NURS 171 Respiratory System: Pneumonia

1. NURS 171Respiratory System: Pneumonia Darlene LoPresto, Graduate Student FSU

2. Pathophysiology • Bacterial or viral • Infection/Inflammation • Exudate • Lobar or diffuse • Streptococcus • Klebsiella

3. Etiology Incompetent distal airway defense mechanisms

4. Prevention • Pneumococcal vaccine • Avoid smoking • Avoid allergens, indoor pollutant exposure

5. Symptoms • Nausea/vomiting/diarrhea • Dyspnea • Productive cough • Pleuritic pain • Confusion

6. Diagnosis & Complications Multi drug resistance Allergic reaction Food/drug interaction

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

8. 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

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

10. 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

11. Nurse Diagnosis: Case Study

12. Bronchiectasis Supportive Educative Nursing 171 Darlene LoPresto, BSN, RN,C http://www.youtube.com/watch?v=zMKaJEgmTT4

13. Continuing cycle d/t Infection

14. Symptoms • Persistent/recurrent cough • Dyspnea • Crackles • Pleuritic chest pain • Hemoptysis • Purulent sputum

15. 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

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

17. Supportive Educative Nursing 171 Lung CancerD.LoPresto, BSN, RN,C

18. Types Primary Lung Cancer • Small cell • Adenocarcinoma • Squamous • Large cell neoplasm

19. Lung Cancer Etiology: Smoking

20. 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%

21. Risk Assessment • Memorial Sloan-Kettering Cancer Center Lung cancer prediction tool www.mskcc.org/PredictionTools/LungCancer

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

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

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

25. Ectopic hormone syndromes • ACTH • ADH • PTH

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

27. Collaborative Care • Surgical Treatment -resection • Radiation • Chemotherapy • Targeted Therapy

28. Nursing Diagnosis: Group Activity