an infectious disease caused by Mycobacterium tuberculosis. usually affects the lungs but can effect other parts of the body.
A sleep disorder characterized by temporary cessations of breathing during sleep and repeated momentary awakenings.
Community Health Measures to control TB - Primary prevention
1. Primary prevention-- before disease
a. Public education re: health promotion, nutrition, how it's spread.
b. Identify & refer those in need of prophylactic drugs & BCG immunization (travelers to countries with high prevalence, e.g.).
Community Health Measures to control TB - Secondary prevention
identifying disease & following thru with treatment
a. Screening & counseling services.
b. Case finding & referral for treatment with medication.
c. Monitor & treat medication side effects.
d. Identify need for & initiate isolation procedures when necessary.
Community Health Measures to control TB - Tertiary prevention
prevent spread & re-occurrence
a. Follow-up after cultures are negative--still taking meds?
b. Monitor effects of treatment.
c. Re-check for prevention of re-infection.
Describe pathophysiology, assessment, treatment & prevention of these disorders. Know drugs used to treat TB & potential side effects. Choose appropriate nursing diagnoses for the patient with respiratory problems.
is a lower respiratory tract infection with onset in the community or during the first 2 days of hospitalization
Review manifestations of pneumonia in the elderly.
Typical signs & symptoms of pneumonia in the elderly:
may not have fever,
low grade fever
UPPER AIRWAY PROPLEMS: Apnea
cessation of air flow through the nose & mouth for a period of 10 seconds or longer.
UPPER AIRWAY PROBLEMS: Sleep Apnea
occurrence of 30 or more apneic episodes during 7 hours of sleep, or 5 or more apneas per hour.
UPPER AIRWAY PROBLEMS: Obstructive Sleep Apnea
partial or complete airway obstruction during sleep.
Affects men, women, and people of any age, including children & elderly; all races.
Central Apnea (upper airway problem)
Brain & CNS-related. Brain does not send message to breath. Seen with neuro-related disorders (CVA involving brainstem, meningitis, encephalitis, prematurity of the newborn).
Hospital acquired or Health-Care Acquired Pneumonia (HAP or HCAP)
Onset in hospital, long term care facility, hospital or hemodialysis clinic. Nosocomial
First step of pathophysiology of pneumonia
Pathogen successfully penetrates airway mucosa & pulmonary tissue, releasing toxins & causing congestion
Decrease mobility of cilia can get congesting
Contributing causes for pneumonia, list 8.
1. Condition of host-- run-down, immunosuppressed, post-op.
2. Chronic disease (Lupus, aids, COPD etc.)
3. Age -- elderly esp.
4. Immobility, bedrest
5. Poor nutrition
6. Smoking -- decreased cillia
7. Caustic -- chemical or environmental agents (air pollution)
8. Nosocomial causes (hosp. acquired)
Complications from Pneumonia (list six)
2. Pleural effusion
3. Lung abscess
4. Empyema --
5. Bacteremia -- SEPSIS
6. Atelectasis - collapse of the lungs
INFLAMMATION of the pleura, often leading to adhesion between the parietal and visceral layers, fairly common; painful when breathing
Lab diagnostics for pneumonia (Hematology)
1) WBC with differential - often 15000 - 25000;
neutrophilia (with a shift to the left)
2) Blood cultures --will show organisms if they have invaded bloodstream. (bacteremia)
Lab diagnostic for pneumonia (urinalysis)
hematuria, pyuria, protein with sepsis. (Pts with pneumonia can become septic easily--especially elderly.)
What labs for pneumonia are used to rule out dehydration & sepsis?
serum creatinine, BUN, glucose, electrolytes, & liver function tests
With pneumonia what tests are used for oxygenation?
1) Pulse oximetry --
2) Blood gasses (ABG's) -- Assess for:
a) Hypoxemia R/T decreased surface area for gas exchange.
b) Respiratory acidosis - seen with underlying lung disease &
R/T hypoventilation & fatigue.
What do Blood gasses (ABG's)--assess for?
used to assess for Hypoxemia and Respiratory acidosis - seen with underlying lung disease &
R/T hypoventilation & fatigue.