Management of Patients with Chest and Lower Respiratory Tract Disorders

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

Which of the following could be a cause of atelectasis?

Hyperventilation

Foreign body obstruction (correct)

Immediate postural changes

Excessive physical activity

What is a common clinical manifestation of acute atelectasis?

Peripheral edema

Chronic cough

Cyanosis (correct)

Jaundice

Which of the following nursing interventions is aimed at preventing atelectasis?

Early mobilization of patients (correct)

Maintaining patients in a supine position

Administering antibiotics proactively

Limiting fluid intake

Which diagnostic finding is typically associated with atelectasis?

O2 saturation less than 90% Signup and view all the answers

What is the primary goal of atelectasis management?

Improve ventilation and remove secretions Signup and view all the answers

Which treatment may be used if a patient with atelectasis is not responding to initial management?

Bronchoscopy or CPAP Signup and view all the answers

Pneumonia is primarily categorized by its inflammation of which part of the body?

Lung parenchyma Signup and view all the answers

What might be a complication of untreated chronic atelectasis?

Pulmonary infection Signup and view all the answers

Which of the following factors may contribute to nonobstructive atelectasis?

Prolonged supine positioning Signup and view all the answers

What is a key assessment finding in a patient with atelectasis?

Decreased breath sounds Signup and view all the answers

What is the primary focus of treatment for viral pneumonia?

Supportive care Signup and view all the answers

Which complication is associated with pneumonia?

Septic shock Signup and view all the answers

What is a primary infectious agent of pulmonary tuberculosis?

Mycobacterium tuberculosis Signup and view all the answers

In the treatment of tuberculosis, what is a common duration for administering anti-TB agents?

6 to 12 months Signup and view all the answers

During a tuberculin skin test, a significant reaction is indicated by what size of induration for at-risk individuals?

5 mm or greater Signup and view all the answers

Which of the following is a crucial nursing management approach for patients with pneumonia and tuberculosis?

Promoting airway clearance Signup and view all the answers

What does a positive skin test for tuberculosis indicate?

Previous TB infection or exposure Signup and view all the answers

What is a common route of transmission for pulmonary tuberculosis?

Airborne transmission Signup and view all the answers

What symptom is most likely associated with ineffective airway clearance in pneumonia patients?

Copious tracheobronchial secretions Signup and view all the answers

Which of the following is considered a risk factor for TB transmission in healthcare settings?

Inadequate ventilation Signup and view all the answers

What characterizes Health Care-associated pneumonia (HCAP)?

The pathogens causing HCAP are usually drug-resistant. Signup and view all the answers

What is a primary risk factor for developing Hospital-acquired pneumonia (HAP)?

Impaired host defenses. Signup and view all the answers

Which organism is commonly responsible for Community-acquired pneumonia (CAP) in the elderly with comorbidity?

S.pneumoniae Signup and view all the answers

What is a significant characteristic of Ventilator-associated pneumonia (VAP)?

It requires a minimum of 48 hours of mechanical ventilation to develop. Signup and view all the answers

Which of the following is a common cause of aspiration pneumonia?

Bacterial infection. Signup and view all the answers

Which diagnostic method is NOT typically included in the assessment for pneumonia?

CT scan. Signup and view all the answers

What defines clinical stability in a hospitalized pneumonia patient?

Respiratory rate less than or equal to 24 breaths/min. Signup and view all the answers

Which of the following is a risk factor for infection with penicillin-resistant pneumococci?

Recent antibiotic therapy. Signup and view all the answers

Which type of pneumonia is most common in patients receiving corticosteroid therapy?

Pneumonia in the immunocompromised host. Signup and view all the answers

Which statement is true regarding the pathophysiology of pneumonia?

