PAT 401 Week 6- Alteration of Pulmonary Function

[Foundations] What is communicability?

The ability of an infectious disease to spread from one person to another.

[Foundations] What is infectivity?

The ability of a microorganism to enter, survive, and multiply in a host.

[Foundations] What is pathogenicity?

The ability of an infectious organism to cause disease.

[Foundations] What is virulence?

The degree of severity or damage an organism can cause.

[Foundations] What is the infectious dose?

The quantity of an organism required to establish infection; ID50 is the dose infecting 50% of exposed hosts.

[Foundations] Why is hand hygiene effective against enveloped viruses?

Soap disrupts the protective lipid envelope, inactivating the virus.

[Foundations] What is the general nursing priority in respiratory infections?

Assess airway and breathing, respiratory rate, work of breathing, oxygen saturation, hydration, and signs of deterioration; use appropriate infection precautions.

[COVID-19] What is COVID-19?

An infectious respiratory and systemic illness caused by SARS-CoV-2.

[COVID-19] What causes COVID-19?

Infection with SARS-CoV-2, an enveloped RNA coronavirus spread mainly through infectious respiratory particles.

[COVID-19] How does SARS-CoV-2 enter host cells?

Viral spike protein binds ACE2 receptors on susceptible cells, allowing viral entry and replication.

[COVID-19] What is the pathophysiology of COVID-19?

Viral infection of respiratory cells triggers immune responses; severe disease causes dysregulated inflammation, alveolar injury, endothelial dysfunction and thrombosis, impairing gas exchange.

[COVID-19] Why can COVID-19 cause hypoxemia?

Damage to pneumocytes and alveolar inflammation impair oxygen diffusion and ventilation-perfusion matching; severe cases may develop ARDS.

[COVID-19] What are common manifestations of COVID-19?

Fever, cough, fatigue, sore throat, congestion, headache, myalgia, and sometimes shortness of breath or gastrointestinal symptoms.

[COVID-19] What findings suggest severe COVID-19?

Hypoxemia, increasing oxygen needs, respiratory distress, altered mental status, or signs of thrombosis or organ dysfunction.

[COVID-19] What are important COVID-19 complications?

Pneumonia, ARDS, thromboembolic events, multisystem organ dysfunction and post-COVID conditions.

[COVID-19] How is COVID-19 tested for?

Viral nucleic-acid amplification testing (such as PCR) or antigen testing; interpretation depends on symptoms and timing.

[COVID-19] What are the main treatment categories for COVID-19?

Supportive care; early antivirals for eligible high-risk patients; oxygen, corticosteroids and selected immunomodulators for certain hospitalized hypoxemic patients; thrombosis prevention when indicated.

[COVID-19] What are priority nursing assessments for COVID-19?

Monitor SpO2, respiratory rate, work of breathing, temperature, mental status, fluid balance, and clinical deterioration; implement appropriate infection prevention.

[COVID-19] What is the nursing priority for a hypoxemic COVID-19 patient?

Promptly assess airway/breathing, provide prescribed oxygen, escalate worsening respiratory distress, and watch for ARDS and thrombotic complications.

[COVID-19] Why can COVID-19 increase clotting risk?

Inflammation and endothelial injury activate coagulation and platelet pathways, increasing thrombotic risk.

[COVID-19] What is multisystem inflammatory syndrome in children (MIS-C)?

A rare severe inflammatory condition occurring after SARS-CoV-2 infection, involving fever and multiple organs, often including the heart.

[COVID-19] What are possible MIS-C manifestations?

Persistent fever, rash, gastrointestinal symptoms, conjunctival findings, hypotension, and cardiac involvement.

[COVID-19] What are nursing priorities in suspected MIS-C?

Urgent escalation, assess perfusion and cardiac/respiratory status, monitor vital signs and urine output, and support specialist-directed care.

[COVID-19 medications] What is the mechanism of action of nirmatrelvir/ritonavir?

Nirmatrelvir inhibits the SARS-CoV-2 main protease, blocking viral protein processing; ritonavir boosts nirmatrelvir exposure by inhibiting CYP3A.

