Flu Vaccine: Is it effective? Polyvalent influenza virus vaccine 85% effective
Flu Vaccine: Who should get it? Age >50 years Nursing home residents Pg women Chronically ill Immunosuppressed Resp. conditions Healthcare workers Fam. members of those at risk
Flu Vaccine: Who should not get it? Allergic to eggs
Small Group Questions 1.What pathogen is assoc. with flu? 2.Identify 5 S&S of the flu 3.What type of isolation would you use for a client with the flu 4.Mary asks you if she should get the flu vaccine, how do you respond? 5.What priority nursing diagnosis would you give for a person with the flu?
Which of the following nursing interventions is appropriate after a client has had a bronchoscopy? A.Report abnormal lab values B.Lay flat for 8 hours with a sand bag to the puncture site C.NPO until gag reflex returns D.Push fluids
Tuberculosis AKA – TB
Tuberculosis - FYI Causes more death than any other disease. 2 billion world wide, 15 million in the US
Tuberculosis - FYI When treated, about 90% of those with active TB survive!
Tuberculosis Pathophysiology Mode of transmission – Air-borne alveoli Multiplies in alveoli
Tuberculosis Immune response phase – Macrophages attack TB – TB has waxy cell wall that protects it from macrophages – Immune system surrounds the infected macrophages – Forms a Lesion – Called a Tubercle
Tuberculosis Dormant phase – Contagious? No – Symptomatic? No – PPD? positive – chest x-ray? Negative
Tuberculosis Active phase – If an infected person has a weakened immune system, – the TB escapes and infects the body
Tuberculosis 5-10% become active Only contagious when active Primarily affect lungs but… – Kidneys – Liver – Brain – Bone
Tuberculosis Etiology Assoc. w/ – Poverty – Malnutrition – Overcrowding – Substandard housing – Inadequate health care Elderly HIV Prison
Tuberculosis: Tx / Rx INH – isonicotinyl hydrazine – Isoniazid – Toxic to the liver Rifampin – Turns urine red
Tuberculosis: Prevention Clean well ventilated living areas Resp. isolation – Negative pressure room If exposed take – INH
Tuberculosis: complication Malnutrition S/E of Rx treatment Multi-drug resistance Spread of TB infection
Small Group Questions 1.What type of pathogen is TB? 2.What is the mode of transmission? 3.What are the classic S&S of TB ? 4.How to administer and read a PPD? 5.If a pt is PPD +, what does that mean?
Small Group Questions 6.What is the standard screening method of TB? 7.That medications are used to treat TB, what are their side effects? 8.Where in the US is TB most prevalent? Why?
Small Group Questions 1.What 2 diseases are assoc. with COPD? 2.Describe the pathophysiology of COPD. 3.What effect does smoking have on the resp. system? 4.Differentiate between chronic bronchitis and emphysema. 5.What are the 3 main S&S of COPD? 6.What 2 classifications of meds are used to treat clients with COPD (what are their actions)?
Pneumonia Pathophysiology An inflammatory process in which there is consolidation – In the alveolar spaces. Gas exchange cannot take place in consolidated area
Pneumonia: Small Group Questions 1.Describe the pathophysiology of pneumonia. 2.What is the difference btw typical and atypical pneumonia? 3.What causes pneumocystis carinii? 4.What lab values are associated with bacterial pneumonia? / viral pneumonia?
Pneumonia: Small Group Questions 5. What is Nosocomial pneumonia 6. Identify 5 risk factors for developing pneumonia 7. What medications might be administered to treat a pt. with pneumonia? 8. What nursing education would you give to a patient with pneumonia? 9. What are the gerontological considerations of caring for the elderly in regards to pneumonia?
Lung Cancer Pathophysiology Carcinogen binds to the DNA and changes it Abnormal growth Usually develops on the wall of the bronchial tree
FYI Lung Cancer is the number one cancer killer in the US
Lung Cancer Etiology/Contributing factors #1 – Tobacco Smoke (85%) – Second hand smoke Carcinogens – Asbestos – Uranium – Arsenic – Nickel – Iron oxide – Radon – Coal dust
Lung Cancer Clinical manifestations: early Insidious and asymptomatic until late stages
FYI – 70% of lung CA have metastasized by the time of diagnosis
Lung Cancer S&S: Early Objective symptoms – #1: Cough – #2 Repeated respiratory tract infection – Wheezing – Dyspnea
Lung Cancer S&S: Late Hemoptysis Chest pain Wt loss Anemia Anorexia
Lung Cancer Dx exams/procedures X-ray CT scan Biopsy via Bronchoscopy – cytology
Lung Cancer Treatment Surgery – Removal Chemotherapy – Metastasis Radiation – To shrink or reduce symptoms
Lung CA Priority Nrs Dx – Ineffective breathing – Ineffective Airway clearance – Ineffective Gas exchange
Activity intolerance Document response to activity – Pulse – Resp. status – Fatigue Planned rest periods Increase activities gradually Enc to remain as active as possible Allow fam. To provide assist PRN Keep frequently used objects nearby
Pain Assess pain Administer analgesics PRN
PAIN & CANCER “For cancer pain, maintain a continuous medication schedule using opiates, NSAIDs and other drugs as ordered” – Addiction is not a concern for the terminal cancer client; adequate pain relief that does not allow “breakthrough” pain is vital.
Pain Assess pain Administer analgesics PRN Alternative pain relief – Massage – Positioning – Distraction – Relaxation techniques
Pain Provide diversion activities – TV – Reading – Social events Allow family to remain
Grieving Spend time with client & family Answer questions honestly Enc. Pt to express feelings (fear, anxiety, concerns) Assist to understand the grief process
Grieving Enc other support systems – Spiritual – Social groups – Social services – Hospice Discuss advanced directives – Living will
Lung Cancer Preventative measures Stop smoking
Small Group Questions What is the number one carcinogen of lung cancer? What are the early S&S of lung cancer? Who is Lung Cancer diagnosed? How is lung cancer usually treated? What is one priority nursing diagnosis for a client with lung cancer? Identify 3 nursing interventions for this diagnosis