Pneumonia can have varied clinical manifestations. Signup and view all the answers

Study Notes

Atelectasis

Atelectasis is the collapse of a lung or part of a lung.
Pathophysiology: Can be non-obstructive (not blocked) or obstructive (blocked). Obstructive can be from reabsorption of gas or compression. Causes include foreign objects, tumors, altered breathing, secretions, pain, airway problems, prolonged lying down, and increased abdominal pressure.
Clinical Manifestations: Increasing shortness of breath, coughing, sputum production. Acute atelectasis includes faster heartbeat and breathing, chest pain, and bluish skin discoloration. Chronic atelectasis can lead to lung infections.
Assessment and Diagnostic Findings: Increased breathing effort, low blood oxygen levels, decreased/abnormal lung sounds (crackles) in the affected area, and low oxygen saturation (less than 90%). X-rays are often used.
Prevention: Frequent position changes, early movement, strategies to expand the lungs, and strategies to manage secretions are all helpful. (Refer to Chart 23-1)
Management: Improve ventilation, remove secretions. Includes Incentive spirometry, coughing and deep breathing exercises, oral hygiene, patient and staff education, and getting out of bed several times daily.(Refer to Chart 23-2) If other methods fail, more aggressive measures like positive end-expiratory pressure (PEEP), continuous positive airway pressure (CPAP), bronchoscopy, intubation, or chest drainage may be necessary.

Pneumonia

Pneumonia is lung inflammation caused by various microorganisms (bacteria, mycobacteria, fungi, viruses).
Types: Community-acquired (CAP), health care-associated (HCAP), hospital-acquired (HAP), ventilator-associated (VAP), pneumonia in immunocompromised hosts, aspiration pneumonia.
Causative Organisms (Examples): Streptococcus pneumoniae (common in some types), Haemophilus influenzae, Mycoplasma pneumoniae, viruses (especially in children). HAP can be caused by various bacteria like Enterobacter, Escherichia coli, Klebsiella, Proteus, Serratia marcescens, Pseudomonas aeruginosa, Staphylococcus aureus, and Streptococcus pneumoniae.
Pneumonia in Immunosuppressed Hosts: Caused by weakened immune systems due to factors like corticosteroids, chemotherapy, malnutrition, broad-spectrum antibiotics, AIDS, genetic disorders, and prolonged mechanical ventilation.
Aspiration Pneumonia: Pulmonary consequences from substances entering the lower airways. Primarily a bacterial infection.
Risk Factors: Age, alcohol use, antibiotic use, immunosuppression, comorbidities, daycare exposure, long-term care facility residence, cardiopulmonary issues, recent antibiotic use, lung conditions, corticosteroid use, broad-spectrum antibiotics.
Clinical Manifestations: Vary depending on the type, organism, and underlying diseases, but could include fever, cough, difficulty breathing.
Assessment and Diagnostic Findings: Medical history, physical examination, chest X-rays, blood cultures, sputum analysis/examination (with proper preparation techniques).
Medical Management: Appropriate antibiotics (IV in severe cases, oral when improving), supportive care (hydration, antipyretics, inhalations, oxygen). HAP treatment may be broad-spectrum IV antibiotics initially, followed by culture-directed therapy after 72 hours.
Complications: Septic shock, respiratory failure, pleural effusion, and empyema.
Nursing Process (Pneumonia): Focuses on ineffective airway clearance, fatigue, fluid balance, nutrition, and knowledge deficits.

Pulmonary Tuberculosis

Primarily affects lung tissue.
Causative Organism: Mycobacterium tuberculosis.
Transmission: Airborne.
Risk Factors: (Refer to Chart 23-7)
Clinical Manifestations: Vary, but could include cough, chest pain, fever, fatigue.
Assessment and Diagnostic Findings: Positive skin test/blood test/sputum culture, complete history, physical assessment (including diminished lung sounds and crackles), tuberculin skin test, chest X-ray, drug susceptibility testing if needed.
Tuberculin Skin Test (Mantoux): Using purified protein derivative (PPD) injected under the skin, with size of induration determining significance (0-4mm=not significant, 5mm=possible risk, 10mm=significant).
Medical Management: Anti-TB medications for 6-12 months. MDR (multi-drug resistant) tuberculosis requires specialized treatment. Prophylactic Isoniazid (INH) for high-risk individuals for 6-12 months.
Nursing Management: Promoting airway clearance, treatment adherence, activity, nutrition, and preventing transmission. (Refer to Charts 23-7 and 23-8)

Pleural Effusion

Note: This chapter covers pleural effusion in the context of broader respiratory care. The details of treatment are not fully outlined.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz explores the critical aspects of atelectasis, including its pathophysiology, clinical manifestations, assessment techniques, and prevention strategies. Understand how atelectasis affects lung function and learn the measures to avoid it. Test your knowledge on key concepts related to this pulmonary condition.