NURS 171RESPIRATORY SYSTEM:

PNEUMONIADarlene 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 171Darlene LoPresto, BSN, RN,C

http://www.youtube.com/watch?v=zMKaJEgmTT4

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

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

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

www.mskcc.org/PredictionTools/LungCancer

Which are Symptoms of lung cancer?

Select all that apply:1) Persistent cough2) Hemoptysis3) Bradypnea4) Hematemesis5) 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