NUR 347- Exam 1 Questions and
Detailed Answers
Pneumonia- Def, S/S, Assessment and Dx, Management ✅Def- Inflammation of the
lung parenchyma caused by various microorganisms
S/S- SOB, upper resp infection, SOB with reclining or supine (orthopnea), lethargic,
decrease appetite and thirst
Assess and Dx- Coarse-Diminished-Absent Lung Sounds, Chest Xray, Sputum Culture
Management- Antitussives, IS, CPT, Humidified O2, PO or IV ABX if Bacterial
5 Types of Pneumonia ✅Community Acquired Pneumonia- Occurs in community or
within 48 hrs of being in hospital
Health Care Associated Pneumonia- MDR- Multi Drug Resistant
Hospital Acquired Pneumonia- Develops 48 hrs or more after admission- ASPIRATION
Ventilator Acquired Pneumonia- Ventilator is cause- Mouth Care!
Aspiration- Exogenous/Endogenous substance enters lower airway- Think NG Tube-
Mouth Care
Complications of Pneumonia ✅Shock, pleural effusion, empyema, resp failure
Best prevention of pneumonia in Gero population ✅Vaccination
Pulmonary TB- Def, S/S, Assess and Dx, Management ✅Def- Directly affect lung
parenchyma- can also affect meninges, bones, lymph, and kidneys; contracted via
airborne- travels down respiratory tract and settles in alveoli
S/S- Insidious in Nature! Low grade fever, cough, night sweats, fatigue, weight loss
Assess and Dx- Tuberculin Skin Test, Quantiferon, Sputum
Management- increased fluids, repositioning (High Fowlers), meds
Nursing Management- Promote airway clearance, promote adherence to treatment
regimen (Must take meds 6-12 months), promote activity and adequate nutrition,
prevent transmission
3 Types of TB Tests ✅Tuberculin- Read w/in 48-72 hours
Quantiferon- Blood test
Sputum- Cultures sputum
Pleurisy/Pleuritis- Def, S/S, Assess and Dx, Management ✅Def- Inflammation of
BOTH visceral and parietal pleura
S/S- knife like Pain in chest due to parietal layer (one side); pleural friction rub upon
inspiration
Assess and Dx- Pleural friction rub early on- swelling will later increase and rub
CANNOT be heard; chest XRay and thoracentesis
, Management- Treat underlying condition, assess pain, comfort, turn, splinting and abd
binders
Causes of Pleuritis ✅Can occur with trauma, PE, cancer-meds, upper resp infection,
TB, pneumonia
Pleural Effusion- Def, S/S, Assess and Dx, Management ✅Def- Collection of fluid in
pleura
S/S-s/s of underlying conditions, bigger effusion= worse s/s
Assess and Dx- Chest XRay, Chest CT, thoracentesis, tracheal deviation to NON
AFFECTED side, PLEURAL FRICTION RUB- WILL SOUND DULL
Management- Treat underlying cause, thoracentesis
Causes of Pleural Effusion ✅PE, heart failure, pneumonia, any lung infection,
nephrotic syndrome
Empyema- Def, S/S, Assess and Dx, Management ✅Def- Accumulation of thick,
purulent fluid in lungs; development of fibrin
S/S-Fever, night sweats, pleural pain, cough dyspnea, s/s of acute resp infection
Assess and Dx- Absent or diminished breath sounds; chest CT, dx thoracentesis
Management- Drain, thoracentesis, encourage fluids, breathing exercises
Causes of Empyema- ✅Bacteria gets locked in pleural space and grows, penetrating
lung injury, lung abscess
Acute Resp Failure- Def, S/S (Early and Late), Assess and Dx, Management ✅Def-
SUDDEN Deterioration of gas exchange, ventilatory perfusion (VQ Mismatch)
S/S- Early- Restlessness, Increased then decreased BP; Late- HA, dyspnea, low BP,
increased HR, cyanotic, confused lethargic, diaphoretic
Assess and Dx- ABG's, physical assessment and manifestations
Management- Tx underlying cause, sedate and intubate
Causes of Resp Failure ✅CF, asthma, malnutrition
Acute Resp Distress Syndrome (ARDS)- Def, S/S, Assess and Dx, Management
✅Def- Inflammatory causing alveolar damage resulting in sudden progressive
Pulmonary Edema, increased bilateral infiltrates, hypoxemia, unresponsive to O2 or
PEEP (Perfusion issue)
S/S-RAPID ONSET of SEVERE DYSPNEA, > than 72 hours after lung injury, crackles
Assess and Dx- increase chest infiltrates, intercostal retractions; Crackles, FOAM
UPON INTUBATION→ immediate code, ECHO, BMP, pulmonary artery cath
Management- Tx underlying causes (initial lung injury), no meds besides sedation,
increase nutrition, turning, sedative and paralytic
PE- Def, S/S, Assess and Dx, Management ✅Def- Obstruction of vessels via thrombus
