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Lower Respiratory ProblemsMedical Surgical Nursing

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What are preventable predisposing factors for pneumonia?
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-Smoking -Alcholism -Malnutrition
T/F Many of the organisms that cause pneumonia are opportunistic pathogens that already reside in the pharynx of healthy adults.
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True
What are the three portals of entry into the lungs for pneumonia?
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-Aspiration of oropharyngeal or nasopharyngeal contents -Inhalation into the lungs -Hematogenous spread from a primary infection elsewhere in the body
The organisms responsible for pneumonia that are most likely to be inhaled from the air into the lungs are:
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Mycoplasma pneumoniae and fungal pneumoniae
An organism that can cause pneumonia from hemtagenous spreading is...
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Staphylococcus aureus
T/F Pneumonia can be caused by parasites.
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True
T/F Pneumonia can be caused by chemicals.
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True
What organisms is the most common cause of a Community Acquired pneumonia?
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Streptococcus pneumoniae
A case of pneumonia that is detected within ______ days of hospitalization is considered community acquired.
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2 days
What is a pneumonia PORT PSI?
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It is a risk assessment scale used to determine whether a patient shhould be treated at home or in a hospital. Pneumonia/Patient Outcomes Research Team (PORT) Pneumonia Severity Index (PSI)
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What is the three step approach to determining where a patient is best treated (home vs. hospital) for a community acquired pneumonia?
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1-Assess the patient's ability to care for themselves at home 2-Calculate the PORT PSI 3-Use clinical judgment
A patient has been scored using the POST PSI. His score is 140. Should he be sent home for treatment or admitted to the hospital for treatment?
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Admitted. The scores range from 0 (treat at home) to 130+ (treat in the hospital).
A patient has been assigned Risk Class III on the PORT PSI scale. Is he being sent home for treatment or admitted?
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Sent home. A risk class of I, II, or III (71-90 pts.) is sent home.
What is the cutoff point score on the PORT PSI to send a patient home?
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90 (Class III), anything higher requires admission
What are the preferred antiobiotics to treat pneumonia?
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-Macrolides like Erythromycin or Azithromycin (Zithromax), clarithromycin (Biaxin), or doxycycline (Vibramycin) If there are comorbidities present: -Beta lactam antibiotics like amoxicillin with clavulanate (Augmentin) may be added
What is an antibiogram and what is it used for?
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It is an antimicrobial susceptibility trending chart designed by a health care facility to guide use of antibiotics
What does it mean when someone says medication needs to be administered, door to dose?
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Within 4 hours of the patient walking into the door. This is a necessity when treating pneumonia patients, the quicker they are treated, the better the outcome
How long after starting antibiotic therapy for pneumonia should a patient start to experience a lessening of symptoms? How long does it take for pneumonia to completely resolve?
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Reduction in symptoms: 2-3 days/48-72 hours Cure: 3 days-3 weeks
What is the hospital discharge criteria for patients with community acquired pneumonia?
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The patient must have no more than one of the following abnormalities 24 hours prior to release: Temp over 100.4 Pulse over 100 Resp. Rate over 24 Systolic BP below 90 SpO2 below 90 Inability to maintain oral intake
What is VAP?
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Ventilator associated pneumonia which occurs 48-72 hours after endotracheal intubation
What organisms are attributed to both Community Acquired and Hospital Acquired cases of pneumonia? (2)
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Streptococcus pneumoniae Staphylococcus aureus All the others (in the chart) are attributed to either CA or HA, not both
  
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