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HESI STUDY GUIDE RESPIRATORY
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HESI STUDY GUIDE RESPIRATORYPenumonia – Inflammation of the lower respiratory tact o Types:  Bacterial (gram positive / negative)  Viral  Fungal (rare)  Chemical o Reach lungs by:  Aspiration  Inhalation  Hematogenous Spread o High Risk Groups  Altered Level of ...

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  • March 3, 2022
  • 8
  • 2021/2022
  • Exam (elaborations)
  • Questions & answers

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  • penumonia – inflammation of the lower respiratory tact o types  bacterial gram positive negative  viral  fungal rare  chemical o reach lungs by  aspiration  inhalation  hematogenous spr

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, Penumonia – Inflammation of the lower respiratory tact
o Types:
 Bacterial (gram positive / negative)
 Viral
 Fungal (rare)
 Chemical
o Reach lungs by:
 Aspiration
 Inhalation
 Hematogenous Spread
o High Risk Groups
 Altered Level of Consciousness
 Depressed/absent gag and cough reflexes
 Susceptible to aspirating -> Oropharyngeal secretions
 Alcoholic, anesthetized individuals
 Drug Overdose
 Stroke Victims
 Immunocompromised
o Nursing Assessment
 Tachypnea – shallow, often accessory muscles
 Sudden onset of fever/shaking/chills
 Productive Cough with pleuritic (lung) pain
 Rapid/bounding pulse
 Breath sounds - crackles
o OLDER ADULTS: confusion, lethargy/malaise, anorexia, tachypnea, tachycardia
o Interventions:
 Assess sputum – COCA
 Turn and deep breath q2hrs
 Humidify room/oxygen
 Chest physiotherapy
 3L/day of fluids (liquefies secretions)
 Monitor ABG’s
 PO2 >80, PCO2 <45
 Encourage at risk groups to get annual pneumonia and flu shots

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