NURS 171 RESPIRATORY SYSTEM: PNEUMONIA Darlene LoPresto, Graduate Student FSU

Pathophysiology  Bacterial or viral  Infection/Inflammation  Exudate  Lobar or diffuse  Streptococcus  Klebsiella

Etiology Incompetent distal airway defense mechanisms

Prevention  Pneumococcal vaccine  Avoid smoking  Avoid allergens, indoor pollutant exposure

Symptoms  Nausea/vomiting/diarrhea  Dyspnea  Productive cough  Pleuritic pain  Confusion

Diagnosis & Complications  Multi drug resistance  Allergic reaction  Food/drug interaction

Medical Management  Limited activity  Antipyretics  Analgesics  Oxygen therapy  I.S.  Bronchodilators  Increase fluid intake  Antibiotic therapy  Rest  Modify r/t patient response

Pneumonia Review Question  What is one of the most common bacterial organisms that cause pneumonia? a) Staph Aureus b) Streptococcus c) Both a & b d) All of the above

Pneumonia Review Question  Symptoms of pneumonia include all of the following except: a) Productive cough b) Dyspnea c) Hemoptysis d) Pleuritic pain

Pneumonia Review Question  Nursing Interventions for the pneumonia patient include all of the following except: a) Blood culture interpretation b) Incentive spirometry c) Increase fluid intake d) None of the above

Nurse Diagnosis: Case Study

Bronchiectasis Supportive Educative Nursing 171 Darlene LoPresto, BSN, RN,C www. youtu be.co m/wat ch?v= zMKa JEgm TT4

Inflammation Airway damage Remodeling Continuing cycle d/t Infection

Symptoms  Persistent/recurrent cough  Dyspnea  Crackles  Pleuritic chest pain  Hemoptysis  Purulent sputum

Medical Management  Dx: HRCT Sputum cultures  Tx: Treat acute flare-ups Maintain lung function Antibiotics Bronchodilators Mucolytic agents Anti-inflammatory agents

Nursing Diagnosis Ineffective airway clearance r/t increased secretions -Chest physiotherapy & Postural drainage -No smoking -Vaccinations -Good oral hygiene -Infection control

Supportive Educative Nursing 171 Lung Cancer D.LoPresto, BSN, RN,C

Types Primary Lung Cancer  Small cell  Adenocarcinoma  Squamous  Large cell neoplasm

Lung Cancer Etiology: Smoking

Incidence of Lung Cancer  Leading cause of Cancer deaths  28% of all cancer deaths  172,570 new cases annually  58% death rate men  African Americans  Hispanics  5 year survival rate 15%

Risk Assessment  Memorial Sloan-Kettering Cancer Center Lung cancer prediction tool ncer

Which are Symptoms of lung cancer? Select all that apply: 1) Persistent cough 2) Hemoptysis 3) Bradypnea 4) Hematemesis 5) Anorexia

Patient Symptoms  Nonspecific  Occur late in disease  Type of cancer & location  Dyspnea  Persistent cough  Persistent pneumonitis  Hemoptysis  Ausculatory wheeze  Weight loss  Fever

Diagnosis  10% with routine CXR  PET scan  CT scan  Bone scan  Lung biopsy  20-30% (+) sputum cytology

Ectopic hormone syndromes  ACTH  ADH  PTH

Prevention  Smoking cessation  Screening CXR  Sputum cytology  The U.S. Preventive Service Task Force  The American College of Chest Physicians

Collaborative Care  Surgical Treatment -resection  Radiation  Chemotherapy  Targeted Therapy

Nursing Diagnosis: Group Activity