Treatments Assessment Labs & Diagnostics Pneumonia
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13-6 www. SimpleNursing.com Pneumonia What am i ? Infection of the pulmonary tissue including the interstitial spaces, alveoli and bronchioles. Patho The pulmonary tissue becomes infected causing edema which stiffens the lungs and decreases lung compliance and vital capacity, this also causes hypoxemia. Pneumonia can be community acquired or hospital acquired. Causes Aspiration pneumonia ❖ Caustic substance entering the airway from either vomiting or impaired swallowing Bacterial and viral pneumonia ❖ Abdominal and thoracic surgery ❖ Alcoholism ❖ Aspiration ❖ Atelectasis ❖ Bacterial or viral respiratory infections ❖ Cancer ❖ Chronic illness and debilitation ❖ Chronic respiratory disease ❖ Endotracheal intubation or mechanical ventilation ❖ Exposure to noxious gases ❖ Immunosuppressive therapy ❖ Influenza ❖ Malnutrition ❖ Sickle cell disease ❖ Tracheostomy Assessment ❖ NEURO: Chills & Fever, Loc changes ❖ RESP: Tachypnea , pleuritic pain, rhonchi, wheezes, use of accessory muscles to breathe, sputum production. W: Wheezes E: Expectoration of sputum E: Elevated temperature Z: Zoned out/ mental status changes Y: Yes they have chest pain and fast breathing. Labs & Diagnostics ❖ White blood cell count and differential identifies leukocytosis. ❖ Blood culture tests are positive for the causative organism. ❖ Arterial blood gas analysis (ABG) values may show hypoxemia. ❖ Fungal or acid-fast bacilli cultures identify the etiologic agent. ❖ Assay for Legionella-soluble antigen in urine detects the presence of the antigen. ❖ Sputum culture, Gram stain, and smear reveal the infecting organism. ❖ Rapid antigen testing reveals the causative organism. ❖ Chest radiography generally shows patchy, interstitial, or lobar infiltrates (bilateral with viral pneumonia; unilateral with bacterial pneumonia). ❖ Bronchoscopy or transtracheal aspiration specimens identify the etiologic agent. Interventions ❖ Airway maintenance ❖ Monitor vitals and Spo2 ❖ Institute incentive spirometry. ❖ Monitor color, amount and consistency of sputum. ❖ Mechanical ventilation with low tidal volumes (6 mL/kg) and positive end-expiratory pressure for respiratory failure ❖ Chest physiotherapy ❖ Swallow evaluation if cause is aspiration ❖ Venous thromboembolism (VTE) prophylaxis, if hospitalized ❖ Nothing by mouth in cases of respiratory failure or of aspiration from impaired swallowing ability ❖ High-calorie, high-protein ❖ Soft, easy-to-chew foods ❖ Adequate fluids ❖ Tube feedings or total parenteral nutrition if necessary Treatments ❖ Antibiotics: clarithromycin, azithromycin (Zithromax), azithromycin for Mycoplasma pneumonia ❖ Piperacillin sodium-tazobactam sodium (Zosyn), imipenem-cilastatin sodium (Primaxin), clindamycin phosphate (injection) (Cleocin), or metronidazole hydrochloride (Flagyl) and a respiratory fluoroquinolone and ceftriaxone sodium (Rocephin) for aspiration pneumonia ❖ Antiviral agents : (Tamiflu) for viral pneumonia; ribavirin (Virazole) for viral pneumonia due to adenovirus; acyclovir (Zovirax) for viral pneumonia due to herpes simplex virus ❖ Humidified oxygen ❖ Antitussives ❖ Analgesics and antipyretics: acetaminophen (Tylenol), ibuprofen (Advil) ❖ Bronchodilators: albuterol sulfate (AccuNeb), for wheezing ❖ I.V. fluids ❖ Glucocorticoids to reduce inflammatory response in certain patients in the intensive care unit.
