Complex Exam 1
What is an acronym for pneumonia patients' expected findings *** "A Fabulous Woman Carried
Conditioner"
- anxiety, fatigue, weakness, chest discomfort due to coughing, confusion from hypoxia
Cellulitis assessment *** - Erythema (Redness)
- Warmth
- Fever, chills, diaphoresis
- Swelling (due to impaired circulation or high BMI)
- Pain
Cellulitis pharmacological interventions (priority over non pharm!!!) *** - PO/IM/IV or cream (PO/IM at
home if not bad start here)
- Antibiotics:
~ Cephalexin (1st choice drug): effective against strep and staph (unless allergic to penicillin due to cross
sensitivity)
~ Trimethoprim: effective against some strains resistant to other abx
~ Clindamycin
~ Doxycycline (some anti-inflammatory properties)
~ NSAIDs can reduce pain/inflammation but have a risk of: GI bleeding (take w/ food).
~ Opioids may be prescribed for severe cases of pain but have a risk of: NARCSU
What medications can be used for cellulitis *** - Cephalexin (1st choice)
- Trimethoprim with sulfamethoxazole
- Clindamycin
- Doxycycline
,- NSAIDs
- Opioids (severe cases)
Cellulitis nursing/non-pharmacological interventions *** - Wound care
- RICE (elevate affected area 3-6 in. above heart & apply cool packs to site q 2-4 hrs until the
inflammation has resolved, and then transition to warm packs)
- Sterline saline dressings
Cellulitis patient education *** - Keep clean/moist
- Monitor for worsening infection (draw lines around it)
- Increased risk for cellulitis again!
- proper hygiene and nutrition and hyrdation
- continue antibiotic therapy
Pneumonia physical assessment *** - SOB
- Tachypnea/Dyspnea
- Fever/chills
- Malaise
- Loss of appetite/diaphoresis
- Pleuritic chest pain (report)
- Cough/Sputum (yellow green)
- Wheezing, crackles
- Decreased O2 sat (cyanosis)
- Decreased LOC, VS
,Pneumonia Diagnostics *** - Chest X-Ray: consolidation (solidification, density) of lung tissue suggestive
of pneumonia
- Pulse Ox: pneumonia pt expected O2 sat <95%
Pneumonia nursing interventions *** - 2-3L fluid intake (IV/PO)
- Promote adequate nutrition
- Admin Oxygen therapy
- High Fowler's (maximize ventilation)
- Remove secretions (by encouraging coughing or suction)
- Incentive spirometer 8-10x an hour (breath in)
- Rest but also mobile
Pneumonia pharmacological interventions *** - ABx: Penicillins & Cephalosporins (FIRST) (take w/ food
& monitor kidney function)
- Macrolides (azithromycin, gentamicin KIDNEY)
- Bronchodilators: (albuterol) : tremors, tachycardia
~ Cholinergic antagonists (ipratropium, atrovent): suck on hard candy, increase fluid, rinse mouth after
- Anti-Inflammatory Steroids like glucocorticoids (fluticasone, prednisone, methyl.): B before C (report
black tarry stool, take w/ food, taper dose) don't take long term due to immunosupression and
hyperglycemia > can give to diabetics (ABCs)
- Mucolytic (Acetylcysteine)
Pneumonia patient education *** - Rest
- Hand hygiene
- Avoid crowded areas
- Stop smoking
- Fluids
, - Diet, increase protein and vit C
- Take meds as prescribed
- Immunizations: pneumonia vaccine, influenza, &/or Pneumovax (65 yrs old and q 5 yrs after - unless
underlying conditions like HIV/cancer)
What is tuberculosis and how is it transmitted *** - An infectious disease caused by Mycobacterium
tuberculosis, can lay dormant for years
- Transmitted through the airborne route and affects the lungs. Report to CDC
What are the expected findings for a patient with tuberculosis *** - Persistent cough (lasting > 3 weeks)
- Purulent sputum (possibly blood-tinged, HEMOPTYSIS), consistently bloody
- Fatigue
- Lethargy
- Weight loss
- Anorexia; loss appetite
- Night-sweats in the afternoon (late afternoon) KEY for TB
- Low-grade fever in the afternoon
What are the physical assessment findings for older adults with TB *** - Older adults often present with
atypical findings of the disease:
~ altered mentation or unusual behavior
~ fever
~ anorexia
~ weight loss
What is the only TB test that tells you if you have active TB *** AFB test sputum culture
What is an acronym for pneumonia patients' expected findings *** "A Fabulous Woman Carried
Conditioner"
- anxiety, fatigue, weakness, chest discomfort due to coughing, confusion from hypoxia
Cellulitis assessment *** - Erythema (Redness)
- Warmth
- Fever, chills, diaphoresis
- Swelling (due to impaired circulation or high BMI)
- Pain
Cellulitis pharmacological interventions (priority over non pharm!!!) *** - PO/IM/IV or cream (PO/IM at
home if not bad start here)
- Antibiotics:
~ Cephalexin (1st choice drug): effective against strep and staph (unless allergic to penicillin due to cross
sensitivity)
~ Trimethoprim: effective against some strains resistant to other abx
~ Clindamycin
~ Doxycycline (some anti-inflammatory properties)
~ NSAIDs can reduce pain/inflammation but have a risk of: GI bleeding (take w/ food).
