Pneumonia and Tuberculosis

Pneumonia & Tuberculosis

• Influenza affects both upper and lower respiratory functions
• Common influenza types are A and B
• Symptoms of influenza include headache, fever, chills, muscle pain, cough, and sore throat which lasts about 7 days
• Pneumonia is a possible complication of influenza
• Pneumonia is an inflammation of the lung parenchyma by various organisms
• Pneumonia leads to fluid in the alveoli and excess fluid in the lungs, affecting ventilation and diffusion
• Pneumonia is considered an opportunistic infection
• Pneumonia can be caused by infectious and non-infectious factors
• Types of pneumonia include lower (lobar) pneumonia and bronchopneumonia (in bronchioles), more common than lobar pneumonia
• Tuberculosis (TB) is an infectious disease mainly affecting the lung parenchyma and starts in the lungs
• Early stages of TB are asymptomatic
• Diagnosing TB involves TB skin tests
• Preventative measures involve wearing an N-95 mask
• TB is caused by mycobacterium tuberculosis bacilli, a gram-positive acid-fast bacillus spread via airborne droplets
• TB primarily affects the lungs but can spread to the lymph, kidney, adrenal glands, bone/joint, meningeal, and peritoneal sites
• Primary TB infection results from person-to-person transmission through inhalation of infected, aerosolized sputum from coughing or sneezing
• With a normal immune system, immunity usually develops within a few weeks, and 90% won't develop clinical or radiologic evidence of TB
• Failure of the immune system to control a primary TB infection results in necrosis and cavitation of lung tissue, thus causing severe destruction without treatment
• Reactivated TB occurs when re-exposed, which renews dormant tubercle bacilli; 60% of new infections are caused by reactivation
• Risk factors for TB: include low-grade fever, productive cough, hemoptysis (coughing up blood), night sweats, weight loss not related to dieting, and fatigue
• Assessment and diagnosis of TB involve acid-fast bacillus smear, TB Gold test, T-spot TB test, sputum culture, and chest X-ray to identify lung damage, as well as TB skin tests

Influenza: Patient Teaching

• The goal is to relieve symptoms and treat early with antibiotics if present
• Antiviral agents should be considered within 48 hours
• For type A influenza: use Rimantadine or Amantadine
• For Type A or B influenza: use Oseltamivir, Zanamivir, or Ribavirin
• Annual flu vaccine is recommended, especially for high-risk groups
• Hand hygiene, covering coughs/sneezes, and avoiding sick individuals are important
• Rest, hydration, and symptomatic treatment with OTC medications can help with symptoms
• Seek medical attention if difficulty breathing, or persistent fever, or worsening symptoms arise

Pneumonia: Risk Factors, Patient Teaching, and Vulnerable Populations

• Risk factors include conditions that produce mucus or bronchial obstruction, interfering with normal lung drainage
• Conditions include cancer, cigarette smoking, and chronic obstructive pulmonary disease (COPD)
• Other Risk factors include smoking, prolonged immobility, and shallow breathing patterns which alter pulmonary defense mechanisms
• Other Risk factors also include being elderly, which means they get very sick and hypoxic and can become confused
• Other risk factors include COPD, immunosuppression (organ transplant, chemo patient), heart disease, renal failure, and diabetes
• Supine positioning in patients who can't protect their airway that may result aspiration pneumonia after inserting NG tube
• Inpatient care: antibiotic therapy can lead to the oropharynx being colonized by gram-negative bacteria
• During care, general anesthetics, sedatives, or opioid preparations which promote respiratory depression, cause shallow breathing and pooling of bronchial secretions, leading to pneumonia
• Patient teaching: should include taking medications on time, knowing how to continue care at home by being careful around smokers or sick individuals, and resting
• Patient teaching: take more than 2-3 L of fluids to get secretions out, take, and finish all antibiotics, and call if shortness of breath comes on
• Patient teaching: should also include smoking cessation, flu vaccines, using an incentive spirometer, and reposition frequently to prevent aspiration
• Patient teaching: perform suctioning and chest physiotherapy as indicated, maintain oral hygiene, check the placement of tubes, elevate the head of the bed to 30 degrees, and use strict hand hygiene and gloves
• Vulnerable populations, in regards to pneumonia: elderly patients (living in nursing homes or retirement community), immunocompromised, post-surgical patients, and people with lung disease
• Management of pneumonia: include bacterial treatments for oxygen therapy, antibiotics, and supportive measures like elevating the head of bed, while also teaching to cough and taking fluids
• Management of pneumonia: viral treatments include oxygen, antivirals, and supportive measures
• Bronchodilators, mucolytics, and oxygen may be used as treatment
• Care should also include increased fluid intake and preventative care like pneumococcal vaccine

