Podcast
Questions and Answers
Which of the following is the most common cause of death from infectious diseases in the U.S.?
Which of the following is the most common cause of death from infectious diseases in the U.S.?
A patient is admitted to the hospital with severe pneumonia. The onset of symptoms occurred 72 hours after admission. This is most indicative of:
A patient is admitted to the hospital with severe pneumonia. The onset of symptoms occurred 72 hours after admission. This is most indicative of:
Which of the following is a common cause of pneumonia in older children and adults, which is spread by respiratory droplets causing earache?
Which of the following is a common cause of pneumonia in older children and adults, which is spread by respiratory droplets causing earache?
Which type of pneumonia is most commonly seen in infants and children, and in immunocompromised adults, with cytomegalovirus being a common cause?
Which type of pneumonia is most commonly seen in infants and children, and in immunocompromised adults, with cytomegalovirus being a common cause?
Signup and view all the answers
Which of the following is most likely to be associated with pneumonia in debilitated patients with altered mental status, and who have had prolonged intubation or tracheostomy?
Which of the following is most likely to be associated with pneumonia in debilitated patients with altered mental status, and who have had prolonged intubation or tracheostomy?
Signup and view all the answers
Which of the following is NOT typically assessed during a physical assessment of the respiratory system?
Which of the following is NOT typically assessed during a physical assessment of the respiratory system?
Signup and view all the answers
A prolonged expiratory phase is MOST associated with what aspect of respiratory assessment?
A prolonged expiratory phase is MOST associated with what aspect of respiratory assessment?
Signup and view all the answers
Which of the following is primarily used to evaluate the effectiveness of gas exchange in the lungs?
Which of the following is primarily used to evaluate the effectiveness of gas exchange in the lungs?
Signup and view all the answers
Which of the following would be classified as an 'endoscopic study' of the respiratory system?
Which of the following would be classified as an 'endoscopic study' of the respiratory system?
Signup and view all the answers
Which of the following is a primary cause of atelectasis?
Which of the following is a primary cause of atelectasis?
Signup and view all the answers
Which patient is at MOST risk for developing atelectasis?
Which patient is at MOST risk for developing atelectasis?
Signup and view all the answers
Which symptom is more closely associated with acute tracheobronchitis than with atelectasis?
Which symptom is more closely associated with acute tracheobronchitis than with atelectasis?
Signup and view all the answers
What nursing intervention is MOST important for a patient suffering from acute tracheobronchitis?
What nursing intervention is MOST important for a patient suffering from acute tracheobronchitis?
Signup and view all the answers
Which of the following is a primary nursing intervention for a patient with a respiratory disorder?
Which of the following is a primary nursing intervention for a patient with a respiratory disorder?
Signup and view all the answers
A patient with a respiratory disorder is experiencing ineffective airway clearance. Which nursing diagnosis is most directly related to this?
A patient with a respiratory disorder is experiencing ineffective airway clearance. Which nursing diagnosis is most directly related to this?
Signup and view all the answers
What is the primary mode of transmission for pulmonary tuberculosis?
What is the primary mode of transmission for pulmonary tuberculosis?
Signup and view all the answers
Which of the following is a typical clinical manifestation of pulmonary tuberculosis?
Which of the following is a typical clinical manifestation of pulmonary tuberculosis?
Signup and view all the answers
A Mantoux PPD test result is considered positive and significant in a patient with normal immunity if the induration is:
A Mantoux PPD test result is considered positive and significant in a patient with normal immunity if the induration is:
Signup and view all the answers
Which of the following is NOT a typical characteristic of Klebsiella-related pneumonia?
Which of the following is NOT a typical characteristic of Klebsiella-related pneumonia?
Signup and view all the answers
What does a positive Mantoux PPD test indicate?
What does a positive Mantoux PPD test indicate?
Signup and view all the answers
A patient with a history of long-term steroid use and nutritional depletion is at an increased risk for which type of pneumonia?
A patient with a history of long-term steroid use and nutritional depletion is at an increased risk for which type of pneumonia?
Signup and view all the answers
Which of the following best describes the primary mechanism of aspiration pneumonia?
Which of the following best describes the primary mechanism of aspiration pneumonia?
Signup and view all the answers
What does the QuantiFERON-TB Gold test indicate?
What does the QuantiFERON-TB Gold test indicate?
Signup and view all the answers
Which of the following is a risk factor associated with the development of tuberculosis?
Which of the following is a risk factor associated with the development of tuberculosis?
Signup and view all the answers
Which of the following is NOT a common risk factor for developing pneumonia?
Which of the following is NOT a common risk factor for developing pneumonia?
Signup and view all the answers
What is one of the primary clinical manifestations of pneumonia as it relates to the breathing pattern?
What is one of the primary clinical manifestations of pneumonia as it relates to the breathing pattern?
