Pneumonia Nursing Care: Airway Clearance and Assessment

Promoting Airway Clearance in Pneumonia Patients

• Maintain adequate fluid intake to liquefy secretions, facilitating easier expectoration
• Splint the chest while coughing to reduce discomfort and promote a more effective cough
• Cough at the end of exhalation to maximize cough effectiveness
• Position the patient upright (high Fowler's) with the head slightly flexed

Nursing Diagnosis for Pneumonia

• The appropriate nursing diagnosis is hyperthermia related to infectious illness
• Productive cough and respiratory rate of 20 are normal parameters

Chest Assessment and Ineffective Airway Clearance

• Basilar crackles are the best indicator of ineffective airway clearance.
• Adventitious breath sounds indicate accumulation of secretions in lower airways

Clinical Manifestations of Pneumonia

• Increased vocal fremitus on palpation is expected in pneumonia.
• Other signs include bronchial breath sounds, egophony, and crackles in the affected area

Priority Nursing Intervention for Lung Secretions

• Increase fluid intake to liquefy secretions for easier expectoration.
• Humidifying oxygen and teaching the patient to splint the affected area can also be helpful

Vaccinations for COPD and Pneumonia

• A 65-year-old with COPD and diagnosed with pneumonia should get the pneumococcal vaccine
• The vaccine is important for heart or lung disease patients, those recovering from severe illness, 65+, or those in long-term care facilities.

Pneumonia Relapse Prevention

• Seek immediate medical treatment for any upper respiratory infections
• Continue deep-breathing and coughing exercises for 6–8 weeks.
• Follow-up chest x-ray should be completed in 6-8 weeks post pneumonia diagnosis

Pneumonia Upon Admission

• Sputum for culture and sensitivity should be sent to the lab prior to antibiotic administration.
• Cefuroxime is important for correct identification of organisms before antibiotics' effect.
• Antibiotic administration should not be delayed waiting for the patient to expectorate sputum.

Treatment for Pertussis

• Pertussis is caused by Bordella pertussis and must be treated with antibiotics
• Corticosteroids and bronchodilators are ineffective

Pneumococcal Pneumonia Assessment

• Increased tactile fremitus over the area of consolidation.
• Dullness to percussion is expected
• Pneumococcal pneumonia usually presents with a loose, productive cough.
• Adventitious breath sounds such as crackles and wheezes are typical

Discharge Instructions for Pneumonia

• Patients should continue to cough and deep breathe after discharge.
• Fatigue should be expected for several weeks post discharge.
• Pneumovax and influenza vaccines can be given at the same time in different arms.
• Follow-up chest x-ray needs to be done in 6–8 weeks post discharge to evaluate pneumonia resolution.

Aspiration Prevention

• Place patients with a decreased level of consciousness in a side-lying position or upright position. Conditions increasing risk of aspiration include decreased level of consciousness, difficulty swallowing, and nasogastric intubation

Effective Pneumonia Treatment

• Effective antibiotics normalize the white blood cell (WBC) count.
• Normal WBC count is 9000/μL.

Airborne Precautions in Tuberculosis

• Negative sputum smears for acid-fast bacilli indicate that Mycobacterium tuberculosis is not present/transmittable.
• Chest x-rays are not used to determine whether treatment has been successful.
• Taking medications for 6 months is necessary
• Repeat Mantoux testing would not be done b/c the result will not change

Tuberculosis Transmission Teaching

• Minimize exposure to close contacts and household members.
• Homes should be well ventilated, especially the areas where the infected person spends a lot of time
• Patient should sleep alone, spend as much time as possible outdoors, and minimize time in congregate settings/public transit

Rifampin Side Effects

• Orange-colored body secretions such as urine and tears are normal while taking rifampin
• Stop taking other medications. The findings are not indicative of an allergic reaction

Older Patients and TB multidrug Therapy

• Noninfectious hepatitis is a toxic effect of isoniazid (INH), rifampin, and pyrazinamide causing yellow-tinged skin.
• Changes in hearing and nail thickening are not expected with the four medications used for initial TB drug therapy

Adherence to TB Treatment

• Arrange for a daily noon meal at a communal center where the drug will be administered, this is the most effective intervention
• Directly observed therapy is also effective

Monitoring TB Treatment

• The first action should be to determine if the patient has complied with the drug therapy.
• Negative sputum smears would be expected if the TB bacillus is susceptible to the medications and the medications have been taken

Latent TB Teaching

• The nurse is considered to have a latent TB infection and should be treated with INH daily for 6–9 months.
• Four-drug therapy would be for nurse had active TB.
• TB skin testing is not done for already pos skin test indiviauals
• BCG vaccine is not used in the USA and is not helpful for individual, who has a already TB infection.

Observing a Student Nurse

• HEPA mask not standard surgical mask should be used
• Hand washing before entering the patient's room is appropriate

Bacterial Pneumonia and Sepsis

• Blood cultures from two sites is priority step
• Cultures must be obtained before antibiotic administration

Pneumococcal Pneumonia

• Early initiation of antibiotic therapy has been demonstrated to reduce mortality.
• Azithromycin (Zithromax) medication is given.

