COPD
What are risk factors of someone with COPD? List 3
Smoking
Secondhand smoke
Air pollution
Genetics
Central cyanosis includes what body parts?
Face, lips, neck, chest
What is the most important standard precaution for infection prevention?
Hand Hygiene
What's the difference between hospital associate pneumonia and healthcare associate pneumonia?
•HCAP; dialysis, wound clinics, physician offices
•HAP; more specific to being in the hospital
Lung pain feels like...
Stabbing
Name 5 signs and symptoms of a client COPD at
Shortness of breath, Air hunger, hard time with physical activity, smaller extremities, wheezing, thickening of airways, increased pulmonary pressure, productive cough, hypoxemia, rapid/shallow breaths, use of accessory muscle, clubbed fingers/toes, pallor and cyanosis nails beds and mucous membranes, decreased O2
Barrel chest is a classic sign of what disease
COPD
Name signs and symptoms of elderly patients with infections
Confusion and Lethargy
Name signs and symptoms of pneumonia
HR/Temp increase
BP/O2 decrease
Fatigue/weakness
Lung= stabbing pain
Chest= dull pain
Chest pain feels like...
Dull pain
What is priority for a client that is experiencing cyanosis
Open airway and oxygen
Nursing Interventions for COPD patient
Position patient in high- fowlers
Administer prescribed medications
Administer oxygen as needed
Monitor for skin breakdown under oxygen therapy devices (bridge of nose, tongue, back of trachea, behind ears, cheeks)
Promote adequate nutrition
Breathing techniques to prevent dyspnea
Name 4 types of pneumonia
Bacterial, Fungal, Viral, Aspiration, HCAP, HAP, Community
Why would we see a prescription for antibiotics in an immunocompromised who has influenza?
To treat secondary bacterial infections
Name alternative pulmonary therapies (ICOUGH)
Incentive spirometry
Cough and deep breathing
Oral care
Understanding (patient and family education)
Getting out of bed 3x/day
High Fowlers position
Which acid-based imbalance do we expect to find in a patient with COPD? Why?
Respiratory acidosis because the airways are narrowed and reduce lung elasticity, restricting the ability to exhale CO2
Why would we turn a client on their side in emergency where the client becomes cyanotic?
Maintain an open airway and reduce the risk of aspiration
What are the expected outcomes of purse lipped breathing? & Explain how to teach purse lipped breathing?
Promote elimination of carbon dioxide
In throw your nose, out through pursed lips à allowing diffusion to happen
Deep breathing and coughing for lung expansion
Encourage smoking cessation
Reposition patient Q2 hours (move the mucous around; lessen the chance for alveoli collapse)
Oral/hand hygiene
Encourage reduced alcohol intake or smoker cessation)
Name 3 diagnostic testing for pneumonia
Sputum, Chest X-ray, Labs, and Bronchoscopy
Diagnostic Testing for Patient with COPD
Increased hematocrit- due to low o2 levels
Chest x-ray (inflammation of the bronchial)
Signs/ symptoms (low O2 levels, wheezing, SOB, cyanosis (grey))
Pulmonary function tests
Alpha antitrypsin levels- enzyme in liver that break down pollutants which attack lung tissue
Change in respiratory rate is first indication of new onset COPD
Clubbing nails and barrel chest is a indication of what?
COPD and oxygen deprivation
Rust colored sputum is a indication of what?
End Stage of COPD
Which is the most important diagnostic testing for pneumonia?
Sputum culture
What can help prevent VAP?
Oral care (Brushing and flossing twice a day)