HESI Med Surg Respiratory
How does fever cause dehydration?
D/t excessive fluid loss from diaphoresis. Increased temperature also increased metabolism
and the demand for O2.
Clients at high risk for pneumonia:
ALOC, depressed or absent gag and cough reflex, susceptible to aspirating oropharyngeal
secretions, including alcoholics, anesthetized patients, brain injury, drug overdose,
stroke victim, immunocompromised, immobile, cigarette smokers, other neuro
disorders, debilitated by accumulated lung secretions.
Nursing assessment and S/SX of pneumonia:
Tachypnea- shallow respirations, often with use of accessory muscles, abrupt onset of fever
with shaking and chills, productive cough with pleuritic pain, rapid bounding pulse.
Elevated WBC's, pain and dullness to percussion over affected lung area, bronchial
breath sounds, crackles, chest radiograph indicative of infiltrates. ABG might indicate
hypoxemia.
S/SX of pneumonia in older adults:
Confusion, lethargy, malaise, anorexia, rapid RR, tachypnea.
Drugs for pneumonia:
1. Penicillins
2. Semisynthetics
3. Penicillins and Combos: Ampicillin, Unasyn, Zosyn.
4. Tetracylcines: Tetraclycine HCL, Vibramycin, Minocin
5. Aminoglycosides: Tobramycin, Gentamicin.
6. Misc: Vancomycin, Flagyl.
7. Cephlaosporins: Kefzol, Keflex, Manol, Cefzil, Suprax.
Bronchial breath sounds in pneumonia:
Heard over areas of density or consolidation. Sound waves are easily transmitted over
consolidated tissues.
Hydration in pneumonia:
Thins out the mucus trapped in the bronchioles and alveoli, facilitating expectoration. Is
essential for client experiencing fever b/c diaphoresis. Is important because 300-400mL
of fluid is lost in the lungs daily by evaporation. Client should also have fluids up to
3L/day
Early signs of cerebral hypoxia:
Irritability and restlessness. The client's brain is not receiving enough O2.
Pneumonia Preventives:
Older adults: get flu shot, pneumonia immunizations; avoid sources of infection and indoor
pollutants- dust, smoke, aerosols; no smoking.
Immunosuppressed and debilitated persons: infection avoidance, sensible nutrition,
adequate intake, balance of rest and activity.
Comotose and immobile patients: elevate HOB to feed and for 1 hr after feeding;
frequently turning.
Patients with functional or anatomic asplenia: Fku and pneumonia immunizations.
Chronic Bronchitis assessment:
"Blue bloaters". Generalized cyanosis, right sided heart failure, distended neck veins , crackles,
expiratory wheezes.
Emphysema assessment:
How does fever cause dehydration?
D/t excessive fluid loss from diaphoresis. Increased temperature also increased metabolism
and the demand for O2.
Clients at high risk for pneumonia:
ALOC, depressed or absent gag and cough reflex, susceptible to aspirating oropharyngeal
secretions, including alcoholics, anesthetized patients, brain injury, drug overdose,
stroke victim, immunocompromised, immobile, cigarette smokers, other neuro
disorders, debilitated by accumulated lung secretions.
Nursing assessment and S/SX of pneumonia:
Tachypnea- shallow respirations, often with use of accessory muscles, abrupt onset of fever
with shaking and chills, productive cough with pleuritic pain, rapid bounding pulse.
Elevated WBC's, pain and dullness to percussion over affected lung area, bronchial
breath sounds, crackles, chest radiograph indicative of infiltrates. ABG might indicate
hypoxemia.
S/SX of pneumonia in older adults:
Confusion, lethargy, malaise, anorexia, rapid RR, tachypnea.
Drugs for pneumonia:
1. Penicillins
2. Semisynthetics
3. Penicillins and Combos: Ampicillin, Unasyn, Zosyn.
4. Tetracylcines: Tetraclycine HCL, Vibramycin, Minocin
5. Aminoglycosides: Tobramycin, Gentamicin.
6. Misc: Vancomycin, Flagyl.
7. Cephlaosporins: Kefzol, Keflex, Manol, Cefzil, Suprax.
Bronchial breath sounds in pneumonia:
Heard over areas of density or consolidation. Sound waves are easily transmitted over
consolidated tissues.
Hydration in pneumonia:
Thins out the mucus trapped in the bronchioles and alveoli, facilitating expectoration. Is
essential for client experiencing fever b/c diaphoresis. Is important because 300-400mL
of fluid is lost in the lungs daily by evaporation. Client should also have fluids up to
3L/day
Early signs of cerebral hypoxia:
Irritability and restlessness. The client's brain is not receiving enough O2.
Pneumonia Preventives:
Older adults: get flu shot, pneumonia immunizations; avoid sources of infection and indoor
pollutants- dust, smoke, aerosols; no smoking.
Immunosuppressed and debilitated persons: infection avoidance, sensible nutrition,
adequate intake, balance of rest and activity.
Comotose and immobile patients: elevate HOB to feed and for 1 hr after feeding;
frequently turning.
Patients with functional or anatomic asplenia: Fku and pneumonia immunizations.
Chronic Bronchitis assessment:
"Blue bloaters". Generalized cyanosis, right sided heart failure, distended neck veins , crackles,
expiratory wheezes.
Emphysema assessment:
