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Questions and Answers
What is the primary causative agent of Community-Acquired Pneumonia (CAP)?
What is the primary method of transmission for Pulmonary Tuberculosis (PTB)?
Which of the following medications is NOT used as anti-TB treatment for PTB?
Which clinical manifestation is typically an early sign of Acute Tracheobronchitis?
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What is a recommended practice while taking anti-TB medications for better absorption?
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What type of pneumonia occurs in patients ≥ 48 hours after being intubated?
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How long does it typically take for a person with PTB to no longer be contagious after starting treatment?
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Which nursing management strategy is advised to help thin viscous secretions in Acute Tracheobronchitis?
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What condition allows air to enter the pleural cavity, resulting in pneumothorax?
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What risk factor is linked to an increased chance of developing pneumonia?
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What is a late clinical manifestation of Acute Tracheobronchitis?
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What is a common mode of transmission for Community-Acquired Pneumonia?
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In severe cases of Acute Tracheobronchitis, which type of sputum might be observed?
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Which virus is the most common cause of pneumonia in immunocompromised adults?
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What treatment method is included in the medical management of Acute Tracheobronchitis?
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What is a common clinical manifestation of a large pneumothorax?
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Which type of pneumothorax is caused by a rupture of small blebs at the lung apex?
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What is a potential cause of iatrogenic pneumothorax?
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Which clinical feature is NOT associated with tension pneumothorax?
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Which of the following is a risk factor for spontaneous pneumothorax?
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What immediate action is required in the emergency management of tension pneumothorax?
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Which symptom is most likely to indicate a large pneumothorax?
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What distinguishes tension pneumothorax from other types?
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What is a common clinical manifestation of Community-Acquired Pneumonia?
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What diagnostic tool is primarily used for identifying Pulmonary Tuberculosis?
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Which of the following factors contributes to the risk of aspiration pneumonia?
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What is an essential nursing management intervention for patients with Community-Acquired Pneumonia?
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Which of the following is a common causative agent of Pulmonary Tuberculosis?
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What type of lung condition is indicated by pulmonary consolidation?
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Which of the following is NOT a recommended preventive measure for pneumonia?
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What is an expected finding on a chest X-ray for a patient with pneumonia?
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What is a key characteristic of tuberculosis transmission?
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Which of the following statements about the management of viral pneumonia is true?
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Study Notes
Lower Respiratory Tract Disorders
- Acute Tracheobronchitis is an acute inflammation of the trachea and bronchial tree.
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Early signs of acute tracheobronchitis include:
- Dry, irritating cough with scant mucoid sputum
- Sternal soreness
- Fever or chills
- Night sweats
- Headache
- Generalized malaise
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Late signs of acute tracheobronchitis include:
- Shortness of breath (SOB)
- Stridor and Wheeze (obstructed airway)
- Purulent sputum
- Blood-streaked sputum in severe cases
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Medical Management of acute tracheobronchitis includes:
- Antibiotic treatment (based on culture and sensitivity)
- Analgesics
- Suctioning
- Bronchoscopy
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Nursing Management of acute tracheobronchitis includes:
- Encouraging increased oral fluid intake to thin viscous secretions
- Encouraging coughing exercises
- Emphasizing completion of the full course of antibiotics
- Steam inhalation to relieve laryngeal and tracheal irritation
- Applying moist heat to the chest to relieve soreness and pain
- Advising the patient to rest between activities
Pneumonia
- Pneumonia is an inflammation of the lung parenchyma.
- Community acquired pneumonia (CAP) occurs at the community level or within 48 hours of admission.
- Healthcare associated pneumonia (HCAP) occurs in non-hospitalized patients with extensive healthcare contact.
- Hospital acquired pneumonia (HAP) occurs at least 48 hours after admission to the hospital.
- Ventilator acquired pneumonia (VAP) occurs at least 48 hours after intubation.
Community Acquired Pneumonia (CAP)
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Causative agents of CAP include:
- Streptococcus pneumoniae is the most common cause.
- Haemophilus influenzae frequently affects older adults and those with comorbidities.
- Mycoplasma pneumoniae causes Mycoplasma pneumonia.
- Viruses such as Cytomegalovirus, Herpes simplex virus, Adenovirus, and Respiratory syncytial virus can cause CAP in immunocompromised adults.
- Transmission of CAP occurs through droplet spread.
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Risk factors for CAP include:
- Immunosuppression
- Smoking
- Prolong immobility and shallow breathing patterns
- Depressed cough reflex
- Aspiration
- Presence of Nasogastric tube, Orogastric tube, or endotracheal tube
- Supine positioning in patients unable to protect their airway
- Antibiotic therapy
- Alcohol intoxication
- Advanced age
- Respiratory therapy with improperly cleaned equipment
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Clinical manifestations of CAP include:
- Sudden onset of chills
- Rapidly rising fever (38.5-40.5 degrees C)
- Pleuritic chest pain
- Tachypnea (respiratory rate of 25-45 breaths per minute)
- Shortness of breath
- Use of accessory muscles
- Cough
- Sputum production
- Orthopnea (shortness of breath when reclining or supine)
- Poor appetite
- Crackles
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Diagnostics for CAP include:
- Chest X-ray (CXR) to reveal areas of consolidation/infiltration.