[COVID-19 medications] When is nirmatrelvir/ritonavir most useful?

Early in symptomatic infection in eligible patients at risk for progression, within the recommended treatment window.

[COVID-19 medications] What are nursing priorities before nirmatrelvir/ritonavir?

Confirm symptom onset and eligibility; check renal/hepatic considerations and critically review drug interactions, including some statins and anticoagulants.

[COVID-19 medications] What does dexamethasone do in severe COVID-19?

It is a glucocorticoid that suppresses excessive inflammation; used in selected patients requiring supplemental oxygen, not routinely for mild illness without oxygen needs.

[COVID-19 medications] What should nurses monitor with dexamethasone?

Blood glucose, infection signs, fluid status, GI symptoms, and mental-status changes.

[COVID-19 medications] How does tocilizumab work?

A monoclonal antibody blocking the interleukin-6 receptor to reduce excessive inflammatory signaling in selected severe cases.

[COVID-19 medications] What should nurses monitor with tocilizumab?

Infection risk, liver enzymes, blood counts, and infusion-related reactions per protocol.

[COVID-19 medications] Why may heparin be used in hospitalized COVID-19 patients?

To prevent or treat venous thromboembolism when indicated; it does not directly kill the virus.

[COVID-19 medications] What is heparin’s mechanism?

Enhances antithrombin activity, reducing coagulation factor activity, particularly factor Xa and thrombin (depending on formulation).

[COVID-19 medications] What are priority nursing checks with heparin?

Assess bleeding, platelet count, prescribed coagulation monitoring, and signs of heparin-induced thrombocytopenia.

[COVID-19 medications] What reverses unfractionated heparin?

Protamine sulfate, administered according to clinical protocol.

[ARDS] What is acute respiratory distress syndrome (ARDS)?

An acute, severe inflammatory lung injury causing noncardiogenic pulmonary edema, reduced lung compliance and significant hypoxemia.

[ARDS] What can cause ARDS?

Common triggers include pneumonia and sepsis; also aspiration, major trauma, pancreatitis and severe systemic inflammation.

[ARDS] What is the pathophysiology of ARDS?

Inflammatory damage to the alveolar-capillary barrier increases permeability, causing protein-rich alveolar edema, surfactant dysfunction, atelectasis, shunting and refractory hypoxemia.

[ARDS] What happens during the exudative stage of ARDS?

Early inflammation and capillary leak cause alveolar flooding, edema, hyaline membranes and collapse of alveoli.

[ARDS] What happens during the proliferative stage of ARDS?

Inflammation begins to resolve, fluid clears and epithelial repair occurs; some patients continue to have impaired gas exchange.

[ARDS] What happens during the fibrotic stage of ARDS?

In some patients, fibrotic remodeling produces stiff lungs and potentially persistent pulmonary impairment.

[ARDS] Why is oxygenation difficult in ARDS?

Fluid-filled or collapsed alveoli are poorly ventilated despite continued blood flow, creating shunt and ventilation-perfusion mismatch.

[ARDS] What are clinical manifestations of ARDS?

Rapid breathing, marked dyspnea, accessory muscle use, hypoxemia, respiratory distress, possible confusion and bilateral lung opacities.

[ARDS] What findings support an ARDS diagnosis?

Acute onset after a trigger, bilateral opacities, hypoxemia, and respiratory failure not fully explained by cardiac failure or fluid overload.

[ARDS] What is the primary treatment approach for ARDS?

Treat the underlying cause and support oxygenation, often with lung-protective mechanical ventilation and careful fluid management.

[ARDS] Why is prone positioning used in severe ARDS?

It improves ventilation-perfusion matching and recruits dependent lung regions, improving oxygenation.

[ARDS] What are key nursing priorities for ARDS?

Monitor oxygenation and ventilation, work of breathing, ABGs when ordered, hemodynamics, urine output, and organ dysfunction; provide ventilator and prone-position safety care.

[ARDS] Why should nurses monitor for multiorgan failure in ARDS?

Severe hypoxemia and systemic inflammation can impair kidney, cardiovascular and other organ function.