Pneumonia in Older Adults: Symptoms

• Classic symptoms include confusion (an infection may be present elsewhere), fatigue, weakness, decreased appetite, anorexia, worsening of chronic conditions and rapid respirations
• Other Classic Symptoms include: acute onset of fever, chills, cough, purulent or rust-colored sputum, pleuritic chest pain, discomfort when laying down, bronchial breath sounds (crackles, rales, "pops" which may come from fluid), and pleural effusion
• Atypical Presentation: gradual onset symptoms, headache and sore throat, aches, fatigue, nausea, vomiting, diarrhea, dry cough, and rales; commonly seen with viral and mycoplasma (bacterial) pneumonia

Tuberculosis: Risk Factors and Patient Teaching

• Risk factors for Tuberculosis include constant and frequent contact with infected individuals, crowded living conditions, impoverished conditions, lower socioeconomic status etc
• Other risk factors: immunocompromised, institutionalized (prisons, nursing homes homeless shelters), substance abuse, immigrants, and healthcare workers
• Patient teaching: avoid sick people, take medicine as prescribed, use infection control, get treated, and take medications after while wearing a mask
• Tuberculosis medications last about 6 months
• Direct Observation Therapy (DOT) and preventative therapy can be implemented
• Direct Observation Therapy (DOT): watch them take their medications due to them being non-compliant due to their environment or situation
• DOT programs can be clinic based, mobile, or through the health department.
• Preventative therapy involves: avoiding the flu and sick people, using infection control, and people living in close quarters wearing masks
• Additionally: partners and spouses of those with TB should wear masks

Tuberculosis Skin Test

• Administered sub dermally (intradermal)
• Look for Reactions that may be visual or a bump
• Positive Results: for immunocompromised patients (HIV, transplant, recent active patient contact, nodular or fibrotic findings in X-ray) being above 5 mm
• Positive Results: for high risk individuals (healthcare workers, recent immigrants, less than 4 years old) intravenous drugs use being >10mm
• Postive Results: for low risk being >15mm

Asthma & COPD

• Asthma is a chronic inflammatory disorder of the airway, lifelong, with no cure, so it must be managed, and its progression slowed down
• Asthma symptoms relate to allergies
• Signs and Symptoms: senses of breathlessness, tightening of the chest, wheezing, dyspnea, cough, tachycardia (anxious), pale and wet skin
• Asthma symptoms are caused by intermittent reversible airflow obstruction, which occur in two ways either inflammation (swelling and redness) or bronchoconstriction which causes chest tightness
• Airway Disease causes asthma, and can cause inflamed and thickened walls
• The cause is an immune mediated airway inflammation
• Physical assessments include dyspnea, wheezing, and cough; Arterial blood gases (ABGs) help determine gas exchange, pulmonary function tests (PFT's), measure airflow, chest x-rays detect potential underlying disorders, high risk for pneumonia and bronchitis (COPDs).
• CO2 will decrease, the body will get tired, CO2 will then elevate, and the patient looks drowsy
• Lung Function Tests: including forced expiratory volume, how much air exhales in 1 second and flow the maximal rate
• Patients that have exercised induced asthma have bodies that doesn't adapt to the environment when they exercise
• Causes of Exercised Induced Asthma broncho-spasms are secondary to loss of heart during breathing and sweeting
• Exercise Induced Asthma peaks during 5-10 minutes resolves 20 to 30 later so Beta two antagonists should be used
• Cromolyn should be used 15 minutes before exercising

Status Asthmaticus: Complications

• Labored breathing, prolonged exhalation, engorged neck veins, wheezing, use of accessory muscles
• GOALS: relieve airway obstruction and hypoxemia, and normalize lung function rapidly
• Initial therapy: oxygen to relieve hypoxemia; nebulized high-dose SABA to relieve airflow obstruction; nebulized ipratropium to reduce airflow obstruction; systemic glucocorticoid administered via IV to reduce airway inflammation.
• Increasing levels of PaCO2 indicate worsening of the condition
• Chronic Obstructive Pulmonary Disease (COPD) is preventable and treatable, being a slow progressive respitory leading to airflow obstruction
• Emphysema: Aveoli doesn't stretch and results in lower lung elasticity , and lung inflation
• Chronis Bronchistis: causes inflammation mucus, inflammation vasodilation
• For Patient teacing when experiencing a Asma Attack to identify triggers allergens cold air, monitor peak flow, adhere to meds, SMOKE CESSATION with breathing and regular exercise and realistic goals
• When they are sich have a asthma flan and emergency management as well as always carry an inhaler Encase the Patient's pillow

