Kenneth Bronson (Pneumonia)

*What risk factor does the nurse recognize that Kenneth Bronson had r/t pneumonia?

Smoking Cigarette smoking disrupts both mucociliary and macrophage activity. Although staphylococcal pneumonia has been noted after epidemics of influenza, Kenneth did not have this particular risk factor.

Epinephrine is administered for Kenneth's acute anaphylactic reaction. Which of the following does the nurse know is a possible side effect of this drug?

Tachycardia

The nurse is assessing the lungs of a patient diagnosed w/ pneumonia. Which of the following would be expected upon auscultation?

bronchial breath sounds this occurs in consolidation, such as pneumonia. Egophony may occur in patients diagnosed with pleural effusion. Absent breath sounds occurs in pneumothorax. Wheezes are associated w/ bronchial wall oscillation and changes in airway diameter.

When a patient presents to the ED with pneumonia, which s/s would the nurse expect the patient to exhibit?

fatigue fever dyspnea orthopnea fever is present with the infection. Pt will exhibit dyspnea, preferring to be propped up or sitting up due to orthopnea (SOB when reclining or supine). The patient is fatigued from the work of breathing.

The nurse understands that which of the following is the most common cause of anaphylaxis?

penicillin penicillin is the most common cause of anaphylaxis and accounts for about 75% of fatal anaphylactic reactions in the US each year. Substances that most commonly cause anaphylaxis include foods, medications, insect stings, and latex. Opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and radiocontrast agents are some of the medications that are frequently reported as causing anaphylaxis.

When a patient develops respiratory distress, what is the appropriate first nursing action for the nurse to take to address this specific concern?

Assess airway, breathing, circulation and auscultate the lungs It's important to determine the cause so appropriate measures to treat the patient can be started. Assessing the airway, breathing, and circulation are the basic first steps. Auscultating the lungs help to further delineate what the potential cause and treatment will be.

What is the priority action by the nurse when a patient experiences sudden respiratory distress?

Assess the airway is priority!!! Raising head of bed will improve lung expansion. The provider should be notified and IV line may be needed, but assessing the patient is priority.

Which medication was administered to Mr. Bronson to decrease inflammation?

Methylprednisolone this is a corticosteroid used to decrease inflammation. Albuterol and epinephrine cause bronchodilation. Acetaminophen is used to treat fever from pneumonia.

Which of the following is used intravenously to maintain blood pressure in a patient experiencing hypotension during an anaphylactic reaction?

Normal saline Epinephrine A bolus of NS is given for hypotension. An epinephrine IV drip will increase BP. Dextrose is not given as a bolus. Aminophylline and albuterol are bronchodilators.

The nurse administering diphenhydramine understands that the medication falls under which of the following categories for the treatment of an anaphylactic reaction?

antihistamine Diphenhydramine (Benadryl) is an antihistamine used to block the histamine released in the immune response with anaphylaxis.

Which of the following represent initial s/s of a patient in respiratory distress?

dyspnea hypoxemia tachypnea dyspnea and tachypnea accompanied by low oxygen in the blood are associated w/ respiratory distress. Cyanosis is a very late indicator of hypoxia to the tissues. Fever is an indication of infection.

The patient experiencing an anaphylactic reaction may experience which of the following s/s?

pruritus bronchospasm laryngeal edema dyspnea -Mild systemic reactions consist of peripheral tingling, warmth, a sensation of fullness in the mouth and throat, nasal congestion, periorbital swelling, pruritus, sneezing, tearing of the eyes. -Moderate systemic reactions may including flushing and anxiety in addition to any of milder symptoms. -More serious reactions include bronchospasm, laryngeal edema, severe dyspnea, cyanosis, and hypotension. Dysphagia, abdominal cramping, vomiting, diarrhea, and seizures can also occur. Cardiac arrest and coma may follow.

The nurse is auscultating lung sounds. What lung sound is associated with narrowing of the airway?

wheezes wheezing is a high-pitched, musical sound associated w/ airway narrowing. Crackles are described as a popping sound heard during inspiration from fluid or delayed opening of collapsed alveoli. Bronchophony or egophony can be auscultated when there is increased lung density from pneumonia and pulmonary edema.

The nurse should include which statement when providing education once the patient is first stabilized after an anaphylactic reaction?

"You will be closely monitored since there is a chance of a delayed reaction" Risk for "rebound" or delayed immune reaction! Pts who have experienced an anaphylactic reaction should receive a prescription for preloaded syringes of epi. Oxygen therapy is individualized and based on SpO2 levels and blood gases. Intubation is not mandated if the patient's respiratory status is stable.

A patient experiencing respiratory distress at home from pneumonia is brought to the hospital and upon presentation requires intubation. How would the nurse classify this type of pneumonia?

Community-acquired pneumonia CAP is pneumonia occurring in the community or within less than 48 hrs of hospital admission. Health-care associated pneumonia (HCAP) occurs in a non-hospitalized patient with extensive health care contact. Hospital-acquired pneumonia (HAP) occurs 48 hrs or more after hospital admission. Ventilator-associated pneumonia (VAP) is a type of HAP that develops 48hrs or more after intubation.

Once the patient is stabilized after an anaphylactic reaction, what information would be most essential for the nurse to include with patient and family follow-up teaching?

What caused the event and how to prevent an anaphylactic reaction They should also receive instruction on the proper use of a preloaded epinephrine syringe.