Signup and view all the answers
What is often the initial diagnostic step to determine which antibiotic is needed for pneumonia?
What is often the initial diagnostic step to determine which antibiotic is needed for pneumonia?
Signup and view all the answers
Besides antibiotic resistance patterns, what is another important consideration for antibiotic selection in pneumonia?
Besides antibiotic resistance patterns, what is another important consideration for antibiotic selection in pneumonia?
Signup and view all the answers
Which vaccine is specifically recommended for pneumonia prevention in certain at-risk populations?
Which vaccine is specifically recommended for pneumonia prevention in certain at-risk populations?
Signup and view all the answers
A patient's sputum sample is being tested for tuberculosis. When is the ideal time to collect the sample?
A patient's sputum sample is being tested for tuberculosis. When is the ideal time to collect the sample?
Signup and view all the answers
Which of the following is NOT typically used to classify TB?
Which of the following is NOT typically used to classify TB?
Signup and view all the answers
A patient is classified as having 'latent TB infection, no disease'. Which TB classification category does this belong to?
A patient is classified as having 'latent TB infection, no disease'. Which TB classification category does this belong to?
Signup and view all the answers
How long is the typical duration for the initial treatment phase with multiple medications for TB?
How long is the typical duration for the initial treatment phase with multiple medications for TB?
Signup and view all the answers
What vitamin is typically administered with isoniazid (INH) to prevent peripheral neuropathy?
What vitamin is typically administered with isoniazid (INH) to prevent peripheral neuropathy?
Signup and view all the answers
When is a patient with TB considered non-infectious after starting continuous medication therapy?
When is a patient with TB considered non-infectious after starting continuous medication therapy?
Signup and view all the answers
Which of the following precautions are not required for airborne isolation of a patient with active TB?
Which of the following precautions are not required for airborne isolation of a patient with active TB?
Signup and view all the answers
Which nursing management action is NOT a priority for a patient with TB?
Which nursing management action is NOT a priority for a patient with TB?
Signup and view all the answers
Study Notes
Assessment of the Respiratory System
- Health History: Includes major signs and symptoms related to respiratory status, how these signs/symptoms affect daily activities, work, and family life; risk factors; and medical history.
Respiratory System Anatomy
- Upper Respiratory Tract: Includes nasal cavity, pharynx, and larynx.
- Lower Respiratory Tract: Includes trachea, primary bronchi, and lungs.
Assessment of the Respiratory System - Physical Assessment
- General Appearance: Focuses on mental status.
- Upper Respiratory System: Assessment of this system.
- Lower Respiratory System (Thorax): Includes chest patterns (e.g., prolonged expiratory phase), respiratory rates, and breath sounds. (Table 20-6, p.481)
Diagnostic Evaluation of the Respiratory System
- Lab & Diagnostic Testing: Includes arterial blood gases (ABGs), pulse oximetry, pulmonary function tests (PFTs), throat cultures, sputum analysis, complete blood count (CBC), and various imaging studies (e.g., chest X-ray (CXR), computed tomography (CT) scan, magnetic resonance imaging (MRI), and lung scans).
- Endoscopic Studies: Includes bronchoscopy, thoracoscopy, and thoracentesis.
- Biopsy: A procedure to remove tissue samples for analysis.
Nursing Interventions
-
Airway Management: Includes oxygen therapy (different methods), artificial airways, and tracheal care.
- Various oxygen delivery methods are mentioned (simple face mask, partial rebreather mask, non-rebreather mask, venturi mask, nasal cannulae).
- Goals of oxygen therapy. Correct hypoxemia by raising alveolar and blood oxygen levels; ease of measurement; decrease symptoms of hypoxemia (e.g., dyspnea/work of breathing, improve mental function).
Disorders of the Respiratory System - Atelectasis
- Definition: Collapse or closure of alveoli due to reduced alveolar ventilation.
- Causes: Excess secretions, abnormal breathing patterns, pain, airway issues, prolonged supine position, and musculoskeletal/neurological disorders.
- Risk Factors: Post-operative patients, immobilized individuals, those with impaired coughing.
- Common Causes: Hypoventilation, compression, airway obstruction, and adhesions.
Disorders of the Respiratory System - Signs & Symptoms & Diagnostic Testing
- Signs and Symptoms: Includes insidious onset, dyspnea, cough, sputum production, tachycardia, tachypnea, and pleural pain. Signs can also include anxiety (decreased or absence of) or absent breath sounds.
- Diagnostic Testing: Mentioned in the context of prevention (Chart 23-1)
- Nursing Management: Improve ventilation, remove secretions.
Disorders of the Respiratory System - Treatment for Atelectasis
- Treatment: Includes coughing and deep breathing exercises, analgesia (pain relief), early ambulation, incentive spirometry, intermittent positive pressure breathing, oxygen therapy, chest percussion, postural drainage, bronchodilators (e.g., Proventil), antibiotics, and mucolytic agents (e.g., Mucomyst). Chest tubes may also be used.
