Pneumonia By Rnpedia

Pneumonia is the most common complication of influenza. It may be either primary influenza viral pneumonia or pneumonia secondary to a bacterial infection. Other complications of influenza include myositis, exacerbation of chronic obstructive pulmonary disease, and Reye’s syndrome. Myocarditis, pericarditis, transverse myelitis, and encephalitis are rare complications of influenza. Although septicemia may arise when any infection becomes overwhelming, it rarely results from influenza. Meningitis and pulmonary edema aren’t associated with influenza.

Showing this patient how to splint his chest wall will help decrease discomfort when coughing. Holding in his coughs will only increase his pain. Placing the head of the bed flat may increase the frequency of his cough and his work of breathing. Increasing fluid intake will help thin his secretions, making it easier for him to clear them.

If the child has bacterial pneumonia, a high fever is usually present. Bacterial pneumonia usually presents with a productive cough, not a nonproductive cough, making answer B incorrect. Rhinitis is often seen with viral pneumonia, and vomiting and diarrhea are usually not seen with pneumonia,

The nasal cannula is the most comfortable method of delivering oxygen because it allows the patient to talk, eat and drink.

Hypoxia is the main breathing stimulus for a client with COPD. Excessive oxygen administration may lead to apnea by removing that stimulus. Anginal pain results from a reduced myocardial oxygen supply. A client with COPD may have anginal pain from generalized vasoconstriction secondary to hypoxia; however, administering oxygen at any concentration dilates blood vessels, easing anginal pain. Respiratory alkalosis results from alveolar hyperventilation, not excessive oxygen administration. In a client with COPD, high oxygen concentrations decrease the ventilatory drive, leading to respiratory acidosis, not alkalosis. High oxygen concentrations don’t cause metabolic acidosis.

Severe pneumonia requires urgent referral to a hospital. Other options are done for a client classified as having pneumonia.

Because of restricted respiratory movement, a recumbent, immobilize patient is at particular risk for respiratory acidosis from poor gas exchange; atelectasis from reduced surfactant and accumulated mucus in the bronchioles, and hypostatic pneumonia from bacterial growth caused by stasis of mucus secretions.

Pneumonia, which is an infection, causes lobar consolidation thus impairing gas exchange between the alveoli and the blood. Because the patient would require adequate hydration, this makes him prone to fluid volume excess.

Question: Which lab values should you monitor for a patient receiving Gentamicin?

Needed Info: Gentamicin: broad spectrum antibiotic. Side effects: neuromuscular blockage, ototoxic to eighth cranial nerve (tinnitus, vertigo, ataxia, nystagmus, hearing loss), nephrotoxic. Nursing responsibilities: monitor renal function, force fluids, monitor hearing acuity. Draw blood for peak levels 1 hr. after IM and 30 min – 1 hr. after IV infusion, draw blood for trough just before next dose.

-Hemoglobin and hematocrit — can cause anemia; less common
-BUN and creatinine — CORRECT: nephrotoxic; will see proteinuria, oliguria, hematuria, thirst, increased BUN, decreased creatine clearance
-Platelet count and clotting time — do not usually change
-Sodium and potassium — hypokalemia infrequent problem

The common feature of all types of pneumonia is an inflammatory pulmonary response to the offending organism or agent. Although most types of pneumonia have a sudden onset, a few (such as anaerobic bacterial pneumonia and mycoplasmal pneumonia) have an insidious onset. Antibiotic therapy is the primary treatment for most types of pneumonia; however, the antibiotic must be specific for the causative agent, which may not be responsive to penicillin. A few types of pneumonia, such as viral pneumonia, aren’t treated with antibiotics. Although pneumonia usually causes an elevated WBC count, some types, such as mycoplasmal pneumonia, don’t.

Severe hypoxia after smoke inhalation typically is related to ARDS. The other choices aren’t typically associated with smoke inhalation.

When clients are on mechanical ventilation, the artificial airway impairs the gag and cough reflexes that help keep organisms out of the lower respiratory tract. The artificial airway also prevents the upper respiratory system from humidifying and heating air to enhance mucociliary clearance. Manipulations of the artificial airway sometimes allow secretions into the lower airways. Whit standard procedures the other choices wouldn’t be at high risk.

Client’s having the insertion of a central venous catheter are at risk for tension pneumothorax. Dyspnea, shortness of breath and chest pain are indications of this complication.

Fever, chills, hemoptysis, dyspnea, cough, and pleuric chest pain are the common symptoms of pneumonia, but elderly clients may first appear with only an altered mental status and dehydration due to a blunted immune response.

