NURS 171
RESPIRATORY SYSTEM:
PNEUMONIA
Darlene LoPresto, Graduate Student FSU
Pathophysiology
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Bacterial or viral
Infection/Inflammation
Exudate
Lobar or diffuse
Streptococcus
Klebsiella
Etiology
Incompetent distal
airway defense
mechanisms
Prevention
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Pneumococcal vaccine
Avoid smoking
Avoid allergens, indoor pollutant exposure
Symptoms
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Nausea/vomiting/diarrhea
Dyspnea
Productive cough
Pleuritic pain
Confusion
Diagnosis & Complications
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Multi drug resistance
Allergic reaction
Food/drug interaction
Medical Management
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Limited activity
Antipyretics
Analgesics
Oxygen therapy
I.S.
Bronchodilators
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Increase fluid intake
Antibiotic therapy
Rest
Modify r/t patient
response
Pneumonia Review Question

What is one of the most common bacterial
organisms that cause pneumonia?
a) Staph Aureus
b) Streptococcus
c) Both a & b
d) All of the above
Pneumonia Review Question

Symptoms of pneumonia include all of the following
except:
a) Productive cough
b) Dyspnea
c) Hemoptysis
d) Pleuritic pain
Pneumonia Review Question

Nursing Interventions for the pneumonia patient
include all of the following except:
a) Blood culture interpretation
b) Incentive spirometry
c) Increase fluid intake
d) None of the above
Nurse Diagnosis: Case Study
Bronchiectasis
Supportive Educative Nursing 171
Darlene LoPresto, BSN, RN,C
http://
www.
youtu
be.co
m/wat
ch?v=
zMKa
JEgm
TT4
Continuing cycle d/t Infection
Remodeling
Inflammation
Airway damage
Symptoms
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Persistent/recurrent cough
Dyspnea
Crackles
Pleuritic chest pain
Hemoptysis
Purulent sputum
Medical Management
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Dx: HRCT
Sputum cultures
Tx: Treat acute flare-ups
Maintain lung function
Antibiotics
Bronchodilators
Mucolytic agents
Anti-inflammatory agents
http://www.youtube.com/watch?v=JmRt9rFmVu4&feature=related
Nursing Diagnosis
•
Ineffective airway clearance r/t
increased secretions
-Chest physiotherapy & Postural drainage
-No smoking
-Vaccinations
-Good oral hygiene
-Infection control
Supportive Educative Nursing 171
Lung Cancer
D.LoPresto, BSN, RN,C
Types Primary Lung Cancer

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Small cell
Adenocarcinoma
Squamous
Large cell neoplasm
Lung Cancer Etiology: Smoking
Incidence of Lung Cancer

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
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Leading cause of Cancer deaths
28% of all cancer deaths
172,570 new cases annually
58% death rate men
African Americans
Hispanics
5 year survival rate
15%
Risk Assessment
 Memorial Sloan-Kettering Cancer
Center Lung cancer prediction tool
www.mskcc.org/PredictionTools/LungCa
ncer
Which are Symptoms of lung cancer?
Select all that apply:
1) Persistent cough
2) Hemoptysis
3) Bradypnea
4) Hematemesis
5) Anorexia
Patient Symptoms
 Nonspecific
 Occur late in
disease
 Type of cancer &
location
 Dyspnea
 Persistent cough
 Persistent
pneumonitis
 Hemoptysis
 Ausculatory
wheeze
 Weight loss
 Fever
Diagnosis
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10% with routine CXR
PET scan
CT scan
Bone scan
Lung biopsy
20-30% (+) sputum
cytology
Ectopic hormone syndromes
 ACTH
 ADH
 PTH
Prevention
Smoking cessation
Screening CXR
Sputum cytology
The U.S. Preventive Service Task
Force
 The American College of Chest
Physicians

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Collaborative Care
 Surgical Treatment
-resection
 Radiation
 Chemotherapy
 Targeted Therapy
Nursing Diagnosis: Group
Activity