Transcript of Treatments Assessment Labs & Diagnostics Pneumonia
13-6
www. SimpleNursing.com
Pneumonia What am i ?
Infection of the pulmonary tissue including the interstitial spaces, alveoli and bronchioles.
Patho The pulmonary tissue becomes infected causing edema which stiffens the lungs and decreases lung compliance and vital capacity, this also causes hypoxemia. Pneumonia can be community acquired or hospital acquired.
Causes Aspiration pneumonia
❖ Caustic substance entering the airway from either vomiting or impaired swallowing
Bacterial and viral pneumonia
❖ Abdominal and thoracic surgery
❖ Alcoholism❖ Aspiration❖ Atelectasis❖ Bacterial or viral respiratory
infections❖ Cancer❖ Chronic illness and debilitation❖ Chronic respiratory disease❖ Endotracheal intubation or
mechanical ventilation❖ Exposure to noxious gases❖ Immunosuppressive therapy❖ Influenza❖ Malnutrition❖ Sickle cell disease❖ Tracheostomy
Assessment ❖ NEURO: Chills & Fever, Loc
changes❖ RESP: Tachypnea , pleuritic
pain, rhonchi, wheezes, use of accessory muscles to breathe, sputum production.
W: Wheezes E: Expectoration of sputumE: Elevated temperatureZ: Zoned out/ mental status changesY: Yes they have chest pain and fast breathing.
Labs & Diagnostics❖ White blood cell count and differential
identifies leukocytosis.❖ Blood culture tests are positive for the
causative organism.❖ Arterial blood gas analysis (ABG) values may
show hypoxemia.❖ Fungal or acid-fast bacilli cultures identify
the etiologic agent.❖ Assay for Legionella-soluble antigen in
urine detects the presence of the antigen. ❖ Sputum culture, Gram stain, and smear
reveal the infecting organism.❖ Rapid antigen testing reveals the causative
organism.❖ Chest radiography generally shows patchy,
interstitial, or lobar infiltrates (bilateral with viral pneumonia; unilateral with bacterial pneumonia).
❖ Bronchoscopy or transtracheal aspiration specimens identify the etiologic agent.
Interventions❖ Airway maintenance❖ Monitor vitals and Spo2❖ Institute incentive spirometry. ❖ Monitor color, amount and
consistency of sputum.❖ Mechanical ventilation with low tidal
volumes (6 mL/kg) and positive end-expiratory pressure for respiratory failure
❖ Chest physiotherapy❖ Swallow evaluation if cause is
aspiration❖ Venous thromboembolism (VTE)
prophylaxis, if hospitalized❖ Nothing by mouth in cases of
respiratory failure or of aspiration from impaired swallowing ability
❖ High-calorie, high-protein❖ Soft, easy-to-chew foods❖ Adequate fluids❖ Tube feedings or total parenteral
nutrition if necessary
Treatments❖ Antibiotics: clarithromycin,
azithromycin (Zithromax), azithromycin for Mycoplasma pneumonia
❖ Piperacillin sodium-tazobactam sodium (Zosyn), imipenem-cilastatin sodium (Primaxin), clindamycin phosphate (injection) (Cleocin), or metronidazole hydrochloride (Flagyl) and a respiratory fluoroquinolone and ceftriaxone sodium (Rocephin) for aspiration pneumonia
❖ Antiviral agents : (Tamiflu) for viral pneumonia; ribavirin (Virazole) for viral pneumonia due to adenovirus; acyclovir (Zovirax) for viral pneumonia due to herpes simplex virus
❖ Humidified oxygen❖ Antitussives❖ Analgesics and antipyretics:
acetaminophen (Tylenol), ibuprofen (Advil)
❖ Bronchodilators: albuterol sulfate (AccuNeb), for wheezing
❖ I.V. fluids❖ Glucocorticoids to reduce
inflammatory response in certain patients in the intensive care unit.
