1118 UNIT 4 QUESTIONS WITH ACCURATE ANSWERS
Acute Bacterial Pneumonia correct answer Acute Bacterial Pneumonia
-50-75% of all pneumonias
-Usually caused by Streptococcus pneumoniae
-May develop after URI
-Acute onset
-Spread by droplet
Acute Bacterial Pneumonia correct answer Acute Bacterial Pneumonia
-You aspirate it into your lungs --> it starts an inflammatory process --> you get
exudate and alveolar edema --> Alveoli and respiratory bronchioles fill with
serous exudate, blood cells, fibrin, bacteria-->Consolidation of lung tissue
-When the alveoli fill with fluid, it gets in the way of O2 exchange.
-When one lobe is involved, it's called lobar pneumonia.
-Bronchopneumonia is more than one lobe, but can be patchy in places. Usually
settles into the bases.
Acute Bacterial Pneumonia correct answer Acute Bacterial Pneumonia
Complications
-Hypoxia: Most of the time, it's uncomplicated. Can be treated in an outpatient
setting. If pts PaO2 is under 75% and O2 sats under 90%, then might have
impaired gas exchange and need to be treated inpatient.
-Bacteremia: The bacteria can move out of the lungs into the bloodstream and to
other parts of the body, including the brain (meningitis), heart (endocarditis),
abdomen (peritonitis). If the bacteria moves, there's a higher risk of death.
,-Empyema (pus in the pleural space), lung abscess, necrosis (can destroy the lung
tissue. Often a Staph aureus infection)
-Death!
Acute Bacterial Pneumonia correct answer Acute Bacterial Pneumonia S/S
-Fever, chills: *Acute onset cardinal sign*
-Chest pain
-Altered breath sounds: Dull to percussion
-Productive cough, rails, crackles. Discolored sputum (green, rusty colored,
purulent, thick)
-CXR shows consolidation
-Elderly pts have less obvious symptoms: Altered mental status, restlessness,
agitation, won't have a strong cough, won't have as much fever.
Acute Bronchitis correct answer Acute Bronchitis
-Inflammation of the bronchi
-Very common, rarely severe. Almost always treated outpatient.
-Usually follows an upper respiratory infection (URI)
-Bacterial or viral, or inflammatory reaction. Can be from inhaling an irritant.
-Non-productive cough --> productive: Lining of the bronchi become inflammed,
they swell, and produce more mucous, which causes the cough. Usually no fever
(contrast with pneumonia that does have a fever)
-Treatment: Treat the symptoms. Cough suppressant at night to help the pt get
some sleep, but during the day, the pt needs to cough up the mucous to clear the
secretions. Usually resolves on its own without antibiotics. Chest x-ray to rule out
pneumonia if it's not resolving. Give pt lots of fluids to make secretions thin. Rest,
good nutrition.
,Acute Epiglottitis correct answer Acute Epiglottitis
-Medical emergency
-Intubation: Should be done early before airway closes. Probably nasally
intubated
-Will see nasal flaring, restlessness, stridor, use of the accessory muscles,
decreased O2 saturation (<90% look at interventions). Comes on children very
quick but they recover fast. With adults, slower onset, but takes longer to get
better.
-Antibiotics: Part of the treatment, but can take hours or a day to have an effect.
-Dexamethasone (systemic corticosteroid): IV steroids Immediate treatment in an
emergency *airway patency most important thing*
-Respiratory distress:
Acute Epiglottitis correct answer Acute Epiglottitis S/S (mnemonic ADD AIR
NURSE)
-Abnormal position (tripod)
-Dysphagia leads to drooling
-Difficulty speaking (muffled, soft)
-Apprehension
-Increased temperature (HIGH)
-Rapid onset
-Nasal flaring
-Using accessory muscles
, -Retractions (chest)
-Stridor (inspiratory)
Enlarged epiglottis (enlarged on X-ray or visible)
Adult Asthma Action Plan correct answer Adult Asthma Action Plan
-Green Zone (stable): No symptoms. Able to do daily activities without much
difficulty. Peak flow reading: 80&-100% of personal best. They continue taking
their medications, and are controlling their triggers. Environmental control
measures work well. They can still exercise. Have them take their medications and
get their vaccines.
-Yellow zone (caution): Coughing, sleep disturbed by asthma symptoms, short of
breath/wheezing, difficulty doing daily activities. Peak flow reading 65-80% of
personal best. Rest needs to be increased. Possibly add a steroid inhaler or steroid
pill to the mix. Take inhaler more often during the day. If peak flow reading ever
gets down to 50-65% they need to call the doctor.
-Red zone (Alert) very SOB, trouble walking or talking, unable to do daily activities.
Peak flow reading less than 50%. Call physician. Add or increase oral steroid.
Might need to use the epi-pen.
-Go to the emergency room immediately if lips or nails have turned blue, if chest
feels tight, if they feel tired, if they feel faint or pass out, if they struggle to
breathe, or if medication doesn't help.
