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34 Cards in this Set

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Define:
Ventilation
Movement of air
into lungs. Includes both
ispiration and expiration.
Perfusion
circulation of blood thru
tissues; distribution of
RBCs to and from the
pulmonary capillaries
Diffusion
Movement of gases (CO2 and O2)
from an area of HIGH to LOW
concentration across the
alveolar cap membrane.
Compliance
is a measure of lung and
thoracic elasticity or the
ability to contract and expand.
Hypoventilation
occurs when alveolar
ventilation fails to meet the
body’s oxygen demand or
eliminate sufficient carbon
dioxide. It can be caused by
atelectasis and COPD
Hyperventilation
state of ventilation in excess
of that required to eliminate
venous CO2 produced by cellular
metabolism. Can be caused by
anxiety, fever, drugs, hypoxia
Hypoxia
inadequate tissue oxygenation at
the cellular level or low levels
of arterial O2
Cyanosis
blue discoloration of the skin
and mucous membranes caused by
the presence of desaturated
hemoglobin in capillaries. It
is also a sign of late stage
hypoxia
Postural
Drainage
use of positioning techniques to
draw secretions from specific
segments or all segments of the
lungs and bronchi into the
trachea
Chest
Percussion (CPT)
involves striking the chest wall
with cupped hands over the area
being drained
Oropharyngeal
Suctioning
require the use of a
round-tipped catheter with a
number of side holes at the
distal end of the catheter
Identify risk factors that
are predisposing to pna
elderly, air pollution,
ALOC (ETOH, CHI, seizures, etc)
altered oropharangeal flora,
bed rest/immobility, chronic
lung dz, dm, heart dz, ca,
ESRD, poor cough effort,
not taking deep breaths - post
op patient, smoking, URI,
malnutrition
Differentiate between:
Hospital acquired
PNA
PNA occurring 48 hrs or longer
after being admitted to the
hops. and not being incubated
at time of hospitalization.
Most common nosocomial infect.
Community
acquired
PNA
Lower respiratory tract
infection of the lung
parenchyma with onset in the
community or during 1st two
days of hospitalization
Aspiration
PNA
diff swallowing, one of most
common causes of HAP, abnrml
entry of secretions into lower
airway.
Discuss the 4
stages of bacterial
(pneumoccal) PNA
Stage 1
congestion - pneumococcus org.
reaches alveoli via
droplets/saliva, infection is
spread into serous fluid,
interfere with lung function
Stage 2
Red hepatization - massive
dilation of the capillaries
and alveoli are filled with
organisms, neutrophils, RBCs
and fibrin. Lun appears red
and granular, similar to liver
Stage 3
Gray hepatization - blood flow
decreases and leukocytes
and fibrin consolidate in the
affected part of the lung
Stage 4
Resolution - complete resolution
and healing occur if there are
no complications
3 common
complications of
PNA
Pleurisy - inflammation of the
pleura, pain, coughing, sneezing
dyspnea, sob, dry mouth, chills
Pleural effusion - intense
inflammation of pleural
surface, cp, pressure, dyspnea
cough.
Atelectasis - collapsed
airless alveoli, cp, sob,
dyspnea, cough
Identify the
expected findings
of a pt with PNA
dyspnea, sob, cough, congestion,
fever, elev WBC, abnormal lung
sounds, tachypnea, asymmetric
chest movement, nasal flaring
n/v, chills, hx lung ca, copd,
dm, malnutrition, use of abx,
smoking, recent URI, allergies
Diagnostic
tests to
dx PNA
CXR, blood cx x 2, sputum cx,
grm stain of sputum, CBC,
pulse ox, H+P, ABGs
Discuss the purpose
and use of the PNA
clinical pathway
Lists goals for pt with PNA
and target date of completion
pt will exhibit adequate
oxygenation, effective
clearance of secretions and be
afebrile for more than 24 hrs
Goals for the
client with PNA
Clear lung sounds
normal breathing patterns
increased activity level
no signs of hypoxia
normal dxr
no fever, decreased WBC,
person feels better
Describe nursing
interventions to promote
lung expansion
mobilization of
pulmonary secretions,
maintenance of pt
airway in client with PNA
Monitor RR and O2 sat to
provide baseline
Ausculate lung sounds
postion pt to minimize resp
effort.
Initiate/maintain O2
Administer meds:abx broncho-
dilators
encourage IS, fluids
Collaborative therapy
in the treatment of PNA
ABX therapy to destroy bacteria
increased fluids to liquify
secretions
limited activity/rest for
recovery of lung function
antipyretic for alveolar
inflammation
analgesics for pain
O2 therapy
General use of
brochodilators
dilate bronchi, make them
bigger, decrease wheezing,
allow air thru
antibiotics
kills and prevents growth of
bacteria causing PNA
empiric tx - draw cultures
and put pt on abx. abx can be
hard on kidneys. Should
see decrease in WBC, temp, RR,
sputum color improved
steroids
anti-inflammatory, can
increase blood glucose, check
blood sugar/give insulin as
appropriate (glucocortisoid)
can cause peptic ulcers - make
sure pt is on sotmach acid
reducer. Lung inflammation =
PNA, steroids put adrenal
glands to sleep (not needed)
when off can cause adrenal
crisis
Discuss the
principles of aerosol
therapy

MASK
Non-rebreather masks – mask
that prevents expired air from
entering bag and being
rebreathed
Discuss the
principles of aerosol
therapy

HHN
For pts that can hold in their hand
adding moisture or medications
to inspired air by mixing
particles of varying sizes
with the air. Nebulizers use
the aerosol principle to
suspend a maximum number of
water droplets or other
particles of an ideal size in
the air
Nutritional
therapy - hydration
Adequate fluid intake is
vital - helps loosen
secretions. if pt is
dehydrated secrections build
up/become sticky. monitor I+O
Adequate hydration and help
the PNA
Influeza
Pneumococcal
vaccines
FLU: every flu season
Pneumococcal: every 5 years
to help prevent PNA
Vaccines are helpful with
the elderly population
some common
abx to treat PNA
Cepholosporin
Aminoglycisides
Fluoroquinilones