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Lower Respiratory ProblemsMedical Surgical Nursing

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Mechanical obstruction is usually the first sign of aspiration pneumonia if the substance is...
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An inert substance like Barium
This is a form of aspiration pneumonia caused when a chemical injury from gastric juices or other toxic substance occurs and a secondary infection develops...
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Chemical pneumonitis...symptoms usually occur 48-72 hours after injury
What is the most important form of aspiration pneumonia?
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Bacterial
What medical conditions make people especially susceptible to respiratory infections?
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-severe protein-calorie malnutrition -immune deficiencies -transplant patients being treated with immunosuppressives -patients receiving radiation, chemo, or are on prolonged corticosteroid therapies
What organisms are opportunistic pathogens that cause pneumonia in immunocompromised patients?
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Pneumocystitis jiroveci (carinii), fungi and cytomegalovirus (CMV)
________ has been identified as the most commonly acquired AIDS-defining opportunistic infection in the United States.
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Pneumocystitis jiroveci pneumonia (PCP)
In this type of pneumonia, an Xray will show a diffuse bilateral alveolar pattern of infiltration, and in more widespread cases will show massively consolidated lung fields.
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PCP (Pneumoncystitis Jiroveci Pneumonia) Check out this weblink for a picture http://www.infectiousdiseasenews.com/200606/discovery.asp
How is PCP treated?
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Bactrim is the primary agent. If the patient is allergic, Dapsone or NebuPent can be used.
________ is a viral cause of pneumonia that occurs in immunocompromised patients, especially those that have undergone transplants.
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Cytomegalovirs (CMV)
How is CMV typically treated?
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Ganciclovir (Cytovene)
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T/F Cytomegalovirus, the cause of viral pneumonia in immunocompromised patients, is highly prevalent and most people are exposed to it in childhood.
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True, it is like chicken pox, it goes latent and then waits for your immune system to be weakened to strike again.
Where is Streptococcus pneumoniae (pneumococcus) typically found in the body?
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The nose and throat.
What race, African Americans or Caucasians, is most likely to to contract Pneumococcal pneumonia (caused by Streptococcus pneumoniae)?
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African Americans are twice as likely to contract it than Caucasians
What are the four general states of pneumococcal pneumonia?
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Congestion Red Hepatization Gray Hepatization Resolution
What phase of pneumonia? The alveoli are invaded and there is an outpouring of fluid. The organisms multiply in the serous fluid and spreads, overwhelming lung function.
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Congestion
What phase of pneumonia? Massive dilation of the capillaries and the alveoli are filled with organisms, neutrophils, RBCs and fibrin causing the lungs to take on the appearance of the liver.
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Red Hepatization (the lungs turn red and granular, similar to the liver)
What phase of pneumonia? Blood flow to the lungs decreases and leukocytes and fibrin consolidate on the affected part of the lung.
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Gray Hepatization
What happens during the resolution stage of pneumonia?
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The exudate is lysed and processed by macrophages, lung tissue is restored as well as gas exchange
A patient comes into the clinic with fever, chills, SOA and is coughing up rust colored sputum. During percussion, the lung fields are dull and auscultation reveals crackles and bronchial breath sounds. You suspect the patient has...
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Pneumonia
In an elderly or debilitated patient, ________ may be the only presenting symptoms of pneumonia.
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Confusion or stupor (possibly r/t hypoxia)
A patient comes to the clinic complaining that they had a persistent dry cough for a few days, but now she has a horrible headache, muscle pains, a sore throat and she's really tired. She also complains of feeling nauseous. You listen to her lungs and hear crackles. You suspect she has pneumonia cause by one of the following organisms:
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Mycoplasm pneumoniae, Legionella or Chlamydia pneumoniae All three of these organisms cause the classic symptoms above. They can also present with diarrhea or vomiting
  
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