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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.
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NURS 171Respiratory 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
Bronchiectasis Supportive Educative Nursing 171 Darlene LoPresto, BSN, RN,C http://www.youtube.com/watch?v=zMKaJEgmTT4
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 http://www.youtube.com/watch?v=JmRt9rFmVu4&feature=related
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 CancerD.LoPresto, BSN, RN,C
Types Primary Lung Cancer • Small cell • Adenocarcinoma • Squamous • Large cell neoplasm
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 www.mskcc.org/PredictionTools/LungCancer
Which are Symptoms of lung cancer? Select all that apply: 1) Persistent cough 2) Hemoptysis 3) Bradypnea 4) Hematemesis 5) Anorexia
Nonspecific Occur late in disease Type of cancer & location Dyspnea Persistent cough Persistent pneumonitis Hemoptysis Ausculatory wheeze Weight loss Fever Patient Symptoms
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