Chapter 28 Adult Health I
Management of Patients with
Lower Respiratory Problems
Chapter 28
Acute Bronchitis
An inflammation of the bronchi in the lower respiratory tract
Clinical Manifestations
Cough, Headache, Malaise, SOB, Fever, Dyspnea,
Normal Breath Sounds or Wheezes, Chest Pain
Nursing Care
Supportive i.e. fluids, rest, cough suppressants, bronchodilators, inhaled corticosteroids
Pneumonia
• Acute inflammation of the lung parenchyma
Types of Pneumonia
• Community Acquired (CAP)
– Before hospitalization
• Medical Care-Associated (MCAP)
– Encompasses 3 forms (HAP, VAP, & HCAP)
• Hospital Acquired (HAP)
– Within 48 hrs or longer after admission
• Ventilator associated pneumonia (VAP)
–
48-72 hours after intubation
• Health Care-Associated (HCAP)
– In hospital for 2 days/longer w/in 90 days, resided in long-term care facility, IV anti bx, chemo, or wound care w/in 30 days, attended hospital or dialysis clinica
Types of Pneumonia-cont
• Aspiration-pathogens in oral mucosa, loss of consciousness • Opportunistic-altered immune system
– Cytomegalovirus (CMV)
– Pneumocystis jiroveci (PCP)
Pneumonia
Predisposition: Normal defense mechanisms overwhelmed by a virus or infectious agent
??What Are the Risk Factors??
Case Study iStockphoto/Thinkstock • D.T. is an 88-year-old woman who lives alone. • She has been feeling weaker over past 2 days. • Last night became confused and disoriented. Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
Case Study iStockphoto/Thinkstock • Her housekeeper notified her daughter, who brought D.T. to the clinic.
• She complains of coughing over the past 3 days.
• She has a history of mild heart failure that is treated medically but has no other significant health disorders.
• She last saw her health care provider 4 months ago. Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
Case Study iStockphoto/Thinkstock 1.What are D.T.’s risk factors for pneumonia? 2.Based on her history, what type of pneumonia would you suspect D.T. has?
Lower Respiratory Problems
Chapter 28
Acute Bronchitis
An inflammation of the bronchi in the lower respiratory tract
Clinical Manifestations
Cough, Headache, Malaise, SOB, Fever, Dyspnea,
Normal Breath Sounds or Wheezes, Chest Pain
Nursing Care
Supportive i.e. fluids, rest, cough suppressants, bronchodilators, inhaled corticosteroids
Pneumonia
• Acute inflammation of the lung parenchyma
Types of Pneumonia
• Community Acquired (CAP)
– Before hospitalization
• Medical Care-Associated (MCAP)
– Encompasses 3 forms (HAP, VAP, & HCAP)
• Hospital Acquired (HAP)
– Within 48 hrs or longer after admission
• Ventilator associated pneumonia (VAP)
–
48-72 hours after intubation
• Health Care-Associated (HCAP)
– In hospital for 2 days/longer w/in 90 days, resided in long-term care facility, IV anti bx, chemo, or wound care w/in 30 days, attended hospital or dialysis clinica
Types of Pneumonia-cont
• Aspiration-pathogens in oral mucosa, loss of consciousness • Opportunistic-altered immune system
– Cytomegalovirus (CMV)
– Pneumocystis jiroveci (PCP)
Pneumonia
Predisposition: Normal defense mechanisms overwhelmed by a virus or infectious agent
??What Are the Risk Factors??
Case Study iStockphoto/Thinkstock • D.T. is an 88-year-old woman who lives alone. • She has been feeling weaker over past 2 days. • Last night became confused and disoriented. Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
Case Study iStockphoto/Thinkstock • Her housekeeper notified her daughter, who brought D.T. to the clinic.
• She complains of coughing over the past 3 days.
• She has a history of mild heart failure that is treated medically but has no other significant health disorders.
• She last saw her health care provider 4 months ago. Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
Case Study iStockphoto/Thinkstock 1.What are D.T.’s risk factors for pneumonia? 2.Based on her history, what type of pneumonia would you suspect D.T. has?