Respiratory 2

Pupils Dilate, Nose Vasoconstriction reduced mucous secretion, Mouth decreased saliva dry mouth, GI constipation intestines relax, decreased peristalsis , Lungs bronchi dilated, Brain more alert, Heart Increases, stronger, increase BP, contractility, cardiac output, decrease blood flow to digits, bladder retention, Large Muscles increase blood flow, tensing of muscles goosebumps, relaxation of smooth muscle

hair loss partial or complete

Breathing in fluids, foods into trachea and lungs. Drawing in or out by suction

Difficulty Swallowing

Bloody sputum

Unintentional administration of solution meds in surrounding tissues

Trouble breathing except in upright position

Decrease number of neutrophils (Mature WBC's)

Originating from hospital during hospitalization (Not present on admission)

Dry, hacky, irritating cough, sternal soreness from coughing, possible fever, general malaise, noisy inspiration, inspirational strider, expiratory wheezes, purulent sputum

Will hear course breath sound Rhonci best over Trachea and Bronchioles

• Follows a viral upper respiratory infection
• Commonly Strep (Streptoccus)
• Also Haemophius (Rusty Brown Sputum)

• Treat Symptoms
• NSAIDs, Fluids (loosen secretions so cilia can remove, rehydrate due to fever increase RR, help kidneys eliminate waste), Rest, Antipyretics (Tylenol, Ibuprofen, ASA), Analgesics, Expectorants

• Consolidation of exudate in lungs (Alveoli)
• It effects ventilation/perfussion

Crackles, wheezing, diminished breath sounds in alveoli, cough, fever (infection), purulent sputum, infiltrate on x-ray, increase resp rate, tachycardia, change in mental status (increase irritability, restlessness, confustion, lethargy)

Alveoli popping open

Should come from lower resp tract (lungs, bronchi, trachea), first thing in morning, rinse mouth first)

• CAP Community acquired (Droplet Isolation)
• HAP Nosocomial hospital acquired
• Aspiration

• Immuniocompromised, Cancer, COPD, Diabetes
• Aids, Alcoholism, Smokers(Cilias impared more mucous),
• Obesity(limits movement of diaphragm)
• Steroid Users, Malnutrition
• Immunosuppressant agents
• Age

• Can't swallow normally
• altered level of consciousness
• mechanically ventilated
• presence of a NG
• those fed by someone else
• Dementia, Medications that increase gastric pH

• Closer to the diaphram the higher the respiratory risk
• Abdominal surgeries
• General anesthesia
• Extended immobilization
• Pain

pneumonia is found in the alveolia & bronchioles

• Lobe of lung
• Lobe consolidated
• Exudate chiefly intra-alveolar
• Common cause-klebsiella

• Patchy consolidation
• Exudate chiefly in bronchioles
• Common cause: staph & strep

• Streptococcus pneumoniae (pneumococci)
• Most common community acquired pneumonia (winter months)
• Onset is typically sudden, chills, fever, pleuritic pain, cough, hypoxia
• Those of african descent, elderly, after influenza, or comormidities

• Higher Mortality
• Long term care residents, alcoholics, COPD, DM
• Sputum may be rust colored

• Middle aged men
• Episodic/Sporadic
• Outbreak at American Legion convention in 1970's
• Thrives in aquatic envinronments (stagnant lakes, hot tubs, humidiferes, air-conditioning units, evacuation sites)

• Commonly adenoviruses or influenza
• No shift to right in CBC with viral infection
• May set the stage for bacterial infection
• Treatment support immuine system (water, rest, O2, nutrition)
• No antibiotic

• Jiroveci--Indicates pt shifted from HIV to full blown AIDS
• Major terminal infection in those with AIDS

• Common secondary infection esp viral resp tract infection
• Thick Yellow Sputum
• May require intubation and mechanical ventilation for sputum removal
• MRSA

• Sweet smell
• Hospitalized pts wtih marked supression of immunological functions
• treat with aminoglycosides (SE kidney damage, hearing loss)
• Those who are terminally ill
• Green to Gray sputum

• Those ho have some other chronic disease (alcoholism)
• Long term care facilities
• Red Currant Jelly Sputum

Creatinine 1 hr before and 1 hr after

• Ineffective breathing pattern
• Ineffective airway clearance
• Anxiety
• Imparied gas exchange
• Acute Pain
• Activity Intolerance
• RF Fluid Volume deficit
• RF aspiration, Knowledge deficit

<5 over 60,

Proper positioning, Early ambulation, Deep breathing, effecctive coughing, adequate pain control, wash hands, asess

Supplemental oxygen, Hydration, Assist with deep breathing and coughing, Frequent position changes, early ambulation, Improve airway patency, rest and conserve energy, promote fluid intake, maintain nutrition, smoking cessation

• Antibiotics
• Monitor for anaphylaxis
• Monitor for pseudomenbranous colitis (diarrhea, slough of tissue)
• may appear up to 3 weeks after cessation of PO antibiotic
• Renal excretion (Ototoxicity, nephrotoxicity) creatine

PCN, Cephlasporin, Macrolides (DC first sign of rash, risk for Stevens Johnson Syndrome), Florquinolone, Carbapenems, Aminglycosides (IV, IM Only, OTO-Renal toxicity), Zanamivir (antiviral)

Alternate between semi-fowlers position and lying with good lung down

an infectious disease that most commonly effects the parenchyma of the lungs

Kidneys, GI System, Meninges of the brain

Airborne transmission, very small droplets containing mycobacterium bacilli, talking, sneezing, laughing or singing, coughing

Person can not transmit the disease but remains infected 2-10 weeks out