes sick
what is something that 3/4 initial 4-drug regimen for TB cause?
non-viral hepatitis is a major side effect for 3 of 4 first-line drugs; liver function tests should be monitored
what are some complications of pneumonia
- atelectasi
-pleural effucion
-pneumothorax
-empyema
-lung absesss
-sepsis
what are drugs that are used for long term control of asthma? and what are their side effects?
Long-acting β2-Adrenergic Agonist Drugs
Examples: Salmeterol (Serevent), formoterol (Foradil)
Added to daily ICSs; combination ICS and LABA available
Never used for acute attacks
Corticosteroids—reduce bronchial hyperresponsiveness and inhibit migrations of inflammatory cells
Most effective long-term control drug
Examples: beclomethasone, budesonide
Local side effects -
Oropharyngeal candidiasis, hoarseness, and a dry cough
Can be reduced using a spacer or by gargling after each use
what is the prefered oxygen saturation for pts with COPD
88-92%
what is empiric antibiotci therapy?
starting treatment before a definitive diagnosis has been made
what are some patient education for pt with TB?
Teach patient to prevent spread
Cover nose and mouth with tissue when coughing, sneezing, or producing sputum; dispose in trash or flush
Hand washing after handling sputum-soiled tissues
Patient wears face mask if outside of negative-pressure room
Identify and screen close contacts
Notification made to public health department is required
what are some assesment data that you would find on a patient with pneumonia
general: fever, restlessness, or lethargy
respiratory: tachypnea, asymmetric chest movements, use of accessory muscles, nasal flaring, decreased excursion, crackles, friction rub, dullness on percussion, increased tactile fremitus, sputum amount and color, productive or non-productive cough, pleuritic chest pain
what are the pros of using a metered dose inhaler?
Reduce oropharyngeal medication deposition - decrease thrush
Increase delivery to lungs
Reduce problems with hand-breath coordination
Why is the O2 saturation goal lower (88-92%) for patients with COPD?
The O2 saturation goal of 88-92% for COPD patients prevents dangerous buildup of carbon dioxide (CO2) by avoiding suppression of their respiratory drive and worsening ventilation/perfusion (V/Q) mismatch, which leads to respiratory acidosis, while still preventing severe hypoxia.