Nutrition, fluid Avoid exposure to others with infections Meds S/S to watch out for Pulmonary HIV/AIDS Dyspnea Tuberculin skin test – read Drug tx tuberculosis Immunocompromised Weight loss 48-72 hours, 10mm (5mm Negative pressure room Cough for immunocompromised) Airborne isolation until 3 Sputum production CXR – if BCG vaccinated sputum cultures are neg Sleep disturbances Acid-fast bacillus smear – 3 Pain management Rust colored sputum positives on 3 different days Fatigue management Night sweats Sputum culture Good nutrition Low grade fever Advanced: Activity intolerance, fatigue Low grade fever, night sweats Blood-streaked sputum Dullness w/percussion over involved area Bronchial breath sounds, increased transmission of whispered sound Lung abscess Pus in the lung itself High-dose antibiotics Fever Necrotizing PNA Chills Bacterial, fungal, parasitic Pulmonary Chest tube for pleural effusion Pus in pleural space Drainage of pus empyema Re-expand the lung Control the infection COPD: Emphysema Dyspnea/wheezing ABG: Assess O2 first Use of accessory muslces PaO2 <80-50 mmHg Admin O2 Vent/perfusion mismatch PaCO2 – increased to 50 Decreased forced expiratory Antibiotics - infection volume Polycythemia vera – high Bronchodilators – reduce Involvement of alveoli H/H airway resistance Cachexia Sputum samples Anticholinergics – Barrel chest Serum electrolytes bronchodilate and decreases Changed muscle definition Serum AAT levels secretions Clubbing – chronic hypoxia CXR: Corticosteroids – decrease Emphysema = Lots of black inflammation, decrease COPD: Chronic Dyspnea/wheezing space/air bronchoconstriction bronchitis Use of accessory muslces
Nutrition, fluid Avoid exposure to others with infections Meds S/S to watch out for Pulmonary tuberculosis HIV/AIDS Immunocompromised Dyspnea Weight loss Cough Sputum production Sleep disturbances Rust colored sputum Night sweats Low grade fever Advanced: Activity intolerance, fatigue Low grade fever, night sweats Blood-streaked sputum Dullness w/percussion over involved area Bronchial breath sounds, increased transmission of whispered sound Tuberculin skin test – read 48-72 hours, 10mm (5mm for immunocompromised) CXR – if BCG vaccinated Acid-fast bacillus smear – 3 positives on 3 different days Sputum culture Drug tx Negative pressure room Airborne isolation until 3 sputum cultures are neg Pain management Fatigue management Good nutrition Lung abscess Necrotizing PNA Bacterial, fungal, parasitic Pus in the lung itself Fever Chills High-dose antibiotics Pulmonary empyema Chest tube for pleural effusion Pus in pleural space Drainage of pus Re-expand the lung Control the infection COPD: Emphysema Dyspnea/wheezing Use of accessory muslces Vent/perfusion mismatch Decreased forced expiratory volume Involvement of alveoli Cachexia Barrel chest Changed muscle definition Clubbing – chronic hypoxia ABG: PaO2 <80-50 mmHg PaCO2 – increased to 50 Polycythemia vera – high H/H Sputum samples Serum electrolytes Serum AAT levels CXR: Emphysema = Lots of black space/air Assess O2 first Admin O2 Antibiotics - infection Bronchodilators – reduce airway resistance Anticholinergics – bronchodilate and decreases secretions Corticosteroids – decrease inflammation, decrease bronchoconstriction COPD: Chronic bronchitis Dyspnea/wheezing Use of accessory muslces
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