Common Diseases: Bronchial Asthma, Pneumonia & More

❑Reversible unless genetic ❑Reversible inflammatory lung disease due to hypersensitivity leading to narrowing of the airway. ❑Extrinsic and Intrinsic as Predisposing factors →EXTRINSIC – external allergens (dust, pollen, fur, mold and food additives) →INTRINSIC – not caused by an allergen (respirat...

❑Reversible unless genetic ❑Reversible inflammatory lung disease due to hypersensitivity leading to narrowing of the airway. ❑Extrinsic and Intrinsic as Predisposing factors →EXTRINSIC – external allergens (dust, pollen, fur, mold and food additives) →INTRINSIC – not caused by an allergen (respiratory infections, stress, and medications) ❑ SIGNS AND SYMPTOMS →Cough →Dyspnea, increase HR and RR →Wheezing (whistling sound) on expiration →Chest tightness →(+) anxiety / panic ❑ MEDICAL MANAGEMENT →Administer medication as ordered: -Bronchodilation (relaxes muscles) -Meter dose inhaler – aka “puffers” -Corticosteroid – reduce swelling in the airways -Anti-histamine – help reduce allergy symptoms -Mucolytics / expectorants ❑ NURSING MANAGEMENT →Administer low flow O2 therapy →Semi fowlers to promote lung expansion →Instruct the patient to pursed lip breathing →Encourage small frequent feeding ❑PREVENTION →Stop smoking →Limit exposure to air pollution, dust, and strong odors →Use air purifiers or humidifiers to maintain clean indoor air. →Avoid close contact with people who have colds or flu. →Improve importance of immunization -Pneumonia Vaccine – q 5 years -Influenza q 1 year DEFINITION → remember: rusty sputum (reddish-brown or rust-colored appearance due to the presence of blood) Inflammation of the lung parenchyma leading to pulmonary consolidation as the alveoli is filled with exudates MOT (Mode of Transmission): Droplet Incubation Period: 1-3 days →High risk groups - Children below 5 years old - Elderly  SIGNS AND SYMPTOMS ▪ Productive cough with greenish to rusty sputum ▪ Dyspnea with prolong expiratory grunt ▪ Fever, chills, anorexia and general body malaise ▪ Weight loss ▪ Rales/crackles ▪ Bronchial wheezing ▪ Cyanosis d/t decrease 02% ▪ Pleuritic friction rub – low pitched, harsh/grating sound ▪ Chest pain  DIAGNOSTIC PROCEDURES ❑ Sputum Gram Staining and Culture Sensitivity – positive to cultured microorganisms ❑ Chest x-ray – reveals pulmonary consolidation ❑ CBC – reveals increase WBC  NURSING MANAGEMENT ❑ Enforce CBR (complete bed rest) ❑ Administer oxygen inhalation low inflow ❑ Administer medications as ordered →antibiotics, antipyretic, analgesics, mucolytics/expectorants ❑Place on Semi-Fowler’s position, encourage DBE ❑Nebulize and suction (PRN); WOF: signs of respiratory distress ❑Provide increase in: Carbs, calories, and proteins / increase OFI ❑Health Teaching: → Avoid smoking, adherence to medication, and importance of follow-up care.  PREVENTION ❑ Pneumococcal vaccine ▪ 0.5ml IM ; vastus lateralis ▪ SE: local tenderness at site of injection, fever ▪ Do not massage site ▪ Cold compress ▪ Antipyretic (Paracetamol); q4 hours if fever is developed DEFINITION → remember: low grade afternoon fever ❑Infection of lung tissue caused by invasion of mycobacterium tuberculosis ❑ MOT: Airborne / droplet / contact: cough / sneeze ❑ Incubation Period: 4-6 weeks ❑Not communicable after 2 weeks of treatment with (-) sputum smear  SIGNS AND SYMPTPOMS ✓ Low grade afternoon fever, night sweats ✓ Productive cough (yellowish sputum) ✓ Anorexia, generalized body malaise ✓ Weight loss ✓ Dyspnea ✓ Chest pain ✓ Hemoptysis (chronic)  DIAGNOSTIC PROCEDURES ✓Mantoux Test (skin test) - Purified protein derivative - DOH 8 – 10 mm induration, 48 – 72 hours - WHO 10 – 14 mm induration, 48 – 72 hours → Positive Mantoux test (previous exposure to tubercle bacilli but without active TB) ✓Sputum Acid Fast Bacillus → Positive to cultured microorganism ✓Chest X-ray → Reveals pulmonary infiltrates ✓CBC → Reveals increase WBC  NURSING MANAGEMENT ▪ Enforce CBR ▪ Institute strict respiratory isolation ▪ Administer oxygen inhalation ▪ Force fluids to liquefy secretions ▪ Place client on semi fowlers position to promote expansion of lungs ▪ Encourage deep breathing and coughing exercise ▪ Nebulize and suction when needed ▪ Comfortable and humid environment  Here are some common medications given for patient with Tuberculosis and their corresponding side effects.  