Nursing Questions on Pleurisy and Pneumonia

Respiratory Disorders and Conditions (Part 2)

• Lower Airway Disorders: Acute bronchitis, inflammation of the bronchial tree, usually triggered by infection or inhaled irritants.
• Clinical Manifestations: Productive cough, wheezing, shortness of breath, chest pain/tightness, low-grade fever, headache.
• Diagnosis: Chest X-ray, sputum cultures.
• Management: Bronchodilators, antibiotics, antipyretics (fever reducers) and analgesics (pain relievers), fluids (avoiding milk).
• Important Considerations: Rest, encouraging cough and deep breathing, smoking cessation (paralyzes cilia, hindering secretion removal).
• Legionnaires' Disease: Caused by Legionella pneumophila, thrives in water reservoirs (e.g., AC units, hot tubs). Life-threatening pneumonia, leading to respiratory failure, renal failure, septic shock, and potentially death. Incubation period: 2-14 days.

Severe Acute Respiratory Syndrome (SARS)

• Cause: Coronavirus (not COVID).
• Transmission: Close contact, airborne droplets.
• Symptoms: Elevated temperature, headache, muscle aches, mild respiratory symptoms (e.g., dry cough, shortness of breath).

Tuberculosis (TB)

• Cause: Mycobacterium tuberculosis infection.
• Stages: Active (contagious), inactive (dormant), latent.
• Symptoms: Fever, chills, night sweats, weight loss, weakness, productive cough, clubbing of fingers/toes, swollen or tender lymph nodes in the neck.
• Diagnostic Tests: Tuberculin skin test, chest X-ray, acid-fast smear, sputum cultures.
• Management: Antibiotic treatment (e.g., Isoniazid, Rifampin) for a prolonged duration (e.g., six to nine months). Airborne precautions until contagious status is confirmed

Pneumonia

• Cause: Bacterial, viral, fungal, or parasitic infections; aspiration, or accumulation of fluid in the interstitial tissue
• Respiratory symptoms: Productive coughing, pain, fever, chills, elevated temperature, shortness of breath, crackles.
• Sputum Appearance: Rust (Streptococcus pneumonia), salmon (Staphylococcus), yellow or green (viral). Nonproductive sputum suggests other causes, such as Mycoplasma.
• Diagnosis: Chest X-rays, blood cultures, sputum analysis, and other tests.
• Management: Antibiotics (targeted towards bacterial causes), analgesics, fluids, expectorants.

Pleural Effusion (Pleura)

• Cause: Fluid accumulation in the pleural space surrounding the lungs, often a complication.
• Symptoms: Difficulty breathing, chest pain (inspiratory or painful), reduced oxygen levels, diminished sounds or crackles, possibly fever.
• Diagnostics: Chest X-rays to detect plural fluid.
• Management: Thoracentesis (fluid removal).
• Other complications: Infection (e.g., empyema).
• Prevention: Treatment of underlying causes

Acute Respiratory Distress Syndrome (ARDS)

• Cause: Direct or indirect pulmonary injuries, including pneumonia, trauma, aspiration, near drowning.
• Symptoms: Difficulty breathing; reduced oxygen levels; chest pain, abnormal lung sounds.
• Diagnosis: Chest X-rays, blood tests, and other tests.
• Management: Respiratory support measures including oxygen, ventilators, and medication to treat underlying and contributing factors.

Pulmonary Embolism (PE)

• Cause: Blood clots (DVT) travelling to the pulmonary arteries
• Symptoms: Chest pain, shortness of breath, sudden onset, anxiety, clammy or bluish skin.
• Diagnostics: Ventilation-perfusion scan (V/Q scan), CT angiogram and other diagnostic and medical tests.
• Management: Anticoagulants, supportive care.

Asthma

• Cause: Narrowing of airways due to various factors, including allergens, respiratory infections, stress, and exercise.
• Symptoms: Wheezing, cough (exploratory or inspiratory), difficulty breathing, tightness in the chest, decreased breath sounds potentially.
• Diagnostics: Pulmonary function tests (PFTs), blood tests for eosinophils.
• Management: Bronchodilators, inhaled corticosteroids. Prevention of triggers.

Chronic Obstructive Pulmonary Disease (COPD)

• Cause: Emphysema, chronic bronchitis. Smoking is a dominant factor in most COPD cases.
• Symptoms: Dyspnea (shortness of breath), cough (chronic), excessive mucus production, barrel chest, clubbing of fingers, rapid breathing (to compensate); reduced breathing volume.
• Diagnostics: Pulmonary function tests (PFTs).
• Management: Oxygen therapy, bronchodilators, mucolytics, pulmonary rehabilitation, pneumonia vaccine. Avoiding triggers.

Lung Cancer

• Types: Small cell, non-small cell (squamous, adenocarcinoma, large cell).
• Symptoms: Persistent cough, shortness of breath, chest pain, unexplained weight loss, fatigue.
• Diagnostics: Chest X-ray, CT scan, bronchoscopy, biopsies.
• Management: Surgery, chemotherapy, radiation therapy.