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Questions and Answers
What is a primary cause of obstructive atelectasis?
Which clinical manifestation is not typically associated with chronic atelectasis?
Which nursing intervention is essential for preventing atelectasis?
What diagnostic finding might indicate worsening atelectasis?
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Which of the following is a goal of atelectasis treatment?
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What patient position can help prevent atelectasis?
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Which of these conditions is a risk factor for developing atelectasis?
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What is the primary characteristic of pneumonia?
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Which of these nursing actions best aids in lung expansion for patients at risk for atelectasis?
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Which complication can arise from untreated acute atelectasis?
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What is the primary objective in the treatment of viral pneumonia?
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Which of the following is a common complication associated with pneumonia?
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What does a Mantoux test size of 5 mm indicate in high-risk individuals?
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Which of the following nursing diagnoses is appropriate for a patient with pneumonia?
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Which bacterium is the primary infectious agent responsible for pulmonary tuberculosis?
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What is the duration of treatment with anti-TB agents recommended for tuberculosis?
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What is a key risk factor for tuberculosis transmission?
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What is one of the primary focus areas in the nursing management of tuberculosis?
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In which of the following situations is the tuberculin skin test NOT significant?
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Which of these is NOT part of the supportive treatment for viral pneumonia?
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What is a common characteristic of Community-Acquired Pneumonia (CAP)?
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Which pathogen is commonly associated with Health Care-Associated Pneumonia (HCAP)?
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What sets Hospital-Acquired Pneumonia (HAP) apart from Community-Acquired Pneumonia (CAP)?
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Which factor contributes to the risk of Ventilator-Associated Pneumonia (VAP)?
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What can lead to pneumonia in an immunocompromised host?
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What is a common cause of aspiration pneumonia?
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Which risk factor is associated with penicillin-resistant pneumococci?
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What common diagnostic finding indicates pneumonia on a chest x-ray?
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What defines clinical stability in a hospitalized patient with pneumonia?
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What is a critical aspect of medical management for suspected Hospital-Acquired Pneumonia (HAP)?
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Study Notes
Management of Patients with Respiratory Disorders
- Patients at risk for atelectasis require nursing interventions for prevention and management.
- Pulmonary infections vary by causes, clinical manifestations, nursing management, complications, and prevention strategies.
- Nursing process is essential for care in pneumonia cases.
- Identification of patients at risk for pulmonary tuberculosis is crucial, along with prevention and management interventions.
- Nursing and medical management strategies are important for pleural effusion.
Atelectasis
- Can be acute or chronic; caused by either obstructive (e.g., foreign body, tumor) or nonobstructive factors.
- Contributing factors include altered breathing patterns, retained secretions, pain, prolonged supine positioning, and increased abdominal pressure.
- Clinical signs include dyspnea, cough, sputum production, tachycardia, tachypnea, pleural pain, and central cyanosis (acute).
- Chronic atelectasis may lead to pulmonary infection.
- Physical assessment can reveal increased work of breathing, hypoxemia, decreased breath sounds, and an O2 saturation below 90%.
- Prevention strategies include frequent turning, early mobilization, lung expansion techniques, and secretion management.
- Management goals focus on improving ventilation and secretion removal, utilizing practices like incentive spirometry, deep breathing, and patient education.
- If initial treatments are ineffective, consider PEEP, CPAP, bronchoscopy, or thoracentesis.
Pneumonia
- Defined as an inflammation of lung parenchyma caused by microorganisms (bacteria, fungi, viruses).
- Types include community-acquired pneumonia (CAP), healthcare-associated pneumonia (HCAP), hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP), and aspiration pneumonia.
- CAP commonly caused by S. pneumoniae in individuals under 60 without comorbidities and older adults with them.
- HCAP pathogens are often multidrug-resistant (MDR), requiring prompt antibiotic treatment.
- HAP develops 48 hours post-admission and is influenced by impaired defenses and exposure to bacteria.
- Common pathogens include Enterobacter species, E. coli, Klebsiella, and Pseudomonas aeruginosa.
- VAP occurs after 48 hours of mechanical ventilation; incidence increases with duration.
- Aspiration pneumonia results from entry of foreign substances into the airway and is generally bacterial.
Risk Factors and Prevention
- Risk factors for penicillin-resistant pneumococci include age over 65, alcoholism, recent antibiotic use, and immunosuppressive disorders.
- Prevention strategies include maintaining lung health and mitigating risk exposures.
Clinical Manifestations and Assessment
- Manifestations can vary by pneumonia type; common symptoms include fever, cough, and difficulty breathing.
- Assessment includes history of respiratory infections, physical examination, chest X-ray, blood cultures, and sputum examinations.
Medical Management
- Antibiotic therapy is essential, transitioning from IV to oral for hospitalized patients based on clinical stability.
- Criteria for clinical stability include controlled temperature, heart rate, respiratory rate, and oxygen saturation.
- Treatment of viral pneumonia is supportive with hydration, antipyretics, and oxygen therapy.
- Complications from pneumonia can include septic shock, respiratory failure, pleural effusion, and empyema.
Nursing Process for Pneumonia Patients
- Ineffective airway clearance due to secretions is a primary concern.
- Monitor for fatigue, risk of fluid volume deficit, and nutritional imbalances.
- Provide education on treatment and preventive measures.
Pulmonary Tuberculosis (TB)
- Primarily affects lung parenchyma; transmitted through airborne pathogens (Mycobacterium tuberculosis).
- Risk factors include prior TB exposure and immune-compromising conditions.
- Diagnostic assessments include tuberculin skin tests, chest X-rays, and sputum cultures.
- Positive skin test indications vary by induration size, with significant reactions suggesting prior exposure.
- Medical management involves a 6 to 12-month course of anti-TB agents; multidrug resistance (MDR) is a concern during treatment.
Nursing Management for TB
- Focus on promoting airway clearance, adherence to treatment, activity and nutrition, and preventing transmission.
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Description
This quiz focuses on the management of patients with chest and lower respiratory tract disorders as outlined in Chapter 23. Learn to identify at-risk patients for conditions like atelectasis and pulmonary infections while applying the nursing process for effective care. Enhance your understanding of nursing interventions, complications, and prevention strategies for respiratory issues.