[ARDS] How does ARDS differ from cardiogenic pulmonary edema?

ARDS is primarily caused by inflammatory alveolar-capillary permeability injury, not elevated hydrostatic pressure from heart failure.

[Croup] What is viral croup?

An acute viral upper-airway illness (laryngotracheitis) causing subglottic swelling and a characteristic barking cough.

[Croup] What causes croup?

Usually parainfluenza viruses; other respiratory viruses can also cause it.

[Croup] What is the pathophysiology of croup?

Viral inflammation produces edema around the larynx and subglottic trachea, narrowing the small pediatric airway and causing turbulent inspiratory airflow.

[Croup] What are the hallmark manifestations of croup?

Barking seal-like cough, hoarseness, inspiratory stridor, and potentially retractions or increased work of breathing.

[Croup] What signs indicate severe croup?

Stridor at rest, marked retractions, fatigue, poor air entry, cyanosis or altered consciousness.

[Croup] Why can crying worsen croup?

Agitation increases airflow demand through an already narrowed upper airway, worsening stridor and distress.

[Croup] What is the treatment for croup?

Dexamethasone is commonly given; nebulized epinephrine is used for moderate-to-severe symptoms, with observation for recurrence.

[Croup] What are nursing priorities for croup?

Keep child calm, minimize upsetting procedures, assess stridor and retractions, monitor oxygenation and response to treatment, and escalate airway compromise.

[Croup] Is cold air definitive treatment for croup?

No. It may temporarily soothe some children, but evidence-based treatment focuses on corticosteroids and nebulized epinephrine when indicated.

[Bronchiolitis] What is bronchiolitis?

An acute viral lower-respiratory illness in infants and young children affecting the small airways (bronchioles).

[Bronchiolitis] What causes bronchiolitis?

Most often respiratory syncytial virus (RSV), though other respiratory viruses can cause it.

[Bronchiolitis] What is the pathophysiology of bronchiolitis?

Viral infection causes bronchiolar inflammation, edema, mucus and epithelial debris, narrowing small airways and causing air trapping, atelectasis and impaired gas exchange.

[Bronchiolitis] What are common bronchiolitis manifestations?

Rhinorrhea, cough, wheeze or crackles, tachypnea, retractions, feeding difficulty, and sometimes hypoxemia or apnea.

[Bronchiolitis] What findings suggest dehydration in bronchiolitis?

Reduced intake, fewer wet diapers, dry mucous membranes, weight loss and lethargy.

[Bronchiolitis] What is the main treatment for bronchiolitis?

Supportive care: nasal suction when needed, hydration, oxygen if indicated, and escalation to respiratory support for severe illness.

[Bronchiolitis] What are nursing priorities in bronchiolitis?

Assess respiratory effort, SpO2, hydration and feeding; clear nasal secretions gently; monitor for apnea and fatigue.

[Bronchiolitis] Are antibiotics routinely indicated for bronchiolitis?

No. It is usually viral; antibiotics are reserved for a suspected or confirmed bacterial infection.

[Bronchiolitis] How can severe RSV disease be prevented in infants?

Preventive immunization strategies, including maternal RSV vaccination or infant monoclonal antibody protection when eligible, according to local guidance.

[Viral pneumonia] What is viral pneumonia?

An infection of the lung tissue caused by a respiratory virus, producing inflammation and impaired gas exchange.

[Viral pneumonia] What causes viral pneumonia?

Respiratory viruses such as influenza, RSV and SARS-CoV-2.

[Viral pneumonia] What is the pathophysiology of viral pneumonia?

Viral infection injures respiratory epithelium and triggers inflammation; interstitial and alveolar changes impair oxygen exchange.

[Viral pneumonia] What are common manifestations of viral pneumonia?

Fever, cough, fatigue, tachypnea, dyspnea, hypoxemia and sometimes diffuse crackles.

[Viral pneumonia] What complications can viral pneumonia cause?

Respiratory failure, ARDS, dehydration and secondary bacterial pneumonia.

[Viral pneumonia] How is viral pneumonia treated?

