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Adult 3205, Pneumonia Week 1

by: Ashlan Notetaker

Adult 3205, Pneumonia Week 1 NURS 3205

Marketplace > University of Memphis > NURSING > NURS 3205 > Adult 3205 Pneumonia Week 1
Ashlan Notetaker
University of Memphis
GPA 3.2
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About this Document

This is lecture will be on the first test on 9/19!!
Nurs Adult I/Common Hlth Alt
Class Notes
Nursing, Pneumonia




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This 3 page Class Notes was uploaded by Ashlan Notetaker on Thursday August 25, 2016. The Class Notes belongs to NURS 3205 at University of Memphis taught by Harrell in Summer 2016. Since its upload, it has received 70 views. For similar materials see Nurs Adult I/Common Hlth Alt in NURSING at University of Memphis.


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Date Created: 08/25/16
Pneumonia  Gets into the alveoli and the interstitial spaces and causes a buildup of interstitial debris (buildup of fluid/pus)  Effecting organism + compromised host = sepsis – dead  Viral is most common infecting organism and when it travels it can get in the lungs causing the viral pneumonia o can progress into bacterial pneumonia  CMs: increase in temperature (>100.5); increase RR (trying to increase gas exchange); crackles, wheezing, or maybe no lung sounds; increase HR; BP should not be effected; and elderly patient may be confused rather than any other sign o Abnormal vital sign is NEVER normal. People may have a high blood pressure that is their “normal”, however, it is NEVER normal and we should NEVER treat that patient like that is normal. o Always get a baseline to know what everything usually is!!  Know which drugs go with which type of pneumonia, don’t need to know the organisms for each o Home- Z-pack, recommended for community-acquired pneumonia o Hospital- acquired pneumonia  IV antibiotic  usually ventilator associated pneumonia- airway compromise  someone who fell and broke their hip and is in the hospital, doesn’t get up much and has atelectasis can get pneumonia and this is still hospital acquired pneumonia  Opportunist Pneumonia (gets us when we are down)- includes those with AIDS and HIV, immunosuppressed diseases or treatments that can affect the immune system like chemotherapy. These people have a more of a chance to get viral or bacterial pneumonia. (PCP pneumonia)  Aspiration Pneumonia- this is when stuff gets caught in the windpipe, and instead of coughing up patients may not be able to do that and will get pneumonia from the stuff that was lodged down their throat. Laying on the right side causes more aspiration than on the left because the right has a steeper angle into the lungs causing liquid and/or secretions to go into the lungs more. Aspiration of food, water, blood, or anything that shouldn’t be in there can cause pneumonia. o Know that if you go too far with intubation then it could end up in the right lung  Nursing Diagnoses o Impaired Gas Exchange – most the time  We want 95% to 100%, usually when then have less than 90% they have impaired gas exchange o Ineffective Airway Clearance - most the time  Secretions can block the airway o Ineffective Breathing Pattern  We have someone so tachypnea they can’t get enough oxygen  Tactile Fremitus- saying “99” or “echo” it tells if she has consolidation, or gunk, in the lungs o Feel more tactile fremitus if there is more gunk  Percussion on the back you will hear dullness that has the area of fluid  Labs- blood work WBC >10 (13-15 with pneumonia) should only get to 18-22; 30 or high is usually caused by drug abuse (high doses of steroids or narcotics), or someone with leukemia o When a patient has completed their drug therapy, what will indicate that the medication was effective?  To improve gas exchange, we must increase SPO2 and not increase RR. The only thing better than O2 stat is ABGs, but we don’t take those o Saturation of peripheral oxygen – SPO2  We want it greater than 95% (want it in the 90s at least!)  Not a good measure for central oxygenation; by the time it decreases in the hemoglobin molecule it has already decreased centrally o Saturation of arterial oxygen – SAO2  Advertise adults greater than 65 to get the pneumococcal vaccine o Expensive o Recommend every 5 years o Decreases incidents o Also anyone without a spleen is REQUIRED pneumo vax  If there is a viral pneumonia, there is no treatment but to just wait it out. Unless there is a specific virus that is to be treated  Empiric therapy is where a person comes in and the xray is taken and pneumonia is seen. Therefore, people just give a standard medication because it is normally that bacteria and this drug will work on it. All this can be done without taking a sputum or culture. o Pt must have first antibiotic within the first hour of being in the hospital o Can take culture 4-5 days sometimes o Can do a gram stain  Check for allergies before giving any medications o If we don’t know the patient is and the patient can’t tell, check chart, or physician o Hold the medication until you can figure out what the patient is allergic to o Then call family or PCP  For any type of infection and the nurse is about to give any antibiotics, MAKE SURE to get the right blood and cultures BEFORE giving ANY medication o Don’t give anything prior to blood culture (this includes treating for a fever)  Drug therapy- watch for people on heart medicines: antirythmics o QT interval prolongation – drugs can cause this to run long (between Q and T on the PQRST EKG) it can cause them to go into a repo arrhythmia: vtach or vfib (-micin drugs) o Kidney functions: Levaquin o When they have someone who is going to die from pneumonia they will die from hypoxia o The first sign of Hypoxia is irritability and this means they need OXYGEN (little disoriented)  Push fluids o Water, chicken noodle, soup, sprite, TCDB o Turn- changes pressure in pulmonary vascular system flow  Turn on stomach so that blood flow goes to the anterior part of the lungs rather saying on the lower back side; help change pressure from belly and causing to deep breathe o Cough- clear airway, quick to release alveoli to increase O2 o Deep Breathe- cause the alveoli to expand- spirometer: breathe in slowly; basic things we can do as a nurse


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