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Med Surg Cert
| Influenza | infectious disease caused by ribonucleic acid (RNA) viruses that can affect humans, birds, and other mammals A, B, and C can infect humans |
| Avian Influenza | infected migratory & domestic birds shed virus in saliva, nasal secretions, feces Strain: H5H1 Transmission limited to people and some animals |
| Influenza Signs & Symptoms | fever, cough, sore throat, muscle aches also eye infections, PNA, acute respiratory distress diarrhea, vomiting, and abd pain may occur |
| Influenza Diagnosis | chest xray - may show PNA, infiltrates, or consolidations sputum gram stains & culture isolate virus |
| Influenza Treatment | Neuraminidase inhibitor - oseltamivir (Tamiflu), peramivir (Rapivab), and sanamivir (Relenxa) can reduce severity & duration M2 inhibitors - amantadine & rimantadine (Flumadine) for pandemic (resistance may develop) maintain fluid/electrolyte balance |
| Influenza Nursing Interventions | standard and contact precautions, fit-tested ventilator, hand hygiene eye protection within 3' of patient maintain patent airway, suctioning |
| Pleural Effusion | accumulation of fluid in pleural space occurs secondary to other disease states empyema - accumulation of pus & necrotic tissue in pleural space; blood (hemothorax) and chyle (chylothorax) may also collect in this space |
| Exudative Pleural Effusion | caused by inflammation of pleura causes - bacterial or fungal empyema or pneumonitis, chest trauma, collagen disease, malignancy, myxedema, pancreatitis, PE, subphrenic abcess, and TB |
| Transudative Pleural Effusion | caused by excessive hydrostatic pressure or decreased osmotic pressure causes - HF, hepatic disease with ascites, hypoalbuminemia, and peritoneal dialysis |
| Pleural Effusion Signs and Symptoms | most common - pleuritic pain and dyspnea decreased chest wall movement, decreased breath sounds over affected area, dullness on percussion infection from empyma may cause - cough, fever, night sweats |
| Pleural Effusion Diagnosis and Treatment | chest xray can diagnose CT of chest, bronchoscopy, pleurocentesis, US underlying cause should be treated thoracentesis - remove fluid (chest tube for continued drainage) thoracotomy if thoracentesis ineffective abx for empyema (depends on organism) |
| Pleural Effusion Nursing Intervention | watch for respiratory distress or pneumothorax after thoracentesis encourage deep breathing and IS maintain integrity of chest tubes; monitor amount, color, consistency of drainage; check for air leaks |
| Pneumonia | acute lung infection with inflammation accompanied by accumulation of exudate in the alveoli major cause of morbidity and mortality among elderly and chronically ill |
| Pneumonia Risks | risk increases with aspiration, CNS depression, chronic illness, COPD, dehydration, trach, immobility, immunosuppression, intubation, pain in thoracic cavity, anesthesia may result from bacterial, fungal, or viral infection; exposure to chemical irritan |
| Pneumonia Signs and Symptoms | common - dyspnea, tachypnea, fatigue, & fever cyanosis/hypoxia in advanced disease cerebral hypoxia - irritability or restlessness crackles, rhonchi, bronchial breath sounds over consolidation; wheezes over affected areas; decreased in advanced disease |
| Pneumonia Diagnosis | chest xray, ABG, sputum culture (bacterial), serologic testing (viral) needle or open biopsy to obtain lung tissue specimen (fungal) |
| Pneumonia Treatment and Nursing Intervention | antibiotics to eradicate infecting organisms bronchodilator to open narrowed airways teach effective coughing/deep breathing, hydration, pain management, hand hygiene |
| Pulmonary Edema | the collection of fluid in the interstitium and alveoli of the lungs as pressure rises in pulmonary vessels can result from ARDS, fluid overload, left-sided HF, mitral stenosis, MI, PE |
| Pulmonary Edema Effect on Left Ventricle | L ventricle can't pump blood from heart; increased resistance = fluid backs up into lungs; surface tension increases, alveoli shrink, lungs become stiff = diff breathing; hypoxemia/altered V/Q ratio; fluid moves into larger airways -> pink, frothy sputum |
| Pulmonary Edema Signs and Symptoms | tachycardia & -pnea, hypoTN; 3rd & 4th heart sounds; skin cold & clammy; dysp, pulm HTN; distended jugular veins; blood-tinged or pink, frothy sputum lung auscultation = dependent crackles confusion, decreased urine output, diaphoresis, lethargy |
| Pulmonary Edema Diagnosis and Treatment | CXR, ABG diuretic; inotropic drugs = increase myocardial contractility, nitro = reduce pre & afterload, and vassopressor; morphine = decrease preload, RR, anxiety if no response = intra-aortic balloon pump or surgery (angioplasty, bypass, valve repair) |
| Pulmonary Edema Nursing Intervention | semi-Fowlers to maximize oxygenation and reverse hypoxemia strict I/O to assess effectiveness of diureti |
| Pulmonary Embolism | blockage in pulm vasculature; bone, air, fat, amniotic fluid, thrombus, foreign object lung isnt perfused = altered V/Q ratio = alveolar collapse -> atelectasis & hypoxemia; pulm infarction may occur can cause pulm HTN, right HF, ventricular hypertrophy |
| Pulmonary Embolism Risk Factors | afib, COPD, family hx of PE, birth control, prior embolism, venous injury or stasis |
| Pulmonary Embolism Signs and Symptoms | dyspnea with CP; pleuritic CP may be pulm infarction; hemoptysis, anxiety, restlessness, hypoTN, tachycardia; crackles, pleural friction rub, wheezes; lowgrade fever may have arrhythmia, cyanosis, diaphoresis fat embolism - confusion, dyspnea, petechiae |
| Pulmonary Embolism Diagnosis and Treatment | ABG, CXR, ECG, lung scintigraphy, MRI, pulm abgiography, V/Q lung scan DVT - contrast venography, Doppler heparin gtt; warfarin embolectomy; vena cava filter; diuretic (for fat em); abx (for septic em); anti-arrhythmic for arrhythmia with ischemia |
| Pulmonary Embolism Nursing Intervention | cough/deep breath; hydration; ambulation, ROM; TED hose; don't raise knees (obstructs venous flow); elevate legs |
| Severe Acute Respiratory Syndrome (SARS) | life-threatening viral infection believed to be coronavirus (mutated from animals) incubation period - 2-7 days risk factors - close contact/contact with exhaled droplets/bodily secretions from infected person, or travel to endemic area |
| Severe Acute Respiratory Syndrome (SARS) Signs and Symptoms | early stages - nonproductive cough, rash, high fever, headache, body aches, PNA later stages - SOB and respiratory distress |
Created by:
chllewellyn
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