Peripheral neuritis - a condition where the nerves outside the brain and spinal cord (the peripheral nerves) are damaged or don't function properly.  Ototoxic - occurs when drugs or other substances negatively impact the inner ear, which is responsible for hearing and balance.  IRON DEFICIENCY ANEMIA (IDA) ❖ Anemia is a condition in which the number of red blood cells is lower than normal. ❖ Anemia occurs when there isn’t enough hemoglobin in the body to carry oxygen to the organs and tissues. ❖Risk factors for IDA – pregnant women, LOW iron diet & malnutrition; bleeding through medical trauma.  SIGNS & SYMPTOMS → Usually asymptomatic - Skin color: pallor - Breathing: dyspnea - Energy levels: fatigue - Head: headache / dizziness - Attention span: poor - Hair: Brittle - Tongue / gums: red and smooth - Nails: spoon shaped / koilonychia - Lips: Angular Cheilitis  DIAGNOSTIC PROCEDURES →CBC →SERUM IRON AND FERRITIN TEST  NURSING MANAGEMENT ❖ FERROUS SULFATE LIQUID INSTRUCTIONS → Drink with – straw – placed at the back of the mouth → After – provide oral care - Rationale: can stain the teeth ❖FERROUS SULFATE IM (DEXTRAN) INSTRUCTIONS → Best route – 90 degree through z-track method - Rationale: prevent leakage and prevent SQ fat discoloration ❖Implications of iron in GUIAC tests: FOBT – (-) / (+)  NURSING MANAGEMENT ❖DAILY ACTIVITY SCHEDULE → spaced schedule ❖DURING ACTIVITY → deep breathing exercises ❖PROMOTE → rest but wit ADL participation ❖DIET (GLORY W) – increase Green leafy veggies, legumes, organ meat, raisins, yolk, and whole grains ❖FERROUS SULFATE SUPPLMENTATION TABLET INSTRUCTIONS: - Increases absorption – w/o meals and w/ vit. C / orange juices - If with GI upset: with meals - Decrease absorption when – (+) CMALT – coffee, milk, alcohol, laxative, and tea →A condition that happens when your diet does not contain the right amount of nutrients. Deficiencies or excesses in nutrient intake, imbalance of essential nutrients or impaired nutrient utilization. →Types of Malnutrition - Wasting – is the inappropriate weight for age - Stunting – is the inappropriate height for age - Underweight - weighing less than the normal amount for one's age, height, and build →Marasmus – sunken skin, and lack both protein and calories →Kwashiorkor – swollen/edematous abdomen; mainly on protein deficiency - Overnutrition → Obesity  SIGNS AND SYMPTOMS →Undernutrition - Severe weight loss, Muscle wasting - Thin appearance - Lack of energy / Weakness - Short stature - Poor growth - Developmental delays in children  SIGNS AND SYMPTOMS →Overnutrition - Excessive body fat, difficulty moving, breathlessness, high blood pressure, increased risk of diabetes ❑NURSING MANAGEMENT ❖Start with oral rehydration solutions (ORS) to correct dehydration. ❖Gradual Feeding with low-protein, high-energy food (e.g., diluted milk, oral rehydration solutions). ❖Increase Protein and Calories and slowly introduce protein(such as milk or soy) and energy-dense foods. ❖Provide vitamins and minerals (such as zinc, iron, and vitamin A) as needed. ❖Monitor growth, weight gain, and clinical improvement. ❑ A metabolic disorder characterized by excessive accumulation of uric acid in the blood mark by urate crystal deposits in joints throughout the body. →TARGET – male and hereditary → S/SX: - Nocturnal pain - Sudden, painful, swollen, warm red joints - Fever, and tophi ❑DIAGNOSTIC TEST -Serum Uric Acid: 2-7 mg/dl -Elevated ESR and WBC -Arthrocentesis -Xray ❑ MANAGEMENT - Bed rest with extremity in foot board - Apply cold and warm compress if tolerated - Take prescribed medication Allopurinol or Colchicine