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Lower Respiratory ProblemsMedical Surgical Nursing

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What are specific factors that can reactivate TB?
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Immunosuppressive therapy, malignancy, or a prolonged debilitating illness
________ is a pulmonary disease that closely resembles TB and cannot be differientiated from TB until a bacteriological study has been performed.
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Atypical Mycobacteria
________ is an opportunistic mycobacterium that is found in water and in commonly contracted from swimming pools, baths, and hot spas. It strikes people who are immunosuppressed or have an underlying lung disease.
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M. avian complex (MAC)
_______ pulmonary infections are typically found in patients who are being treated with corticosteroids, antineoplastic or immunosuppressive drugs, or who are on multiple antibiotics. People with AIDS or cystic fibrosis are also vulnerable.
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Fungal (common ones are: candidiasis, aspergillosis and cryptococcosis)
_________ is the standard therapy for treating serious systemic fungal infections.
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Amphotericin B
Amphotericin B, used to treat fungal infections, has many side effects including hypersensitivity reactions, fever, chills, malaise, nausea, vomiting, thrombophlebitis at the injection site, and abnormal renal function. __________ one hour prior to infusion can reduce the instance of many of these Side Effects.
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Diphenhydramine (Benadryl), also, hydrocortisone in the infusion can reduce instance of thrombophlebitis
What are the priorities when monitoring a patient on Amphotericin B?
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Monitoring of renal function and ensuring adequate hydration
How long does treatment on Amphotericin B typically last?
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4-12 weeks
Oral _______ & __________ compounds like ketoconazole (Nizoral), fluconazole (Diflucan), voriconazole (Vfend) and itraconazole (Sporanox) have been found to be successful in the treatment of fungal infections and may be an alternative to Amphotericin B.
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Imidazole and Triazole
...this fungal infection is indigenous to the soil of North American river valleys, inhalation of mycelia into the lungs leads to an infection which often has no symptoms. It is self limiting, but a chronic disease like TB.
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Histoplasmosis
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This fungal infection is indigenous to semiarid regions of SW United States. Inhalation of arthrospores into the lungs causes a suppurative and granulomatous reaction in the lungs. Only 1/3 of people who get it show symptoms...
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Coccidioidomycosis
This fungal infection is indigenous to the SE and MW United States. The fungus is inhaled into the lungs and the progression is often insidious. It can include skin involvement...
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Blastomycosis
This fungal infection is a true mold inhabiting the mouth. It is widely distributed and invasion of the lung tissue can result in necrotizing pneumonia.
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Aspergillosis
A patient with Aspergillosis and asthma may require ___________ therapy.
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Corticosteroid therapy
________ is a fungal infection of the lung caused by a yeast. It lives worldwide in soil and pigeon poop. Inhalation into the lungs can lead to possible meningitis.
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Cryptococcus
__________ is the leading cause of mycotic (fungal) infections in hospitalized and immunocompromised hosts. It often occurs following a broad-spectrum antibiotic therapy that allows colonization of the GI and UR tracts. Can cause pulmonary infiltrates or widespread bilateral lung consolidation with hypoxemia...
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Candidiasis
__________ isn't caused by a true fungus, but instead an anaerobic, gram positive bacteria with branching hyphae. Aspiration causes necrotizing pneumonia and pneumonitis most commonly in the lower lobes with abscesses or empyema...
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Actinomycosis
_________ is caused by an anaerobic bacteria with branching hyphae and is a widely distributed soil saprophyte. It is contracted by direct contact with nature and is rarely in the sputum without the accompanying disease.
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Nocardiosis
What is the cause of most lung abscesses?
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Aspiration of foreign material from the GI
Which parts of the lungs are most commonly affected by abscesses?
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SLUP: Superior part of the Lower Lobe and Posterior part of the upper lobes
If a person has an acute onset of a lung abscess, it is most likely caused by a _______ organism. If it has an insidious onset, it is most likely caused by a __________ organism.
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Acute = aerobic Insidious = anaerobic
  
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