Pneumonia bacterial associations (risk factors)
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PCP = AIDS
staphylococcal = influenza
H. influenzae & pneumococci = increased risk in COPD
enteruc gram negative bacilli & S. aureus = HAP
Antimicrobial
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, antibacterial agent that kills bacteria or suppresses their growth
Side effects: diarrhea, upset stomach, nausea
Diagnostic tests meningitis
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CT scan: detects brain shift
Bacteria culture
Gram staining
resident bacteria
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Bacteria found under fingernails, in hair follicles, and in the openings of
sebaceous glands, and in the deeper layers of the skin
aspiration pneumonia
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can occur when a foreign substance, such as vomit, is inhaled into the lungs
A nurse is caring for a patient who is admitted to the hospital with injuries sustained in
a motor vehicle accident. While he is in the hospital, his wife tells him that the bottom
,level of their house flooded, damaging their belongings. When the nurse enters his
room, she notes that the patient is visibly upset. The nurse is aware that the patient will
most likely be in need of which type of counseling?
A. Long-term developmental
B. Short-term situational
C. Short-term motivational
D. Long-term motivational
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B. Short-term counseling might be used during a situational crisis, which
occurs when a patient faces an event or situation that causes a disruption in
life, such as a flood. Long-term counseling extends over a prolonged
period; a patient experiencing a developmental crisis, for example, might
need long-term counseling. Motivational interviewing is an evidence-
based counseling approach that involves discussing feelings and incentives
with the patient. A caring nurse can motivate patients to become interested
in promoting their own health.
Sulfonamides
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trimethoprim/sulfamethoxazole
Side effects: dizziness, lethargy, nausea, skin rash
Contradiction: allergy to sulfonamides, group A streptococci pharyngitis
Opportunist bacteria
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, Bacteria that normally cause no problems but can be potentially harmful
(e.g. E. coli migrating from intestine to urinary tract resulting in UTI)
Therapeutic Management RSV
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Supplemental O2
Suctioning
Hydration
Inhaled bronchodilator therapy (racemic epinephrine or albuterol)
Infants managed at home
Hospital admission = tachypnea, retractions, poor oral intake, lethargy
Nurse Management RSV
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Maintaining patent airway: head elevated, suctioning (Yankauer or tonsil tip,
or nasal bulb; pressure 60-100 mm Hg)
Promoting adequate gas exchange: supplemental oxygen
Reducing risk of infection: droplet precautions, isolation c safe cohort
Family Education: notify provider if breathing becomes rapid/difficult,
cannot eat, cough can last days-weeks
Prevention: hand washing; Palivizumab (Synagis) monoclonal antibody IM
for children under 2yrs who were premature, have chronic lung disease,
congenital heart disease, or neuromuscular disorders
Box 24-1 Basophil
Give this one a try later!
PCP = AIDS
staphylococcal = influenza
H. influenzae & pneumococci = increased risk in COPD
enteruc gram negative bacilli & S. aureus = HAP
Antimicrobial
Give this one a try later!
, antibacterial agent that kills bacteria or suppresses their growth
Side effects: diarrhea, upset stomach, nausea
Diagnostic tests meningitis
Give this one a try later!
CT scan: detects brain shift
Bacteria culture
Gram staining
resident bacteria
Give this one a try later!
Bacteria found under fingernails, in hair follicles, and in the openings of
sebaceous glands, and in the deeper layers of the skin
aspiration pneumonia
Give this one a try later!
can occur when a foreign substance, such as vomit, is inhaled into the lungs
A nurse is caring for a patient who is admitted to the hospital with injuries sustained in
a motor vehicle accident. While he is in the hospital, his wife tells him that the bottom
,level of their house flooded, damaging their belongings. When the nurse enters his
room, she notes that the patient is visibly upset. The nurse is aware that the patient will
most likely be in need of which type of counseling?
A. Long-term developmental
B. Short-term situational
C. Short-term motivational
D. Long-term motivational
Give this one a try later!
B. Short-term counseling might be used during a situational crisis, which
occurs when a patient faces an event or situation that causes a disruption in
life, such as a flood. Long-term counseling extends over a prolonged
period; a patient experiencing a developmental crisis, for example, might
need long-term counseling. Motivational interviewing is an evidence-
based counseling approach that involves discussing feelings and incentives
with the patient. A caring nurse can motivate patients to become interested
in promoting their own health.
Sulfonamides
Give this one a try later!
trimethoprim/sulfamethoxazole
Side effects: dizziness, lethargy, nausea, skin rash
Contradiction: allergy to sulfonamides, group A streptococci pharyngitis
Opportunist bacteria
Give this one a try later!
, Bacteria that normally cause no problems but can be potentially harmful
(e.g. E. coli migrating from intestine to urinary tract resulting in UTI)
Therapeutic Management RSV
Give this one a try later!
Supplemental O2
Suctioning
Hydration
Inhaled bronchodilator therapy (racemic epinephrine or albuterol)
Infants managed at home
Hospital admission = tachypnea, retractions, poor oral intake, lethargy
Nurse Management RSV
Give this one a try later!
Maintaining patent airway: head elevated, suctioning (Yankauer or tonsil tip,
or nasal bulb; pressure 60-100 mm Hg)
Promoting adequate gas exchange: supplemental oxygen
Reducing risk of infection: droplet precautions, isolation c safe cohort
Family Education: notify provider if breathing becomes rapid/difficult,
cannot eat, cough can last days-weeks
Prevention: hand washing; Palivizumab (Synagis) monoclonal antibody IM
for children under 2yrs who were premature, have chronic lung disease,
congenital heart disease, or neuromuscular disorders
Box 24-1 Basophil
