Infection- Pneumonia, UTI, Influenza, Cellulitis, and Gastroenteritis

Pneumonia
-7th leading cause of death
-inflammation of the lung parenchyma- includes bronchiole and alveoli
-infection is constantly a possibility

Types of pneumonia
-acute bacterial
-legionnaires disease
-primary atypical
-Viral
-aspiration
-pneumocystis carinii

acute bacterial pneumonia
-pneumococcal, strep, staphaureus-70% URI
-purulent rust or cream colored sputum, cough, SOB, fever, chill, dyspnea, and cyanosis
-decreased breath sounds and crackles
-causes parenchymal damage and pleural effusions
-if you get a pocket -do thoracentesis
– abrupt, acute onset of action

Legionnaires disease
-get from air conditioners and airplanes
-legionella pneumonia
-gradual onset 2-10 days
-dry cough, dyspnea, chills, fever, general malaise, headache, confusion, decreased appetite, and diarrhea

primary atypical pneumonia
-known as walking pneumonia
-develops independently from another disease
-mycoplasma pneumoniea and pharyngitis
-fever, headache, myalgias, arthalgias, and non productive dry hacking cough

viral pneumonia
-mild
-constitutes 10% of people who get it
-headache, fever, malaise, fatigue, muscle aching, dry cough, flu like symptoms

aspiration pneumonia
-aspirate & get infection
-stroke pts and ppl with emergency surgery , ppl who have a depressed cough and gag, ppl with PEG tube and NGT

Pneumocystis carinii pneumonia
-(PCP) abrupt onset
-includes fever, tachycardia, SOB, and dry non productive cough
-mostly ppl with HIV (+)- 60%

Pneumonia Diagnostics
-to rule out possible things
-Chest X Ray
-computed tomography-used when more detailed image needed
-sputum gram stain-type of culture for what antibiotics is right
-sputum C&S
-CBC- WBC increased
-serology testing-is blood test that detects antibodies to toxins
-pulse oximetry
-ABG- low PO2
-Fiberoptic bronchoscopy

Pneumonia Symptoms
-cough, excess mucus production, dyspnea, hemoptysis, chest pain, fever, decreased appetite, malaise, cyanosis

pneumonia treatment
-pain fever control
-fluids
-rest
-O2
-Chest PT

Urinary tract Infection
-an infection that can include urethra, bladder, ureters and/or kidneys
-infecting agent- escherichia coli (E.Coli), staphylococcus saprophyticus, proteus, klebsiella, serratia, pseudomonas

UTI symptoms
-dysuria
-pyuria
-frequency
-hematuria
-urgency
-suprapubic discomfort
-nocturia

Lower UTI
-involves urethritis, cystitis, prostitis

Upper UTI
-involves the Kidneys (pyelonephritis)

UTI Diagnostics
-Urinalysis- >100,000mL
-urine gram stain- (+) or (-) bacteria
-urine C&S- to get specific bacteria
-WBC with differential- increased blood cells luckocytosis
-intravenous pyelography- structural
-voiding cystourethrography
-cytoscopy- direct visualization up through urethra
-pelvic/prostate exam
-renal/bladder ultrasound- detect pyelonephritis and scars
-uretoplasty- uretal stent – helps urine drain/ only in a couple days

UTI treatment
-antibiotics
-encourage fluids
-administer analgesics

Influenza
-THE FLU
-is a highly contagious, viral respiratory disease

Influenza symptoms
-Coryza- inflammation of nasal mucus membrane
-cough
-substernal burning
-sore throat
-fever and chills
-muscle aches
-malaise
-fatigue

Influenza diagnostics
-based on history
-clinical findings
-community outbreaks
-chest X ray – to rule out pneumonia
-WBC

Influenza treatment
-antivirals
-amantadine and rimanitidine -prophylactic who has it and who’s been exposed
-Zanamivir- inhalation- decrease length of time and symptoms
– oseltamivir and ribavirin- tamaflu -PO and inhalation- decreases length of time and symptoms
-aspirin, acetaminophen, NSAIDS- to relieve fever and aches

Influenza Prevention
– Vaccine
-this causes reyes-syndrome

Cellulitis
-acute bacterial infection of the dermis and underlying connective tissue
-common cause tineapedis- athletes foot

cellulitis symptoms
-Inflammation
-pain
-warmth
-redness- erythema
-swelling
-drainage-weepy
-peripheral neuropathy
-decreased sensation; temporary

cellulitis diagnostics
-WBC- Increased- wound culture helps to diagnose it
-Blood cultures-make sure it is not systemic- can cause sepsis if untreated

Cellulitis treatment
-maintain adequate hydration
-administer antipyretics, antibiotics
-administer pain medication as needed
-maintain bed rest
-encourage adequate nutrition for healing

Gastroenteritis
-Inflammation of the mucous membranes of the stomach and intestine (usually small bowel)
-bacterial- “traveler’s diarrhea” from e.coli or campylobacter
“dysentary” from shigellosis

Gastroenteritis symptoms
-increased frequency of stooling
-increased water content of stool

Gastroenteritis diagnostic
-gram stain
-culture stool

Gastroenteritis treatment
-fluids
-antibiotics
-skin care

Gastroenteritis teaching
-wash hands, own set of dishes, clean bathroom extra well, food prep-should not do

Patho -Streptococcus pneumoniae -most commonly found organism -60-75% of adults -Haemophilus influenzae, moraxella catarrhali -common in patients with underlying lung disease -Staphylococcus aureus -common in influenza-associated pneumonia -Mycoplasma pneumoniae Goals of Treatment -Return to baseline respiratory status -Improvement in 48-72 …

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Lower respiratory tract infections: Infections of the bronchi, bronchioles, and lungs (as opposed to upper respiratory tract infections: common cold, sinusitis, pharyngitis, etc.) Influenza Also known as the flu. It is an infection caused by the influenza virus. There are …

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