If ICOUGH doesnt work INTERVENTIONS PEEP positive end expiratory pressure a

If icough doesnt work interventions peep positive end

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If ICOUGH doesn’t work… INTERVENTIONS : PEEP (positive end expiratory pressure) - a simple mask and one-way valve system that provides varying amounts of expiratory resistance Continuous positive airway breathing (CPAB) Chest physiotherapy Nebulizer treatments with a bronchodilator or sodium bicarbonate Bronchoscopy - acutely remove secretions/mucous and increase ventilation IF the cause of atelectasis is compression of lung tissue- the goal Decrease compression of alveoli Large pleural effusion that is compressing lung tissue and causing alveolar collapse TX Thoracentesis - removal of the fluid by needle aspiration Or Insertion of a chest tube Pneumonia Pneumonia can be classified into four types: chart 23-3 1. CAP: Community Acquired Pneumonia 2. HCAP: Health Care Associated Pneumonia Ex: nursing home, long term care facility, chemotherapy 3. HAP: Hospital Acquired Pneumonia 4. VAP: Ventilator Associated Pneumonia Develops after endotracheal tube intubation Risk factors for developing pneumonia:
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PNEUMONIA REVIEW – Acute care management need for fluids, signs of hypoxia (oxygen is given if hypoxemia develops), You want blood & sputum cultures, but you are not going to hold off on antibiotics if they are not producing sputum Pneumonia vaccine can be prevented of? Orders sputum culture and sensitivity and pt does not have a productive cough you are not going to hold off antibiotics until pt produces sputum – YOU ARE GOING TO GIVE THE ANTIBIOTICS! MEDS TABLE 24-4 – inhale corticosteroid teaching (to prevent thrush), video from that lecture SPECFICS for pneumonia vaccines
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Aspiration Pneumonia What are the Risk Factors? What are some preventative measures to take? Clinical Manifestations of pneumonia Varies, Can’t diagnose type based on symptoms. Sudden onset of chills, rapidly rising fever Pleuritic chest pain that is aggravated by deep breathing and coughing Tachypnea Bradycardia Upper respiratory tract infection (nasal congestion, sore throat)
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Gradual and nonspecific Headache, low-grade fever, pleuritic pain, myalgia, rash, and pharyngitis Sputum Orthopnea Poor appetite Diaphoretic Fatigues easily Streptococcal (pneumococcal) pneumonia May present with: Sudden onset of chills, Rapidly rising fever (38.5° to 40.5°C [101° to 105°F]) Pleuritic chest pain that is aggravated by deep breathing and coughing Tachypnea (25 to 45 breaths/min) – in respiratory distress What are some of the other symptoms? diagnosis of pneumonia is made by: history – what is important to ask about? physical examination, chest x-ray, blood culture what are they looking for? Sputum collection for culture: what are the 4 steps? How can you prevent pneumonia? What are the recommendations? Medical Management Antibiotic Do not delay for sputum culture Hydration why? Antipyretics antitussive oxygen, if needed Complications hypotension septic shock respiratory failure Pleural effusion empyema
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NURSING PROCESS - The Patient with Pneumonia Assessment What is the nurse going to assess for?
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