Asthma: Treatment

• Encasing pillows and mattresses in ocvers impermeable to allergens, wash bedding weekly in a hot-water wash cycle
• Prevention of Exacerbations which can only be treated when symptoms start picking up, avoid triggers, and when using correct inhalers
• Short Acting (SABA): helps with asthma attacts long lasting beta which prevents
• Patiens taking steriods and Bronco dialor should be given steriods first
• Patiens that have lung function is impaired the patient should give a low space spacer after needed, and a nebulizers

COPD Care

• Destruction of the wall in the avoili, air gets trapped in longs
• Bronchitis is a high source of inflammation and too much mucus
• Patiennts with CORD shpuld quit smoking and breath exercising patients

CoPd Patients

• Are like pink puffers are wheezing , trouble with eating, frequents lungs infections

COPD Patients

• Can Have a high Infection and a lot of mucus in inflammatation, impaired cliary function high risk decreased oxygen

COPD Treatment for Patients to Reliev Symptoms

• Include Breathing Exercisies with SABA Nebulizer mask Hydrating Them
• Rinse Mouth After Steriods with medicated space needed

Bronchoscopy- Post Procedure

• Visualization of bronchitis
• Diagnostic bronchoscopy are tissue analysis and to obtain diagnosis
• Patient must be taken out for until could reflex returns, monitor respitory status, coughing is normal with bloody stupum, fever

Hematology

• Hematology liver helps blood cotting pro that the spleen contains major anti body production
• Anemia helps the red blood count if it goes up and loss of function
• Red Blood Formations begins in the bone marrow is essential for b12 and folic
• Lack of fatigue poor circulation cold feet anemia

Amneais

• In the Body with Iron
• Red Bloof Formations begins in the bone marrow is essential for Healthy formation
• Lack of fatigue poor circulation cold feet anemia

B12 Deficiency

• Means decrease in RBC Count can not produce

Vitiamen B

• Folice acid defiency, you can not make new cells due this defiency if not absorbed early intestines
• Also it can not be stored either
• Patient must have increased risk for cancer treatment
• Platelets are defromed

Platelete

• Platelete defromed , manage pain
• Triggers dehydration infections
• Can be helped by oxygen and hydration
• Sickle cell assessskin, cardiovascular and changes to to pain

Neutropenia

• Means lack of White cells from chemo elderly patients
• Can easily get sic
• Nursing intervention should to isolated wear mask and wash

Blood Trasfunsion

• The procedure should be administered 30 mins in the blood bank
• This should be check on to patient in 15 mins
• Reaction to reaction overload fever allergy if blood count match
• Should be running for 4 hours with the procedure

Oncology

• Breast exam ( annually 40 years) HPV - leads to vaccine (10-25) breast an colon screening
• Major cells are impacted
• Patient should ate bland and immuneosupressed cells
• Checkup includes hygiene for nausea etc

Radiation

• May harm canacer and destroy cells by high energy from
• Administer akin care mark stay to treat
• Patient needs help cough and breath and change wound

NueroLogics Cancer

• Can cause parastestia, nuimnbess, fatigue and

Diabities

• Glucose is for fuel and espically for cells
• Glucaon causes release of glucose from storage
• If glucose is not able to be stored a person may become Diabities
• Symotoms consist of casual glucose and glucose levels, and 3/4 symotoms
• Type 1 Diabetes are caused by immune beta cells and has fast regression
• Type one Can not use oral medications
• Type 2 is when the heart had to increase
• Inuslin when the rotate the area 2 inches a week
• Make sure they are well educated while fasting
• A patinet can get eyes kidney failure and toe/finger problems The patinet can get glucose problems that kidney proplems
• Paitents can suffer when stress , eat regular and call pcp

Thyriod Levels

• Maintaing Metoblism Patents that are hyper are tachycardic, hot high metabolism, bulging eyes anixous
• Hypo: Slow metabolism cold, fatigue, weigh gain, brittle Autoimmune: Hashimoto: auto immunity disorders, can end up in coma, Can Destroy gland cannot create hormone , can't serete TsH (high TsH) Parathyroid: reguklates caclium Hyparathroid: elavated calcium Hypaoparariid: low calcium

Endrocrine: PTH

• PTH Pulls calcium from bone and the kidneys
• Patients with Hyper Calcium deep bone Pain
• Parathyroid: controls serum calcium levels High calcium leads to low calcium leads to increased calium

Hyper Paraoidims

is an increase in the bone a wearker bone

• Is an increase from GI system of kidneys
• Can casue kidney Stones

Patients with Hypo

Decrease PHI From muscle , muscle

• Patients must be monitor for Patients must be monitor Calcium
• Patients mush have decreased Calcium levels

Overview of influenza, pneumonia, and tuberculosis (TB). Influenza affects respiratory functions, with pneumonia being a potential complication caused by infectious and non-infectious factors. TB is an infectious disease primarily affecting the lungs, often asymptomatic in early stages, diagnosed via skin tests, and preventable with N-95 masks.