- Complete blood count (CBC) to detect leukocytosis (elevated white blood cell count).
- Prevention of CAP includes receiving the Pneumococcal conjugate vaccine (PCV13).
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Medical Management of CAP includes:
- Hydration
- Antipyretics
- Warm, moist inhalation
- Supplemental oxygen if hypoxemia is present
- If viral pneumonia, the same management as bacterial pneumonia applies, except for antibiotics.
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Nursing Management of CAP includes:
- Encouraging increased oral fluid intake (2-3 L/day) unless contraindicated
- Facilitating chest physiotherapy as ordered
- Instructing the patient to assume a comfortable position to promote rest and breathing, such as semi-Fowler’s position.
- Instructing the patient to avoid overexertion
- Advising small, frequent meals
- Encouraging intake of electrolyte fluids such as Gatorade or Pocari Sweat.
Pulmonary Tuberculosis (PTB)
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Pulmonary tuberculosis is an infectious disease that primarily affects the lung parenchyma.
- Approximately 1 million Filipinos have active TB.
- More than 70 Filipinos die of PTB each day.
- Causative agent of PTB is Mycobacterium tuberculosis, an acid-fast aerobic rod.
- Transmission is through airborne droplet nuclei.
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Clinical manifestations of PTB include:
- Cardinal signs:
- Cough
- Unexplained fever
- Unexplained weight loss
- Night sweats
- Other signs:
- Sputum production
- Hemoptysis
- Cardinal signs:
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Diagnostics for PTB include:
- Chest X-ray (CXR) - PA view as a screening test for presumptive cases.
- Sputum GenXpert as the primary diagnostic test for PTB.
- Direct Sputum Smear Microscopy (DSSM) as an alternative diagnostic tool if GenXpert is not available.
- Mantoux Test as an adjuvant test for children when there is doubt in making a clinical diagnosis.
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Medical Management of PTB includes:
- Anti-tuberculosis medications (primary treatment).
- Adherence to the medication regimen is crucial.
- Anti-TB medications include:
- Rifampicin
- Isoniazid
- Pyrazinamide
- Ethambutol
- The treatment regimen is divided into intensive and maintenance phases.
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Nursing Management of PTB focuses on health education about:
- Transmission
- Treatment
- Precautions
Pneumothorax
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A pneumothorax occurs when air enters the pleural cavity. This can be caused by an open pneumothorax resulting from a disruption of the chest wall that allows outside air to enter, or a spontaneous pneumothorax resulting from a rupture of small blebs in the lung.
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Clinical manifestations of small pneumothorax include:
- Mild tachycardia
- Dyspnea
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Clinical manifestations of large pneumothorax include:
- Shallow, rapid respirations
- Dyspnea
- Air hunger
- Desaturation
- Absent breath sounds on affected area
- Air/fluid seen on CXR
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Types of pneumothorax include:
-
Spontaneous pneumothorax occurs due to the rupture of small blebs (air-filled blisters) located at the apex of the lungs. Risk factors include:
- Smoking
- Tall and thin stature
- Male gender
- Family history
- History of spontaneous pneumothorax
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Iatrogenic pneumothorax occurs due to laceration or puncture of the lung during medical procedures. Causes include:
- Transthoracic needle aspiration
- Thoracentesis
- Pleural biopsy
- Tearing during nasogastric tube insertion
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Traumatic pneumothorax can occur from either penetrating (open) or non-penetrating (closed) chest trauma.
- Penetrating chest wound (a.k.a. sucking chest wound) air enters the pleural space through the chest wall during inspiration.
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Tension pneumothorax occurs when air enters the pleural space but cannot escape. Causes include:
- Mechanical ventilation
- CPR
- Clamped/occluded chest tubes.
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Spontaneous pneumothorax occurs due to the rupture of small blebs (air-filled blisters) located at the apex of the lungs. Risk factors include:
-
Clinical manifestations of tension pneumothorax include:
- Dyspnea
- Marked tachycardia
- Tracheal deviation to unaffected side
- Decreased or absent breath sounds
- Neck vein distention
- Cyanosis
- Profuse diaphoresis
- Emergency management for tension pneumothorax includes needle decompression, as this requires a sterile needle to puncture the chest wall on the affected side.
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Description
Test your knowledge on acute tracheobronchitis and its management. The quiz covers early and late signs, medical and nursing management strategies, and critical nursing practices for patient care. Perfect for nursing students and healthcare professionals.