and NSAIDs - Forced fluid ❑PREVENTION - Avoid food rich in purine - Limit or Strict alcohol consumption - Forced Fluid - Balanced diet containing fish oil, antioxidants, and vitamin D ❑ Wear and tear of weight bearing joints (overused) ❑Degeneration of articular cartilage ❑S/SX: - Joint pain, and stiffness - Reduced range of motion (ROM) - Swelling and Tenderness - Grating or crackling sensation ❑ MANAGEMENT - Applying hot or cold packs to the joints can relieve the pain and symptoms - Pain relievers can help reduce pain and inflammation - Prioritize safety ( use assistive device, slip-on shoes) ❑ Prevention - Weight Reduction - Avoid Repetitive Task Exercises ❑Diagnostic Test - X-ray - Osteophytes formation ❑ Autoimmune Disorder (EBV), causes the inflammation of synovial fluids that primarily affects joints, causing pain, swelling, and stiffness, and can also affect other parts of the body. ❑SIGNS & SYMPTOMS (Symmetrical) - Morning stiffness (>30mins) or after prolonged inactivity - Fatigue - Weight loss - Warm, soft, tender, & swollen joints - Ex., Swan Neck Deformity ❑ MANAGEMENT -CBR during acute pain -ROM exercise (bike, walking, swimming) -Hot or Cold compress (pain and inflammation) -Warm bath in the AM -Pain Medication (NSAIDS, Narcotic, Steroid) ❑ PREVENTION -Regular exercise and check up/screening -Limit or Strict alcohol consumption -Avoid and reduce high salt and sugar -Balanced diet containing fish oil, antioxidants, and vitamin D ❑DIAGNOSTIC TEST -X-ray -WBC, Platelet Count, and ESR ❑Irreversible, AKA Heart Attack ❑It occurs when blood flow to a part of the heart is blocked, usually by a blood clot. ❑The terminal stage of CAD characterized by total occlusion leading to necrosis and scarring. ❑ SIGNS AND SYMPTOMS ▪Chest pain last longer than 30mins ▪Pain radiating to left arm, jaw, and back ▪Unrelieved by NTG and Rest ▪Sweating ▪Increased HR, BP ▪Hard to breath ▪Indigestion ❑MANAGEMENT →Treatment - Decrease myocardial workload - Monitor Respiratory sound - Administer 02 inhalation: 2-4 LPM (low flow) - Enforce CBR - Encourage to take 20-30cc/ week of whiskey → Emergency: Emergent Percutaneous Coronary Intervention (less than 90mins) → SURGICAL PROCEDURE - Coronary Arterial Bypass and Graft surgery ❑PREVENTION - Lifestyle modification (e.g. Healthy diet, exercise) - Weight Management - Quit Smoking and Control alcohol Intake - Medication Compliance in Anti- Hypertensive - Control/Maintain Blood Pressure and Cholesterol in normal level - Blood Sugar Control - Regular Check up and Watch out sign and symptoms of MI ❑EMERGENCY TREATMENT FOR MI ❑MONA -M – MORPHINE - Used for pain relief -O – OXYGEN - Intended to improve oxygen delivery to the heart -N – NITROGLYCERINE - A vasodilator that helps relax blood vessels and improve blood flow to the heart -A – ASPIRIN – to dissolve blood clot formation ❑As plaque builds up, your artery wall grows thicker and harder. This “hardening of the arteries” is usually a silent process in the early stages. ❑ SIGNS AND SYMPTOMS →Shortness of breath (dyspnea) during light physical activity. →Chest pain or discomfort (angina). →Pain in your back, shoulders, neck, arms or belly. →Feeling dizzy or lightheaded →Heart palpitations →Fatigue →Nausea or vomiting that may feel like indigestion. ❑Arteriosclerosis is a type of vascular disease where the blood vessels carrying oxygen away from the heart (arteries) become damaged from factors such as high cholesterol, high blood pressure, diabetes and others. ❑In many cases, arteriosclerosis may not cause symptoms until it leads to more serious complications. It's important to manage risk factors like high blood pressure, cholesterol, and diabetes to prevent or slow down the progression of arteriosclerosis. ❑SIGNS & SYMPTOMS ▪Burning or aching pain in your feet at rest & Leg pain (intermittent claudication) ▪SOB ▪Chest pain or angina. ▪Dizziness & Fatigue ▪ weakness or numbness in the face, arm, or leg ▪Heart palpitations & Shortness of breath