Preventing Hospitalization

1. Preventing Hospitalization Mimi H. Baugh MSN, RN-BC, RAC-CT

2. Bacterial Pneumonia

3. What is Bacterial Pneumonia? • Infection of the lung caused by bacteria germs • The streptococcus pneumoniae germ is the most common cause of bacterial pneumonia

4. Who's at risk? • Over 65 years • Have chronic illnesses like Parkinson’s disease, diabetes, kidney disease, or heart disease • Have any lung diseases such as asthma, COPD • Have any diseases that may weaken your immune system such as, cancer, HIV/AIDS • Are taking medicines that may weaken your immune system such as prednisone • Are a smoker

5. What are the signs? • High fever (up to 105 degrees) • Tiredness (less energy) • Rapid breathing • Chills • Cough with mucus (might be greenish or have blood) • Chest pain, especially with coughing or deep breathing • Shortness of breath • Loss of appetite

6. How is it treated? • Bacterial pneumonia is usually treated with antibiotics • In some cases, the person may stay in the hospital for treatment • Hospital treatments may include: • Oxygen • Fluids and medicines given through an IV • Breathing treatments and exercises to help loosen mucus • With treatment, usually improves within 24 to 48 hours

7. Steps to prevention • If you do smoke, stop • Wash your hands • Get plenty of rest • Eat a healthy diet • Stay physically active • Don’t use alcohol heavily • Get a yearly flu shot • Get a pneumococcal vaccine

8. Urinary Track Infection UTI

9. What is a UTI? • A UTI is a condition where one or more parts of the urinary system (kidneys, ureters, bladder, and urethra) become infected • UTIs are the most common of all bacterial infections and can occur at any time in the life of an individual • Diabetes/chronic diseases that affect the immune system may decrease your resistance to infection

10. Who's at risk? • People of any age can get UTIs • More women get UTIs than men • Diabetes or problems with the body’s natural defense system • Need a tube to drain their bladder (catheter) • Urinary tract abnormalities that block the flow of urine • Spinal cord injuries or other nerve damage

11. What are the signs? • Frequent and intense urge to urinate • Painful, burning feeling in the bladder or urethra during urination • Feeling tired, shaky, and weak • Muscle aches • Abdominal pain • Only small amounts of urine passed, despite a strong urge to urinate • Cloudy, dark, or bloody urine or urine that has a foul smell • Pain in the back or side below the ribs • Nausea and vomiting • Fever may indicate a kidney or prostate infection

12. How is it treated? • Antibiotics that can kill the bacteria causing the infection • The antibiotic prescribed will depend on the type of bacteria causing your UTI • The length of treatment depends on: • Severity of the infection • Bacteria resistance to the antibiotic • Repeat infections • Urinary tract abnormality that blocks the flow of urine • Men may need longer treatment because bacteria can hide deep inside prostate tissue

13. Steps to prevention • Drink plenty of water throughout the day. This will allow your urine to be less concentrated and cause you to void more frequently. • Empty your bladder every 3-4 hours • After urinating, a woman should only wipe from front to back.

14. Steps to prevention • Avoid constipation • Void immediately before and after intercourse • Avoid potentially irritating feminine products • Use cotton underwear and loose-fitting clothes

15. Chronic Obstructive Pulmonary Disease COPD

16. What is COPD? • Chronic Obstructive Pulmonary Disease is an illness that makes it hard to breathe • COPD generally involves a combination of chronic bronchitis and emphysema • People with COPD are more likely to get respiratory infections

17. Who's at risk for COPD? • Cigarette smoker • Age older than 40 years • Exposure to occupational dust and chemicals • Exposure to indoor air pollution • Alpha-1 antitrypsin deficiency

18. Who's at risk for COPD? Occupational Risk Factors: • Cooks • Furnace workers • Grain farmers • Miners • Women who cook over open fires • Railroad workers (from exposure to diesel exhaust)

19. What are the signs of COPD? • Constant coughing • Shortness of breath • Producing a lot of sputum • Feeling like you can't breathe or take a deep breath • Wheezing

20. How is it treated? • Medications for management of symptoms • If severe, oxygen therapy may be used to help with shortness of breath • Be sure to understand how to safely use oxygen • Pulmonary Rehabilitation • Surgery

21. Steps to prevention • If you are a smoker, Stop smoking • If you don't smoke, don't start • Avoid exposure to secondhand smoke • Make your home smoke-free • Take care to protect yourself against chemicals, dust and fumes in your home and at work

22. Dehydration

23. What is dehydration? • Dehydration occurs when you lose more fluid than you take in, and your body doesn't have enough water and other fluids to carry out its normal functions, your system literally dries out • If you don't replace lost fluids, you have an increased risk for becoming dehydrated

24. Who’s at risk? • Age • Living in a nursing home • Neurological conditions, such Stroke or Cerebral Palsy • Memory problems or Dementia • Chronic medical conditions • Athletic competition

25. Who's at risk? • Diarrhea,Vomiting,Fever • Exposure to heat & sun, Excessive sweating/exercise • Medications, including: Diuretics (water pills)& Laxatives • Fluid imbalance caused by illnesses, such as: • Diabetes mellitus • Diabetes Insipidus • Lung disease • Kidney problems • Burns

26. What are the signs? • Dry, sticky mouth • Sleepiness or tiredness • Thirst • Decreased urine output • Few or no tears when crying • Dry skin • Sunken eyes • Headache • Constipation • Dizziness or lightheadedness • Irritability and confusion in adults • Little or no urination — any urine that is produced will be dark yellow or amber

27. How’s it treated? • Therapy aims to rehydrate the body, replace lost electrolytes, and prevent complications • If an underlying cause is identified, therapies to treat that condition may be included if appropriate • Unfortunately, thirst isn't always a reliable gauge of the body's need for water, especially in children and older adults • A better indicator is the color of your urine: Clear or light-colored urine means you're well hydrated, whereas a dark yellow or amber color usually signals dehydration

28. Steps to prevention • Take water breaks throughout the day • Take a sip of water when you pass a water fountain • Carry a bottle of water with you • Drink a beverage with each meal • Drink more when exercising • Consider foods as sources of water • Keep cool

29. Next to oxygen, water is the nutrient most needed for life A person can live without food for a month, but most people can survive only three or four days without water

30. References • http://www.cdc.gov/copd/pdfs/framework_for_copd_prevention.pdf • http://www.cdc.gov/features/pneumonia/ • http://my.clevelandclinic.org/disorders/pneumonia/hic_pneumonia.aspx • http://www.drugs.com/cg/bacterial-pneumonia.html • http://www.hhs.gov/opa/reproductive-health/general-reproductive-health/urinary-tract-infections/ • http://kidney.niddk.nih.gov/kudiseases/pubs/utiadult/ • https://www.knowcopd.com/copd-lungs.jsp • http://www.lung.org/lung-disease/copd/about-copd/symptoms-diagnosis-treatment.html • http://nihseniorhealth.gov/copd/treatingcopd/01.html • http://www.nlm.nih.gov/medlineplus/ency/article/000145.htm • http://www.nlm.nih.gov/medlineplus/urinarytractinfections.html • http://www.umm.edu/patiented/articles/how_antibiotics_used_treating_urinary_tract_infections_000036_8.htm • http://www.thoracic.org/clinical/copd-guidelines/for-patients/what-are-the-signs-and-symptoms-of-copd.php • http://www.urologyhealth.org/urology/index.cfm?article=47 • http://www.ushistory.org/franklin/quotable/quote67.htm

31. An ounce of prevention is worth a pound of cure. Benjamin Franklin