Meds : antihistamine , decongestants 2. Sinusitis infection antibiotics (amoxicillin) 3. Influenza high contagious viral infection S/S Severe headache Fever Chills Muscle ache Diarrhea N/V Treatment: antivirals (started 24-48hrs of symptoms) Flu vaccine (over 6 months of age ) Complications: Pneumonia Pneumonia: older patient (confusion) 22
S/S Fever Chills Sob Difficulty breathing Tachypnea Chest pain Crackles/wheezing Cough Lab: sputum sample before antibiotics Chest x-ray: show consolidation in the lungs Pulse ox: below 95% Nursing interventions High flowers position Coughing/deep breathing Oxygen Incentive spirometer (suck in and hold breath to measure) High calorie diet Fluids 2-3L a day Antibiotics Bronchodilator albuterol Anti-inflammatory glucocorticoids (watch for hyperglycemia, decrease immunity, GI bleed, fluid retention, canker sores, weight gain) Chapter 21: Asthma: chronic inflammatory that results in intermittent and reversible Trigged Environmental factors S/S Wheezing Coughing Prolonged exhalation Barrel chest (chronic) Diagnosis: Peak flow meter take highest value out of the measurements Nursing care High fowlers position 23
Oxygen Rest Meds Bronchodilator albuterol S/E increased HR, tremors Anticholinergic ipratropium dry mouth (increase fluids), suck hard candy Theophylline monitor blood levels Long acting salmeterol prevents attacks Anti-Inflammatory corticosteroids, leukotriene antagonist Complications: Status asthmatics airway obstruction intubation, epinephrine Respiratory failure persistent hypoxia Chapter 22: COPD 1. Emphysema: Loss of lung elasticity and hyperinflation of lung tissue Causing destruction on alveoli Retention of CO2 2. Chronic bronchitis: inflammation of bronchioles Risk factors Smoking Advanced age Air pollution Alpha 1 deficiency S/S Dyspnea w/ exertion Crackles, wheezing, Rapid shallow respirations Use of accessory muscles Nasal flaring Barrel chest Percussion hyperresonance (trapped air ) Swelling of extremities right sided HF Clubbing of fingers/toes Below expected O2 Labs Increased hematocrit PaO2 less than 80 PaCO2 greater than 45 24
Respiratory acidosis Tests: Pulse ox 91/ 92 % normal Nursing High fowlers Cough/ deep breathing Incentive spirometer High calorie/high protein Breathing techniques Abdominal breathing deep breaths from diaphragm Pursed lip breathing breath in through nose out through pursed lips Meds: Bronchodilator albuterol S/E: tachycardia & tremors Anti-Cholinergic watch for drying (fluids) Theophylline relax smooth muscle watch serum levels Anti-inflammatory’s corticosteroids Mucolytic agents loosen secretions, guaifenesin, acetylcysteine Chest physiotherapy: percussions Complications: Right-sided failure
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- Spring '17
- English, acute pain