Disorders of the Respiratory System - Acute Tracheobronchitis
- Definition: Inflammation of the tracheal and bronchial tree mucous membranes (secondary to upper respiratory infection).
- Symptoms: Cough, fever, chills, night sweats, headache, weakness, and shortness of breath (SOB), noisy respirations.
Disorders of the Respiratory System - Medical Management
- Medications:
- Nursing Management: Encourage fluid intake, avoid overexertion, encourage coughing.
Disorders of the Respiratory System - Acute Bronchitis
- Cause: Bacterial or fungal infection; chemical irritation.
- Diagnostics: Sputum cultures, Chest films.
- Signs/Symptoms: Initial non-productive cough, fever, malaise; later blood-streaked sputum, coughing attacks, and inspiratory crackles.
- Treatment: Antipyretics, expectorants, antitussives, humidifiers, and broad-spectrum antibiotics.
Disorders of the Respiratory System - Acute Tracheobronchitis - Nursing Care
- Management: Antibiotic treatment, expectorants, deep suctioning, and ventilation support.
- Nursing Care: Increasing fluid intake, breathing and coughing exercises, encourage rest, education related to medications.
Disorders of the Respiratory System - Pneumonia
- Definition: Inflammation of the lungs commonly secondary to infection or inhaled toxins (e.g., aspiration).
- Cause: Inflammatory reaction in alveoli interfering with gas exchange, potentially occluding bronchi or alveoli.
- Pneumonia Types: Different Types (Community-acquired; Hospital-acquired) described.
Disorders of the Respiratory System - Pneumonia - Types
- Community-acquired: Pneumococcal (high fever, sputum); Mycoplasma (older children/adults, spread by droplets).
- Community-acquired (contd.): H. Influenza (elderly, comorbidities; cough, low-grade temp); Viral Pneumonia (infants/children, immunocompromised adults).
- Hospital-acquired: Onset of symptoms typically more than 48 hours after admission; often associated with endotracheal intubation and mechanical ventilation. Common organisms: Klebsiella, Pseudomonas aeruginosa, MRSA
- Hospital-acquired (contd): Pseudomonas pneumonia, Staphylococcal pneumonia, characterized by destruction of lung structures and alveolar walls (consolidation).
- Pneumonia in immunocompromised host - -PCP (Pneumocystis jirovecii pneumonia), caused by use of steroids, chemotherapy, nutritional depletion, etc. (similar organisms as CAP and HAP). Aspiration Pneumonia (aspiration of bacteria in the upper airway or other substances in the lungs leading to bacterial growth).
- Pathophysiology (Aspiration Pneumonia): Occurs due to normal flora (or introduced substances) in the upper airway and lungs. Affects ventilation and diffusion.
Disorders of the Respiratory System - Risk Factors
- Risk Factors: Residence in long-term care facilities, compromised immune defenses, and underlying diseases.
Disorders of the Respiratory System - Clinical Manifestations
- Clinical Manifestations: Symptoms vary depending on type, organism, and presence of underlying diseases. Assessment; includes dyspnea, tachypnea, fever, sputum, chest pain, WBC, mental status changes, abnormalities in breath sounds (e.g., crackles, rhonchi, rales). Certain types of pneumonia may present with a variety of symptoms.
Disorders of the Respiratory System - Tuberculosis (TB)
- Cause: Communicable infection caused by Mycobacterium tuberculosis.
- WHO Estimates: TB is the cause of death for 11% of all AIDS patients.
- TB Classification: The infection exists in stages (latent and disease), and is classified differently (class 0-5).
- Medical management (TB): Anti-tuberculosis agents for 6-12 months with prolonged treatment to prevent relapse. Treatment is in stages.
- Nursing Management (TB): Airway clearance, adherence to the treatment regimen, activity and nutrition, hygiene, and handwashing education.
Disorders of the Respiratory System - Diagnostic Testing (Pulmonary Tuberculosis)
- Diagnostic Testing for TB includes Mantoux PPD test (exposure indicator), BCG vaccine response, and CXR. The QuantiFERON-TB Gold Test helps determine TB infection but not the stage of disease.
- Sputum-AFB & culture: Used to diagnose TB; takes 3+ weeks to get results from the lab. Helps classify the stage of TB (classes 0-5).
Disorders of the Respiratory System - Nursing Management
- Interventions: Airway clearance, adherence to treatment, activity, nutrition, and education on hygiene and living conditions.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
Test your knowledge on pneumonia causes, symptoms, and assessment techniques. This quiz covers common pathogens, clinical indicators, and evaluation methods in respiratory medicine. Perfect for medical students and healthcare professionals!