HIV and Active TB Disease

• Communications of patient to health care provider is the medication pt is taking for antiviral therapy.
• Drug interactions can occur between the antiretrovirals, anti tuberculs

Supervising UAP With a Patient w/R Lower Lobe Pneumonia

• Nursing Should intervene if a patient's head is lowered to 15 degrees
• Positioning the patient w/head lowered will decrease ventilation

Assessing Patients

• Patients on bed rest who are immobile are at high risk for DVT
• Sudden shortness of breath suggests possible pulmonary embolism requires assessment and action
• The other patients should also be assessed as soon as possible, but there is no indication that they may need immediate action to prevent clinical deterioration

Tuberculosis Skin Test

• Patient should first be screened, has pt had the bacille calmette-guerin vaccine for tb b/c this can effect man taux test

Pertussis community setting

• Teaching patients about the need for adult pertussis immunizations is the most effective step.

The Nurse to asses first ( Tension Pneumothorax) Subclavian Cath

• Patient’s history & symp suggest possible tension pneumothorax, or medical emergency

CURB-65 score factors

• Mental State ( confusion), BUN (Elevated), Blood Pressure( Decrease) Respiratory Rate( Increase) , age (65 & older)

The nursing diagnosis of ineffective

• Weak, nonproductively cough support this _ the other data would be would be supported Such as impaired gas exchange & ineffective breathing pattern.

Find during assess chest

Increase tactile fremitus over the area of pulmonary consolidation is expected w/ bacterial Pneumonia

Bacertial Pneumonia & Rhonchi & thick soutum

• Assist pt to splint chest whe coughing, fluids encourged
• Nasal oxygen will gas improve change. But Will not improve the airway

Continue cough & deep breathe

Patient should continiue tought for a Seval week Home oxygen therapy is not needed and successful treatment of Pneumovax & influenza vaccines can be given at the same time

Decrease Aspiration

Placing Patients w/altered consciousness of inter side lying position

Antibiotics 2 days

Normal WBC counts , inicated that antibiotics has been effective.

Heakth care provides orders

3 sep specimens on diff days

Airbone Isolation Precaustions & Negative Sputium

• Negative sputiem, indication for not transmmting bactiers threw air borne toure.

Information To Teach about Rifampin

• Urin, sweat & tears , Will be orange colored.

Apply Planning Cares For Patients

_ Application refe 555 top- nursing process applying Miscelanous -NcTex

• Yellow tingued skills

After 2 of TB Treatment w/a 4 drug REg

Ask Patient weather medications have veen taken directed

• The 1st Action should be to deter ment to be whether the patient has been complaints w! drug Therepy

Msc

NClex halth proo

• Used & side effects insonizod

What is the nurse look fot family remember is this

Put on a surgue face make before isitng the patients

Orders Nurse Act (Bacteria)

• Obtaining Blood colure, must. BE done frist then antobiotics

A Patient whith just be admitted pneumocacale Phuemnia

Early initiation of antibiotic Theropy,

In the the lungs will test (HBV)

C., The pain is BEING treated with Antiretroviblas. For HIV infechon

Lobe Phuenmia And H

• Positioning the patients With their head of bed lowered will decrease ventation The other are appropriate for Patient with Pneumonia

The Nuess. Receives Change of shift Report

A 4r Yeak. Old Patient W/ D uho is complaining. sudden ON set shortnees Of breaths Pasehts ON red vest w ho area immobile Are High risk For Dvir Saddén. ON set Of shorthess Of Breath IN a patient w/ DVt. suggest A polutonany embolism. and requites Ammmediate assessment and achia

Patients Who REceived TB  Vaccine

Have YOU receive the backle Calmette -Guérin (Bé) vacune or TD Patents who haver received 406. vaccine With 248. Test. Another methods For Screening.

Patient. Who wads Admitted The previous day with. Phuemona.. complains. a Sharp Pain the

. Listening to the Patien's lungs

A. Patient is Hormally Alert and

.  Oriented, in which . Order Should The Huse take following Actrions A. 6 Obtains ONYgen SATuation B. heck Patients The. Palse pate C. dloccument the change in status D, HOtIFY the halth cade PROVIDers A, B. D, C assessmenTs For Physiologie causes Of 9 N set Confusion Such as   Pneumonia Infections

Most importaint Action

1. The most important Action the halse shosld do before and after Sullioniing 2 clienTs a HyperVentilating client Whith, 100%

Position Of a Consious cuend During Suilliiong

PosihON A. cousois Persons whos Has a . Functionary gaj rettex IN. thateSemi fowler's Positions Whith Head Turned TO sidefor Oral Saclionning. ON The Heck Hyper extended For nasal -Saillon. In. the cliemt. is VN cousous Place the patient s . a lateral POS itioN Facing . YO

Presence OF Querdis tended AND WON functionary Aivelie condition

B. EmphoysemA An OVER dis tended AND WON functionary Condition Celled Emphoysend Atelleclasis the colapse OF pats a whole lung.

Q

Nurses Assesing

A. yellaw Tinguad Skin

T: Nurise. caring Fon patient. Whew has Beew Homies. With alhive TB

Arang for A. daily, 200m. meal At a community Center Where   the dhus Will be adminstared.: aws, D

Fter 2 mouths Of Theatment

Ask the Patient Whether medications, have BEEN taken AS diracted +

This lesson covers key aspects of nursing care for pneumonia patients, focusing on promoting airway clearance through hydration, effective coughing techniques, and optimal positioning. It also addresses nursing diagnoses, chest assessment findings, and clinical manifestations to guide effective interventions.