General information

 Nursing management The nurse should monitor and assess the following: Changes in temperature and pulse. Amount, odor, and color of secretions. Frequency and severity of cough. Degree of tachypnea or shortness of breath. Changes in physical assessment findings (primarily assessed by inspecting and auscultating the chest) Changes in the chest x-ray findings In addition, it is important to assess the elderly patient for unusual behavior, altered mental status, dehydration, and excessive fatigue. Nursing diagnosis: Based on the assessment data, the patient's major nursing diagnoses may include: Ineffective airway clearance related to copious tracheobronchial secretions. Activity intolerance related to impaired respiratory function.   Risk for deficient fluid volume related to fever and dyspnea. Imbalanced nutrition: less than body requirements. Deficient knowledge about the treatment regimen and preventive health measures. Nursing Intervention: Isolation of the patient is necessary in

  pneumonia Classifications of pneumonia according to causes: Bacterial pneumonia. Viral pneumonia. Fungal pneumonia. Inhalation pneumonia, (this is caused by inhalation of gasteric content leading to mechanical blockage of airways with secondary infection and death) Classifications by areas involved:   Lobar pneumonia; If one or more lobe is involved.   Broncho-pneumonia; the pneumonic process has originated in one or more bronchi and extends to the surrounding lung tissue. Symptoms : The signs and symptoms of pneumonia vary from mild to severe, depending on factors such as the type of germ causing the infection, and your age and overall health. Mild signs and symptoms often are similar to those of a cold or flu, but they last longer. *Signs and symptoms of pneumonia may include: Chest pain when you breathe or cough Confusion or changes in mental awareness (in adults age 65 and older) Cough, which may produce phlegm Fatigue Fever, sweating and shaking chills Lower than normal body tem

Chronic obstructive pulmonary disease                                                                   Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs.  Most common associated with emphysema and  chronic  bronchitis Pathophysiology:  COPD results from the combined processes of peripheral airway inflammation and narrowing of the airways.   This leads to airflow limitation and the destruction and loss of alveoli, terminal bronchioles and surrounding capillary vessels and tissues, which adds to airflow limitation and leads to decreased gas transfer capacity.   The extent of airflow limitation is determined by the severity of inflammation, development of fibrosis within the airway and presence of secretions or exudates.   Reduced airflow on exhalation leads to air trapping, resulting in reduced inspiratory capacity, which may cause breathlessness (also known as dyspnoea) on exertion and reduced exercise cap

 Bronchial Asthma  Asthma is a chronic inflammatory disease of the airways that causes airway hyper-responsiveness, mucosal edema, and mucus production. This inflammation ultimately leads to recurrent episodes of asthma symptoms: cough, chest tightness, wheezing, and dyspnea  Causes : Possible causes are:  dust - dust mites   -  roaches -  pets  certain types of cloth  -  horses - detergents, and soaps  Certain foods - molds and pollens.  pollens can be strongly suspected (If the attacks are seasonal)  Genetic predisposition - Smoking and Environmental Tobacco  Exercise and hyperventilation - Cold air  The most common symptoms of asthma are:  Cough, with or without mucus production.  Mucus is so tightly wedged in the narrowed airway that the patient cannot cough it up.  Generalized wheezing (the sound of airflow through narrowed airways),  Generalized chest tightness and dyspnea occur.  Prolonged expiration with effort.  Diaphoresis  Tachycardia, and a widened pulse pressure  Hypoxemia

                                    Hepatitis     Hepatitis is an inflammation of the liver. The condition can be self-limiting or can progress to fibrosis (scarring), cirrhosis or liver cancer. Hepatitis viruses are the most common cause of hepatitis in the world but other infections, toxic substances (e.g. alcohol, certain drugs), and autoimmune diseases can also cause hepatitis Causes:  Causes of hepatitis can be divided into the following major categories:  1. Infectious  2. Metabolic  3. Ischemic  4. Autoimmune  5. Genetic, and other.   Types of viral hepatitis : Scientists have identified 5 unique hepatitis viruses, identified by the letters A, B, C, D, and E. While all cause liver disease, they vary in important ways                     Hepatitis A virus (HAV) Is present in the faeces of infected persons and is most often transmitted through consumption of contaminated water or food. Certain sex practices can also spread HAV.   Infections are in many cases mild, with m

  Edema Definition of edema:  Edema is an abnormal accumulation of fluid in the interstitium, located beneath the skin and in the cavities of the body    Causes of edema:  Five factors can contribute to the formation of edema:  Increased capillary hydrostatic pressure   Reduced plasma oncotic pressure   Increased blood vessel wall permeability e.g. Inflammation   Obstruction of fluid clearance in the lymphatic system   Changes in the water retaining properties of the tissues themselves. Raised hydrostatic pressure often reflects retention of water and sodium by the kidney  Major Types : Edema can be majorly classified into following types:  Peripheral Edema   Pulmonary Edema   Cerebral Edema  *Symptoms include bloating, tightening of skin, and skin that holds an imprint or looks pitted Diagnosis:  History   Physical examination  Laboratory investigation  Urine analysis: heavy proteinuria with nephrotic syndrome  CBC: HB decrease in malaborption  Electrolyte: elevated urea and creatinin

                       Diabetic Ketoacidosis DKA is caused by an absence or markedly inadequate amounts of insulin and has three major features of  hyperglycemia, dehydration and acidosis .  Manifestations:  Dehydration   Tachycardia   Kussmaul’s respirations   Nausea and vomiting   Abdominal pain   Acetone breath (fruity odor)   Decreased level of consciousness   DKA:  Blood glucose levels more than 250 mg/dL.   Ketoacidosis is reflected in low serum bicarbonate and low pH values.   High level of ketone bodies in blood and urine.   Sodium and potassium concentrations may vary depending on the degree of dehydration.   Increased levels of creatinine, blood urea nitrogen, and hematocrit.   Arterial blood gas indicate metabolic acidosis.   Management of DKA:  Treatment goal is to supply sufficient doses of insulin, prevent dehydration, and acidosis.  Normal saline (0.9%) is infused at a high rate to replace fluid loss.   Administer regular insulin infusion at a rate of 0.1 ml/kg/hour.   M