Podcast
Questions and Answers
Which of the following would be MOST appropriate to help clear secretions from the lower airways?
Which of the following would be MOST appropriate to help clear secretions from the lower airways?
- Inhaling steam
- Turning and repositioning (correct)
- Drinking hot tea
- Using a humidifier
Which of the following would be MOST appropriate to help clear secretions from the upper airways?
Which of the following would be MOST appropriate to help clear secretions from the upper airways?
- Coughing and deep breathing (correct)
- Lying flat on the back
- Nasal decongestants
- Drinking cold beverages
What are classic manifestations of pneumonia?
What are classic manifestations of pneumonia?
Frequent cough with purulent sputum, dyspnea, tachypnea, fatigue, tachycardia, fever, chills, and crackles in the lung bases.
What is the goal for fluid intake in patients with pneumonia?
What is the goal for fluid intake in patients with pneumonia?
A client with pneumonia usually has a low white blood cell count.
A client with pneumonia usually has a low white blood cell count.
Which of the following signs would indicate that the azithromycin was having a therapeutic action? (Select all that apply)
Which of the following signs would indicate that the azithromycin was having a therapeutic action? (Select all that apply)
What vital signs should be assessed to determine if a client is doing well?
What vital signs should be assessed to determine if a client is doing well?
If the mucus thickens, it can form ______ which can obstruct the client's airways.
If the mucus thickens, it can form ______ which can obstruct the client's airways.
What is the first sign of pneumonia in elderly clients?
What is the first sign of pneumonia in elderly clients?
What position should clients be in during periods of dyspnea?
What position should clients be in during periods of dyspnea?
What is the importance of splinting while coughing for clients with pleurisy?
What is the importance of splinting while coughing for clients with pleurisy?
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Study Notes
Pneumonia
- Pneumonia is an infection in the lungs caused by bacteria.
- It can be serious and lead to breathing difficulty.
- The immune system responds by causing inflammation and fluid to build up in the lungs, making it harder to breathe.
Signs and Symptoms
- Signs:
- Frequent cough
- Purulent sputum
- Dyspnea
- Tachypnea
- Fatigue
- Tachycardia
- Fever
- Crackles in the lungs
- Wheezing
- Chest pain (pleurisy)
- Classic signs are less common in the Elderly
- May present with altered mental status
- High White blood cell count
Treatment
- Goal of treatment:
- Improve breathing
- Clear secretions
- Treat infection
- Interventions:
- High Fowler's position during dyspnea
- Adequate fluids (2,000-3,000mL/day)
- Supplemental oxygen if needed (Pulse Ox > 90%)
- Mobility (turn and reposition every 2 hours)
- Balance of rest and exercise
- Antibiotic therapy
- Fever control
- Coughing and deep breathing (teach huff coughing and use of an incentive spirometer)
- Inhaler use
- Splint chest when coughing or breathing deeply if pleurisy is present
Case Study: Herbert Scott
- Herbert Scott presents with signs and symptoms of pneumonia.
- He has a productive cough, fever, crackles in the lungs and thick yellow sputum.
- A chest x-ray confirms the diagnosis.
- Azithromycin (a macrolide antibiotic) is prescribed.
- Mr. Scott's condition is expected to improve as the antibiotic takes effect.
Assessing Client Condition
- General appearance:
- Breathing difficulty
- Mobility (ambulating or orthopneic)
- Eating and drinking
- Vital Signs:
- Respirations (12-20 BPM)
- Pulse oximetry (95-100%)
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