~ Opioids may be prescribed for severe cases of pain but have a risk of: NARCSU
What medications can be used for cellulitis *** - Cephalexin (1st choice)
- Trimethoprim with sulfamethoxazole
- Clindamycin
- Doxycycline
,- NSAIDs
- Opioids (severe cases)
Cellulitis nursing/non-pharmacological interventions *** - Wound care
- RICE (elevate affected area 3-6 in. above heart & apply cool packs to site q 2-4 hrs until the
inflammation has resolved, and then transition to warm packs)
- Sterline saline dressings
Cellulitis patient education *** - Keep clean/moist
- Monitor for worsening infection (draw lines around it)
- Increased risk for cellulitis again!
- proper hygiene and nutrition and hyrdation
- continue antibiotic therapy
Pneumonia physical assessment *** - SOB
- Tachypnea/Dyspnea
- Fever/chills
- Malaise
- Loss of appetite/diaphoresis
- Pleuritic chest pain (report)
- Cough/Sputum (yellow green)
- Wheezing, crackles
- Decreased O2 sat (cyanosis)
- Decreased LOC, VS
,Pneumonia Diagnostics *** - Chest X-Ray: consolidation (solidification, density) of lung tissue suggestive
of pneumonia
- Pulse Ox: pneumonia pt expected O2 sat <95%
Pneumonia nursing interventions *** - 2-3L fluid intake (IV/PO)
- Promote adequate nutrition
- Admin Oxygen therapy
- High Fowler's (maximize ventilation)
- Remove secretions (by encouraging coughing or suction)
- Incentive spirometer 8-10x an hour (breath in)
- Rest but also mobile
Pneumonia pharmacological interventions *** - ABx: Penicillins & Cephalosporins (FIRST) (take w/ food
& monitor kidney function)
- Macrolides (azithromycin, gentamicin KIDNEY)
- Bronchodilators: (albuterol) : tremors, tachycardia
~ Cholinergic antagonists (ipratropium, atrovent): suck on hard candy, increase fluid, rinse mouth after
- Anti-Inflammatory Steroids like glucocorticoids (fluticasone, prednisone, methyl.): B before C (report
black tarry stool, take w/ food, taper dose) don't take long term due to immunosupression and
hyperglycemia > can give to diabetics (ABCs)
- Mucolytic (Acetylcysteine)
Pneumonia patient education *** - Rest
- Hand hygiene
- Avoid crowded areas
- Stop smoking
- Fluids
, - Diet, increase protein and vit C
- Take meds as prescribed
- Immunizations: pneumonia vaccine, influenza, &/or Pneumovax (65 yrs old and q 5 yrs after - unless
underlying conditions like HIV/cancer)
What is tuberculosis and how is it transmitted *** - An infectious disease caused by Mycobacterium
tuberculosis, can lay dormant for years
- Transmitted through the airborne route and affects the lungs. Report to CDC
What are the expected findings for a patient with tuberculosis *** - Persistent cough (lasting > 3 weeks)
- Purulent sputum (possibly blood-tinged, HEMOPTYSIS), consistently bloody
- Fatigue
- Lethargy
- Weight loss
- Anorexia; loss appetite
- Night-sweats in the afternoon (late afternoon) KEY for TB
- Low-grade fever in the afternoon
What are the physical assessment findings for older adults with TB *** - Older adults often present with
atypical findings of the disease:
~ altered mentation or unusual behavior
~ fever
~ anorexia
~ weight loss
What is the only TB test that tells you if you have active TB *** AFB test sputum culture
