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Chamberlain College of Nursing - NR 507 FNP1 Exam 2 Lower Respiratory Tract Infections Study Guide. Latest 2020

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 BELOW the level of the larynx  Presentation depends on age, infecting organism and site of infection  Viral etiologies – Flu A, RSV, human metapneumovirus (hMPV), VZV (chickenpox)  B... acterial etiologies – S. pneumoniae (majority of bacterial pneumonias), H. influenzae, S. aureus, K. pneumoniae, Enterobacteriae (E. coli), anaerobes  Atypical organisms – if inpatient or patient was just d/c’d and you suspect PNA, consider these o Mycoplasma pneumoniae, Legionella pneumophilia, Chlamydophila pneumoniae, Coxiella burnetii  Signs of trouble breathing; pt may: o Widen nostrils and squeeze the muscles under his rib cage to try and get more out in and out of his lungs o May grunt when breathing and tighten his stomach muscles o Make a high-pitched whistling sound (wheeze) when he exhales o May have trouble drinking b/c may have trouble sucking/swallowing o Bluish tint around lips/fingertips  Signs of dehydration: o Drinking less than normal o Dry mouth o Crying without tears o Urinating less often than normal Bronchiolitis  Inflammation of the bronchioles o Swelling blocks airflow through the lungs, making it hard to breathe o Occurs most often in infants  Can be caused by influenza, RSV, parainfluenza and hMPV  Wheezing, retractions, dyspnea in children; cold symptoms in adults  Spread through contact of respiratory droplets – gown and gloves? o Often spreads through families and child care centers  Worry about dehydration  May cause more severe illness in children with hx of cystic fibrosis, congenital heart disease, chronic lung disease, immune deficiencies, organ/BM transplants, chemo  Tx: o Suctioning o Albuterol/ProAir – also Rx an aerosol chamber and mask! o Teach parents to look for s/s respiratory distress and F/U frequently Bronchitis  Inflammation of the larger, more central airway bronchial tubes (larger airways that carry air to your lungs)  Main goals of acute/chronic bronchitis tx are to relieve symptoms and make breathing easier  Abx usually aren’t prescribed b/c they don’t work against viruses (most common cause)  Acute Bronchitis: o Most etiologies are viral – influenza, RSV, parainfluenza, rhinovirus, adenovirus o Usually have cold symptoms  bronchitis  Fever and URI symptoms for about 6 days 2  Dry hacking cough initially; becomes productive  Chest pain aggravated by coughing o Main symptom is a persistent cough which may last for 10-20 days  Smokers – may last up to 6 weeks  May be productive with clear mucus  If yellow/green mucus, may be bacterial  May also have wheezing, low-grade fever, chest tightness/pain, SOB  Children may have a runny nose, mild fever, coughing up sputum or vomiting mucus  Tx  SUPPORTIVE! Symptoms improve in 5-10 days  Bacterial – Amoxicillin/Augmentin  Analgesics, hydration  Bronchodilators if wheezing  Avoid antihistamines and cough suppressants  Antiviral if positive for influenza A and underlying condition  Macrolide is suspected for M. pneumoniae or C. pneumonia o Chronic Bronchitis:  Productive cough lasting > 3 months  Symptoms of other diseases:  Allergies, asthma, CF, cigarette smoking, GERD  Tx  Treat cause; avoid irritants [Show More]

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