Pneumonia

While the nurse is caring for a neonate at 32 weeks' gestation in an isolette with continuous oxygen administration, the neonate's parent asks why the baby's oxygen is humidified. What should the nurse should tell the parent?

"Oxygen is drying to the mucous membranes unless it is humidified."

Atelectasis

-Absence of gas or air in 1 or more areas of the lung -Portion of the lung does not expand completely

What are 2 ways organisms reach lungs

-Aspiration -Inhalation of microbes -Hematogenous

Complications of pneumoniaa

-Atelectasis -Pleurisy -Plural effusion -Bacteremia -pneumothorax -ARF -Sepsis/septic shock

Classifications of pneumonia

-Community acquired -Hospital acquired

What are goals of pneumonia

-No signs of hypoxia -normal breathing patterns -clear breath sounds -normal chest x-ray =normal WBC count =No complications

Types of pnuemonia

-Viral -bacterial -mycoplasma -aspiration -necrotizing -opportunistic

Cues for atelectasis

-dyspnea -chest pain -anxiety -tachypnea -tachycardia -diaphoresis -cyanosis -hypoxemia -decreased breath sounds -accessory muscle use with respiration

Cue of pneumonia

-dyspnea -cough -tachycardia -fatigue -chills & fever -LOC changes -pleuritic chest pain -increased sputum

What are patient teachings for a patient with pneumonia

-hygiene, nutrition, rest, regular exercises -cough or sneeze into elbow -avoid cigarette smoke -avoid exposure to URIs -Flu and pneumococcal vaccines

Treatment for atelectasis

-oxygen -chest PT -mucolytics -acetylcysteine -guaifenesin -bronchodilators -albuterol z

A 10-year-old child with a history of bronchial asthma triggered by exposure to cold and smoke is brought to the hospital's emergency department by their parent. Appearing restless and anxious, the child has a respiratory rate of 36 breaths/min and a pulse rate of 160 bpm. Which finding requires immediate action?

Absence of wheezing

Community acquired pneumonia

Acute infection in patients who have not been hospitalized or resided in a long-term care facility within 14 days of the onset of symptoms

A client admitted with bacterial pneumonia develops a fever. Which health care provider order should the nurse implement first?

Draw blood cultures from two sites

A child is admitted to the emergency department with an acute asthma attack. Which early assessment finding does the nurse expect?

Expiratory wheezing

The nurse is caring for a homeless client with pneumonia. Laboratory testing reveals the following results: blood urea nitrogen (BUN) 180 mg/dl, creatinine 30 mg/dl (2652 mmol/L), potassium 6.2 mEq/L (6.2 mmol/L), and hemoglobin 6.2% (62 g/L). Based on the health care provider's order, which drug order would the nurse question?

Gentamicin sulfate

Ventilator-associated pneumonia

Occurs more than 48 hours after endotracheal intubation

What should the nurse do to help a client prevent atelectasis and pneumonia after surgery?

Offer pain medication before having the client deep-breathe and use incentive spirometry

Pneumonia

acute infection of lung parenchyma

Consolidation

alveoli become filled with water, fluid and/or debris

opportunistic pneumonia

caused by bacteria, virus, or microorganisms that do not normally cause disease

What lung sounds are heard with pneumonia

fine or coarse crackles

PJP

fungal infection, most common with HIV

A client is experiencing status asthmaticus. For which would the nurse anticipate an immediate order?

inhaled Beta-2 adrenergic agonist

The nurse is caring for an 8-year-old child experiencing an acute asthma attack. The nurse takes immediate action to address total airway obstruction based on what assessment finding?

marked decrease in level of consciousness

Hospital acquired pneumonia

occurs 48 hours or longer after hospitilization and not present at time of admission

Pneumonia risk factors

patients with respiratory disease comorbid conditions hozpitalizations weakned or suppressed immune system

Necrotizing pneumonia

rare complication of bacterial lun infection

When discussing the use of a fluticasone and salmeterol inhaler with the parent of a child diagnosed with asthma, the nurse should teach the parent that the medication will be most effective if it is administered at which time?

twice daily