For a child aging 2months up to 5 years old can be classified to have severe pneumonia when he have any of the following danger signs:
• Not able to drink
• Convulsions
• Abnormally sleepy or difficult to wake
• Stridor in calm child or
• Severe under-nutrition

Hypoxia is the main breathing stimulus for a client with COPD. Excessive oxygen administration may lead to apnea by removing that stimulus. Anginal pain results from a reduced myocardial oxygen supply. A client with COPD may have anginal pain from generalized vasoconstriction secondary to hypoxia; however, administering oxygen at any concentration dilates blood vessels, easing anginal pain. Respiratory alkalosis results from alveolar hyperventilation, not excessive oxygen administration. In a client with COPD, high oxygen concentrations decrease the ventilatory drive, leading to respiratory acidosis, not alkalosis. High oxygen concentrations don’t cause metabolic acidosis.

With an extracellular fluid or plasma volume deficit, compensatory mechanisms stimulate the heart, causing an increase in heart rate.

An FO2 greater than 0.5 for as little as 16 to 24 hours can be toxic and can lead to decreased gas diffusion and surfactant activity. The ideal oxygen source is room air F IO 2 0.18 to 0.21.

Pentamidine can cause fatal hypoglycemia, so the low blood glucose level indicates a need for a change in therapy. The low blood pressure suggests that the IV infusion rate may need to be slowed. The other responses indicated need for independent nursing actions (such as obtaining a new IV site and encouraging oral intake) but are not associated with pentamidine infusion.

In IMCI, chest indrawing is used as the positive sign of dyspnea, indicating severe pneumonia.

This decrease in PaO2 indicates respiratory failure; it warrants immediate medical evaluation.

The client at highest risk for complications is the client with multiple sclerosis who is being treated with cortisone via the central line. The others are more stable. MRSA is methicillin-resistant staphylococcus aureus. Vancomycin is the drug of choice and is given at scheduled times to maintain blood levels of the drug.

Contact or Body Substance Isolation (BSI) involves the use of barrier protection (e.g. gloves, mask, gown, or protective eyewear as appropriate) whenever direct contact with any body fluid is expected. When determining the type of isolation to use, one must consider the mode of transmission. The hands of personnel continues to be the principal mode of transmission for methicillin resistant staphylococcus aureus (MRSA). Because the organism is limited to the sputum in this example, precautions are taken if contact with the patient”s sputum is expected. A private room and BSI, along with good hand washing techniques, are the best defense against the spread of MRSA pneumonia.

The rationale for administering leucovorin calcium to a client receiving Methotrexate is to reverse drug toxicity. Methotrexate is a medication that can cause toxic effects on the body, particularly in the bone marrow and gastrointestinal tract. Leucovorin calcium is a form of folic acid that helps to counteract the toxic effects of Methotrexate by providing the body with a source of folate. By administering leucovorin calcium, the drug toxicity caused by Methotrexate can be reversed, reducing the risk of side effects and improving the client's overall health.

The nurse uses the ulnar surface, or ball, of the hand to asses tactile fremitus, thrills, and vocal vibrations through the chest wall. The fingertips and finger pads best distinguish texture and shape. The dorsal surface best feels warmth.

The appropriate nursing diagnosis for a hospitalized client with bacterial pneumonia and shortness of breath would be "Risk for self-care deficit related to fatigue." This is because the client may experience difficulty performing activities of daily living due to the fatigue caused by the pneumonia and shortness of breath. The client may require assistance with self-care tasks such as bathing, dressing, and eating.

These clients have a potential for an inability to have voluntary and involuntary muscle movement or activity.Thus, active and passive range of motion exercises twice a day and every 4 hours incentive spirometer are inadequate with this problem in mind. Repositioning every 2 hours around the clock is not specific for prevention of complications associated with the lung.

Taking antiretroviral medications such as indinavir on a rigid time schedule is essential for effective treatment of HIV infection and to avoid development of drug resistant-strains of the virus. The other medications should also be given within the time frame indicated in the hospital policy (usually within 30 minutes of the scheduled time).

A child can be classified to have Pneumonia (not severe) if:
• the young infant is less than 2 months- 60 bpm or more
• if the child is 2 months up to less than 12 months- 50 bpm or more
• if the child is 12 months to 4 y/o- 40 bpm or more

Legionnaires’ disease accounts for 15% of community-acquired pneumonias. Streptococcal pneumonia demonstrates the highest occurrence in winter months.Mycoplasma pneumonia demonstrates the highest occurrence in fall and early winter.Viral pneumonia demonstrates the greatest incidence during winter months.