Supportive oxygen and hydration as needed; virus-specific antiviral treatment may be indicated for selected infections.

[Viral pneumonia] What are nursing priorities in viral pneumonia?

Assess oxygenation and respiratory effort, monitor temperature and hydration, provide supportive care and appropriate infection precautions.

[Viral pneumonia] Why can bacterial pneumonia follow viral pneumonia?

Viral damage to airway defenses and epithelium can increase susceptibility to secondary bacterial infection.

[Bacterial pneumonia] What is bacterial pneumonia?

An infection of lung parenchyma caused by bacteria, often leading to inflammatory alveolar exudate and consolidation.

[Bacterial pneumonia] What are common causes of bacterial pneumonia?

Streptococcus pneumoniae is an important cause; other bacteria vary by age, exposure and clinical setting.

[Bacterial pneumonia] What is the pathophysiology of bacterial pneumonia?

Bacteria reach alveoli and trigger neutrophilic inflammation; fluid and cellular exudate fill airspaces, causing consolidation and impaired gas exchange.

[Bacterial pneumonia] What are manifestations in adults?

Fever, chills, cough, sputum, pleuritic chest pain, fatigue, dyspnea, tachypnea and crackles.

[Bacterial pneumonia] What are manifestations in children?

Fever, cough, tachypnea, retractions, reduced feeding, lethargy and sometimes grunting or nasal flaring.

[Bacterial pneumonia] What assessment findings suggest worsening pediatric pneumonia?

Hypoxemia, marked retractions, grunting, poor intake, lethargy, cyanosis or altered mental status.

[Bacterial pneumonia] How is bacterial pneumonia diagnosed?

Clinical assessment with respiratory findings; chest radiography and selected microbiologic testing may be used depending on severity.

[Bacterial pneumonia] How is bacterial pneumonia treated?

Appropriate antibiotics based on likely organism and setting, plus oxygen, hydration and symptom management as needed.

[Bacterial pneumonia] What are nursing priorities for bacterial pneumonia?

Assess airway/breathing, SpO2, breath sounds and work of breathing; administer prescribed antibiotics, monitor response and hydration, and watch for sepsis.

[Bacterial pneumonia] What complications can bacterial pneumonia cause?

Pleural effusion, empyema, bacteremia, sepsis, respiratory failure and occasionally ARDS.

[Bacterial pneumonia] What is the difference between crackles and wheezes?

Crackles are discontinuous popping sounds often associated with fluid or reopening airways; wheezes are musical sounds associated with narrowed airways.

[Pneumonia antibiotics] How does azithromycin work?

A macrolide that binds the bacterial 50S ribosomal subunit and inhibits protein synthesis.

[Pneumonia antibiotics] What nursing precautions apply to azithromycin?

Review allergy history, QT-prolongation risk and interacting drugs such as warfarin; monitor adverse effects.

[Pneumonia antibiotics] How does amoxicillin work?

A beta-lactam penicillin that binds penicillin-binding proteins and inhibits bacterial cell-wall cross-linking.

[Pneumonia antibiotics] What nursing precautions apply to amoxicillin?

Check penicillin allergy, monitor rash, GI effects and treatment response; ensure prescribed course is followed.

[Pneumonia antibiotics] How does cefotaxime work?

A third-generation cephalosporin that binds penicillin-binding proteins, inhibits peptidoglycan cross-linking and causes bacterial cell-wall failure.

[Pneumonia antibiotics] What nursing precautions apply to cefotaxime?

Assess beta-lactam allergy, renal function where relevant, diarrhea and signs of response or superinfection.

[Pneumonia antibiotics] How does ciprofloxacin work?

A fluoroquinolone that inhibits bacterial DNA gyrase and topoisomerase IV, preventing DNA replication.

[Pneumonia antibiotics] What important precautions apply to ciprofloxacin?

Monitor for tendon injury, neuropathy, CNS effects, QT issues and drug interactions; use only when clinically appropriate.

[Pneumonia antibiotics] Why is antibiotic stewardship important in pneumonia?

Using antibiotics only when indicated and choosing an appropriate agent reduces resistance, adverse effects and unnecessary treatment.