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Med/Surg Exam 1 (Pneumonia, TB, Asthma, COPD)
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Med/Surg Exam 1 (Pneumonia, TB, Asthma, COPD)
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Med/Surg Exam 1 (Pneumonia, TB,Asthma, COPD)
Patient presents with fever and burning pain in chest with breathing,
auscultation reveals crackles, and patient's cough produced yellow sputum.
What is the patient likely suffering from? - -Pneumonia
-A patient arrives at the hospital and complains of difficulty breathing with a
productive cough that you suspect is pneumonia, what should you do first?
A: Administer 02
B: Administer broad spectrum IV antibiotics
C: Collect sputum sample
D: Take full health history - -A: administer 02
Remember your ABCs! Airways, blood, circulation.
After giving 02, you'd want to take a sputum sample and then admin broad
spectrum antibiotics so that the antibiotics would not affect the sputum
sample.
-Which patient is most at risk for pneumonia?
A: A very active and thin elderly woman who gets all of her vaccines on time.
B: A young man who is in the hospital recovering from a small bowel re-
sectioning
C: A 50 year old stroke victim who has been bedridden during recovery and
is receiving tube feedings
D: A young, diabetic man who works in a factory with a risk of chemical
inhalation - -C: A 50 year old stroke victim who has been bedridden during
recovery and is receiving tube feedings
The patient's history of stroke puts them at risk for aspiration pneumonia as
do the tube feedings. The bed rest is another risk factor.
This patient has 3 risk factors which is more than any of the other patients:
patient A has one risk factor, patient B has one RF, patient D has two risk
factors
-What labs would you look at to determine if a patient has pneumonia? - -
Sputum C&S, chest X-ray, 02 saturation, ABGs
-What complications can occur from pneumonia? - -Pleurisy, pleural
effusion, atelectasis, bacteremia, lung abscess, empyema, pericarditis,
meningitis, sepsis, respiratory failure, pneumothorax
, -Patient complains of increasing burning pain with breathing and worsening
cough, which complications do you suspect? - -Pleurisy, pleural effusion,
empyema
-Medical Care Associated pneumonia - -Symptoms begin within 48 hours of
hospital admission, within 48 hours of hospital discharge, or 48 hours
following ventiliation
-Community Acquired pneumonia - -Patient has not been hospitalized in the
last 14 days and begins developing symptoms
-Opportunistic Pneumonia - -An organism (P. jiroveci or cytolomegalovirus)
that does not normally cause pneumonia in healthy individuals causes an
infection in an immunocompromised individual.
-Aspiration Pneumonia - -Mouth or GI contents enter the lung and leads to
an infection. RFs are stroke victim, tube feedings, dysphagia
-What changes should be made to a pneumonia patient's diet? - -Patient
should be given small, frequent meals that are nutrient dense and high in
calories. Patient should increase fluids.
-Select all the patient teaching you would want to include:
1: Deep breathing/effective coughing techniques
2: Proper handwashing
3: Cough etiquette
4: Ambulate until exhausted
5: smoking cessation - -1, 2, 3, 5
Patient should not exercise to the point of exhaustion.
-How is mycobacterium tuberculosis normally spread? - -Airborne
-Select all the individuals who are at risk for developing TB
1: A young immigrant woman who is the primary caretaker for a relative with
active TB infection
2: A middle aged man who smokes and drinks at least six beers a day
3: A mission worker who lives with five other missionaries in a small
apartment and provides medical care to the impoverished, underdeveloped
community she serves
4: An elderly, financial retiree who lives alone and has never traveled outside
of the United States. - -1: People who have lived in other countries where TB
is common are at risk, caretakers of those with TB are at Risk
2: Individuals who have substance abuse problems are at increased risk of
TB
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