pneumonia
What is the definition of Community Acquired pneumonia
(CAP): refers to a pneumonia acquired from normal social contact (i.e., in the community) as opposed to being acquired while in hospitals or extended-care facilities (e.g., nursing homes)
What is the definition of Chronic pneumonia
A long on going pneumonia that typically involves a localized lesion in patients with a normal immune system, with or without reginal lymph node involvement
What is the definition of Aspiration pneumonia
A lung infection that develops after you aspirate (inhale) food, liquid, or vomit into your lungs. Common pathogenic agents associated with aspiration pneumonia include anaerobic oral flora (Bacteroides, Prevotella, Fusobacterium, Peptostreptococcus), admixed with aerobic bacteria such as S. pneumonia, S. aureus, H. influenza, and P. aeruginosa. It is commonly missed because acute inflammatory reactions may not begin until several hours after aspiration of the gastric fluid.
What can increase the risk of death with pneumonia
A weakened immune system, the chronic damage found with COPD, and Heart disease
The cause of pneumonia from most common to least is broken down how
About half of all pneumonia cases are caused by viruses. The other half of cases will be caused by bacteria, protozoa, or fungi.
What is the abg for mild to moderate pneumnoia
Acute alveolar hyperventilation with hypoxemia Ph: up PaCO2: down HCO3: down PaO2: down
what is the abg for severe pneumonia
Acute ventilatory failure with hypoxemia pH: down PaCO2: up HCO3: up PaO2: down
What are the risk factors for pneumonia?
Age over 65 years, Aspiration of oropharyngeal secretions, Viral respiratory infections, Chronic illness and debilitation (diabetes mellitus, uremia), Chronic respiratory disease, COPD, asthma, cystic fibrosis, Cancer (especially lung cancer), Prolonged bed rest, Tracheostomy or endotracheal tube, Abdominal or thoracic surgery, Rib fractures, Immunosuppressive therapy, AIDS
What is the definition of Hospital Acquired pneumonia
Also, called nosocomial pneumonia it is an infection whose development is caused by the hospital environment
What is the definition and differential characteristics of bronchopneumonia
Bronchopneumonia usually involves both lungs and is seen more often in the lower lobs of the lung and is characterized by a patchy pattern of infection that is limited to the segmental bronchi and surrounding lung parenchyma.
What is the definition of Atelectasis
Collapsed or airless lung (alveoli)
What are the acquired pneumonia classification
Community, nursing home, hospital, and ventilator
Describe Thoracentesis
Diagnostic and therapeutically, thoracentesis may be used if a pleural effusion is present. From a diagnostic standpoint, fluid samples may be examined for the ollowing: Color, Odor, RBC count, Protein, Glucose, Lactic dehydrogenase (LDH), Amylase, pH, Wright's, Gram, and acid-fast bacillus (AFB) stains, Aerobic, anaerobic, tuberculosis, and fungal cultures, Cytology, Therapeutic thoracentesis may be used to encourage lung re-expansion when, atelectasis is part of the clinical presentation
What kind of PFT flows and volumes would you expect to obtain with pneumonia
FVC = decreased, FEVT = Normal or decreased, FEV1/FVC ratio = Normal or increased, FEF 25% - 75% = Normal or decreased
What is the definition of Walking pneumonia
Has no clinical significance, it is often used to describe a mild case of pneumonia
What is the definition of consolidation?
If the infection is overwhelming, the alveoli become filled with fluid, RBCs, polymorphonuclear leukocytes, and macrophages.
What are the expected vitals for pneumnoia
Increased Respiratory Rate (Tachypnea) and Increased Heart Rate (Pulse) and Blood Pressure
What kind of CXR would you expect to obtain with pneumonia
Increased density (from consolidation and atelectasis), Air bronchograms, Pleural effusions
What kind of vitals would you expect in a patient with pneumonia
Increased hr and bp with tachypnea
What is the definition and differential characteristics of interstitial pneumonia?
Interstitial pneumonia is usually a diffuse and often bilateral inflammation that primarily involves the alveolar septa and interstitial space
What is the definition of Pneumonia in the immunocompromised patient
Involves anything which can weaken an immune system (HIV, Chemo, drug treatments, illegal drugs, etc.) and thus increase a patients risk of contracting pneumonia
What is the definition and differential characteristics oflobar pneumonia
Lobar pneumonia is typically the end result of a severe or long-term bronchopneumonia in which the infection has spread from one lung segment to another until the entire lung lobe is involvedWidespread or diffuse alveolar inflammation and consolidation or diffuse alveolar inflammation and consolidation.