Aspiration Pneumonia correct answer Aspiration Pneumonia
-Both chemical irritation & bacterial infection causes severe inflammation
-People who aspirate are those who don't have an intact gag reflex (lidocaine can
cause this)
-Prevention is critical
Acute Bacterial Pneumonia correct answer Acute Bacterial Pneumonia
-50-75% of all pneumonias
-Usually caused by Streptococcus pneumoniae
-May develop after URI
-Acute onset
-Spread by droplet
Acute Bacterial Pneumonia correct answer Acute Bacterial Pneumonia
-You aspirate it into your lungs --> it starts an inflammatory process --> you get
exudate and alveolar edema --> Alveoli and respiratory bronchioles fill with
serous exudate, blood cells, fibrin, bacteria-->Consolidation of lung tissue
-When the alveoli fill with fluid, it gets in the way of O2 exchange.
-When one lobe is involved, it's called lobar pneumonia.
-Bronchopneumonia is more than one lobe, but can be patchy in places. Usually
settles into the bases.
Acute Bacterial Pneumonia correct answer Acute Bacterial Pneumonia
Complications
-Hypoxia: Most of the time, it's uncomplicated. Can be treated in an outpatient
setting. If pts PaO2 is under 75% and O2 sats under 90%, then might have
impaired gas exchange and need to be treated inpatient.
-Bacteremia: The bacteria can move out of the lungs into the bloodstream and to
other parts of the body, including the brain (meningitis), heart (endocarditis),
abdomen (peritonitis). If the bacteria moves, there's a higher risk of death.
,-Empyema (pus in the pleural space), lung abscess, necrosis (can destroy the lung
tissue. Often a Staph aureus infection)
-Death!
Acute Bacterial Pneumonia correct answer Acute Bacterial Pneumonia S/S
-Fever, chills: *Acute onset cardinal sign*
-Chest pain
-Altered breath sounds: Dull to percussion
-Productive cough, rails, crackles. Discolored sputum (green, rusty colored,
purulent, thick)
-CXR shows consolidation
-Elderly pts have less obvious symptoms: Altered mental status, restlessness,
agitation, won't have a strong cough, won't have as much fever.
Acute Bronchitis correct answer Acute Bronchitis
-Inflammation of the bronchi
-Very common, rarely severe. Almost always treated outpatient.
-Usually follows an upper respiratory infection (URI)
-Bacterial or viral, or inflammatory reaction. Can be from inhaling an irritant.
-Non-productive cough --> productive: Lining of the bronchi become inflammed,
they swell, and produce more mucous, which causes the cough. Usually no fever
(contrast with pneumonia that does have a fever)
-Treatment: Treat the symptoms. Cough suppressant at night to help the pt get
some sleep, but during the day, the pt needs to cough up the mucous to clear the
secretions. Usually resolves on its own without antibiotics. Chest x-ray to rule out
pneumonia if it's not resolving. Give pt lots of fluids to make secretions thin. Rest,
good nutrition.
,Acute Epiglottitis correct answer Acute Epiglottitis
-Medical emergency
-Intubation: Should be done early before airway closes. Probably nasally
intubated
-Will see nasal flaring, restlessness, stridor, use of the accessory muscles,
decreased O2 saturation (<90% look at interventions). Comes on children very
quick but they recover fast. With adults, slower onset, but takes longer to get
better.
-Antibiotics: Part of the treatment, but can take hours or a day to have an effect.
-Dexamethasone (systemic corticosteroid): IV steroids Immediate treatment in an
emergency *airway patency most important thing*
-Respiratory distress:
Acute Epiglottitis correct answer Acute Epiglottitis S/S (mnemonic ADD AIR
NURSE)
-Abnormal position (tripod)
-Dysphagia leads to drooling
-Difficulty speaking (muffled, soft)
-Apprehension
-Increased temperature (HIGH)
-Rapid onset
-Nasal flaring
-Using accessory muscles
, -Retractions (chest)
-Stridor (inspiratory)
Enlarged epiglottis (enlarged on X-ray or visible)
Adult Asthma Action Plan correct answer Adult Asthma Action Plan
-Green Zone (stable): No symptoms. Able to do daily activities without much
difficulty. Peak flow reading: 80&-100% of personal best. They continue taking
their medications, and are controlling their triggers. Environmental control
measures work well. They can still exercise. Have them take their medications and
get their vaccines.
-Yellow zone (caution): Coughing, sleep disturbed by asthma symptoms, short of
breath/wheezing, difficulty doing daily activities. Peak flow reading 65-80% of
personal best. Rest needs to be increased. Possibly add a steroid inhaler or steroid
pill to the mix. Take inhaler more often during the day. If peak flow reading ever
gets down to 50-65% they need to call the doctor.
-Red zone (Alert) very SOB, trouble walking or talking, unable to do daily activities.
Peak flow reading less than 50%. Call physician. Add or increase oral steroid.
Might need to use the epi-pen.
-Go to the emergency room immediately if lips or nails have turned blue, if chest
feels tight, if they feel tired, if they feel faint or pass out, if they struggle to
breathe, or if medication doesn't help.
Aspiration Pneumonia correct answer Aspiration Pneumonia
-Both chemical irritation & bacterial infection causes severe inflammation
-People who aspirate are those who don't have an intact gag reflex (lidocaine can
cause this)
-Prevention is critical
