Tuberculosis
How is TB diagnosed?
chest xray and sputum testing
pneumonia can be prevented by
getting the vaccine
pathophysiology of chronic bronchitis
Scar tissue narrows air passages, bronchial walls thicken, mucus may plus airway
Madelyn Lenore Jordan uses the peak flow meter to see where she is in her asthma treatment/diagnosis. she is in the "yellow" zone. what does this mean?
may need more medication
green - good
red - asthma attack
Mr Busby was arrested for Zyning on the job. He spent 2 months in prison. Which respiratory disorder is he at the highest risk for?
Tuberculosis
Highest risk is those in prisons, homeless, overcrowded populations where TB is prevalent
this type of isolation is required for TB patients
airborne
negative pressure room
unique signs/symptoms of pneumonia
fever, fatigue, tachypnea, chills, dyspnea, cough, tachycardia, myalgia/arthralgia, agitation, and pleuritic chest pain, increased tactile fremitus (vibration when speaking)
what would an ABG from a patient with chronic bronchitis show?
respiratory acidosis
CO2 is not getting out
patients cant get rid of air, so its building up in the lungs
pathophysiology of asthma
Chronic inflammatory disease of the airways that causes mucosal edema and mucus production
these patients may be known to have a "barrel" shaped chest
emphysema
Trouble getting lungs to shrink back dow
what are interventions nurses can use to promote airway clearance? (3)
increase fluids to thin out secretions
turn cough and deep breath
change positions
Unfortunately Nurse Lenore is caring for a very entitled JB jones who is suffering from pneumonia. Lenore is trying to educate JB on ways to decrease his risk for pneumonia. She tells him that these 2 things often increase the risk for pneumonia in hospitalized patients :
surgery and aspiration
which intervention is WRONG?
- O2 sat of 89%
- titrating the O2 sat to 5L
- put the patient on CPAP or BiPAP
- titrating the O2 sat to 5L is WRONG
4L is MAX
rescue medications vs long term control medications
rescue medications are for an asthma attack
long term control medications are supposed to be used daily
Oliviuh is experiencing trouble breathing so she puts herself into the tripod position. she also has pursed lip breathing. she is suffering from....
chronic bronchitis
what is the treatment for TB?
abx therapy for 6-12 months
noninfectious after 2-3 weeks of medication therapy... sputum cultures repeated every 3 months or so to see if they are still infectious
Mateolyn has an order from the doctor to get a sputum culture for her patient's bacterial pneumonia. She starts the antibiotics through the patient's IV. Then she gets the cup to collect the sputum culture. What did she do wrong?
She started the abx before collecting the sputum culture
****always get the sputum culture BEFORE starting the antibiotics
Madelyn was diagnosed with chronic bronchitis. She is under going treatment but has started to experience wheezing and diminished breath sounds, mostly due to her bronchioles tightening. which complication is she most likely experiencing?
bronchospasm
Hale, Samantha Nicole is hospitalized for her asthma because it did not respond to treatment. She is most likely experiencing
status asthmaticus
sami has allergies to dust mites and cats. she lives with madelyns cat. suddenly she cannot speak in full sentences. what will the nurse suspect?
asthma (asthma attack)
Sami needs to obtain a sputum sample from her patient. Her patient just received her breakfast tray but has not eaten yet. What procedure should sami follow to collect the sample?
should be obtained in the morning before eating
rinse mouth, take some deep breaths, and then a deep cough to get up the sputum
name some of the treatments for pneumonia (7)
Antibiotics - fever should be gone by 48 hours of treatment
Supportive care - fluids
Oxygen and humidity - patient may get confused and changed in LOC if hypoxic
Antipyretics for fever and pain
Antitussives, decongestants, antihistamines
Pulmonary hygiene - incentive spirometer, turn cough and deep breathe
Chest, physiotherapy, and percussion respiratory therapy
3 complications of chronic bronchitis
- bronchospasm
- respiratory failure
- pneumothorax
pathophysiology of status asthmaticus
bronchioles clamp down
rescue inhaler is not working
may need intubation
increasing levels of PaCO2
An older patient comes into the emergency room with new confusion. They dont have a fever. What may the nurse suspect?
Pneumonia