Describe Lung Expansion Protocol
Lung expansion therapy may be administered to attempt to offset the atelectasis associated with some pneumonias, but its effects are not consistently good
What cough and sputum clinical data would you expect in pneumonia
Nonproductive barking or hacking cough
What pulmonary infection is most commonly seen in patients with AIDS
Pneumocystis carinii
What are the signs and symptoms of pneumonia?
Pneumonia is an insidious disease because its symptoms vary greatly, depending on the patient's specific underlying condition and the type of organism causing the pneumonia. It often mimics a common cold or the flu
What is the issue with hospital readmission regarding this disease?
Pneumonia is one of several conditions in which readmission to the hospital for any cause will result in possible significant financial penalties to the hospital for patient on Medicare
What is the definition of pneumonia, or pneumonitis with consolidation?
Pneumonia, or pneumonitis with consolidation, is the result of an inflammatory process that primarily affects the gas exchange area of the lung. In response to the inflammation, fluid (serum) and some red blood cells (RBCs) from adjacent pulmonary capillaries pour into the alveoli.
Describe Oxygen Therapy Protocol
Scientifically based set of procedures designed to guide the use of oxygen to decrase the WOB and of the heart, and address hypoxemia which in pneumonia may have been caused by alveolar consolidation and capillary shunting
What is the definition of Community Atypical pneumonia
The clinical presentation of the patient with community-acquired atypical pneumonia is often subacute. The patient typically presents with a variety of both pulmonary and extrapulmonary findings (e.g., respiratory symptoms such as cough plus headache, general fatigue, or diarrhea)
What are polymorphonuclear leukocytes
The macrophages that enter the alveoli to engulf and kill the invading bacteria causing pneumonia
what are the 3 major structural or pathological changes associated with pneumonia
The major pathologic or structural changes associated with pneumonia
What is the definition of Lung expansion
The measure of the ease of expansion of the lungs and thorax. Therapies include a variety of respiratory care modalities designed to increase patient's lung volume
What is the definition of Thoracentesis
The surgical preformation of the chest wall and pleural space with a needle to aspirate fluid for diagnostic or therapeutic purposes or to remove a specimen for biopsy.
What are the components of general management of pneumonia
The treatment of pneumonia is based on (1) the specific cause of the pneumonia, and (2) the severity of symptoms demonstrated by the patient.
What is VAP
Ventilator associated pneumonia which develops more than 48 to 72 hours after endotracheal intubation.
What medication is used to treat RSV in pneumonia
Virazole (Ribavirin)
What is the definition of Double pneumonia
When both lungs are involved, the condition is sometimes called double pneumonia
A CT scan results on a patient with pneumonia will show what and why
air bronchograms and consolidation because the alveoli are filled with fluids while the airways are patent
What are causes of pneumonia
bacterial, atypical organisms, virus, fungus, aspiration, and acquired
When a patient has pneumonia, what would be found in the alveolar effusion fluids
effusion fluids in the alveoli will contain serum fluid, red blood cells, and polymorphonuclear leukocytes and macrophages
What would be the expected oxygenation status of a patient with pneumonia
hypoxemia
What is the definition of Pleural effusion
it is excess fluid that accumulates in the pleural cavity, the fluid-filled space that surrounds the lungs. This excess can impair breathing by limiting the expansion of the lungs.
What kind of ABG would you expect to obtain with pneumonia
pH = increased, PaCO2 = decreased, HCO3 = decreased (but normal), PaO2 = decreased
What is the definition of Necrotizing pneumonia and Lung Abscess
refers to localized pus information and necrosis within the pulmonary parenchyma, resulting in one or more large cavities.
What is the most important test to determine the exact cause of a pneumonia
sputum sample
What is the definition of Bronchial or Bronchpulmonary Hygiene
the care and cleanliness of the respiratory tract and of ventilatory/respiratory therapy. Hygienic care may include providing assistance with postural drainage and controlled coughing techniques, percussion, vibration, nasotracheal or endotracheal suctioning, and rib shaking.
How would you treat a pleural effusion related pneumonnia
thoracentesis which uses a needle through the chest wall to withdraw the pleural effusion fluid. This allows the lung to reexpand.