Docsity
Log inSign up
Docsity
Prepare for your exams
Prepare for your exams

Study with the several resources on Docsity

Earn points to download
Earn points to download

Earn points by helping other students or get them with a premium plan

Guidelines and tips
Guidelines and tips
Sell on Docsity
Sell on Docsity
Log inSign up

Prepare for your exams

Study with the several resources on Docsity

Find documents

Prepare for your exams with the study notes shared by other students like you on Docsity

Search Store documents

The best documents sold by students who completed their studies

Search through all study resources
Docsity AINEW

Summarize your documents, ask them questions, convert them into quizzes and concept maps

Explore questions

Clear up your doubts by reading the answers to questions asked by your fellow students

Earn points to download

Earn points by helping other students or get them with a premium plan

Share documents
download point icon20 Points

For each uploaded document

Answer questions
download point icon5 Points

For each given answer (max 1 per day)

All the ways to get free points
Get points immediately

Choose a premium plan with all the points you need

Study Opportunities

Choose your next study program

Get in touch with the best universities in the world. Search through thousands of universities and official partners

Community

Ask the community

Ask the community for help and clear up your study doubts

University Rankings

Discover the best universities in your country according to Docsity users

Free resources

Our save-the-student-ebooks!

Download our free guides on studying techniques, anxiety management strategies, and thesis advice from Docsity tutors

From our blog

Exams and Study
Go to the blog

Pneumonia: Nurse's Guide on Diagnosis, Mimics, and Antibiotics, Exams of Nursing

Southwestern Indian Polytechnic InstituteNursing

Essential information for nurses on the diagnosis of pneumonia, its mimics, and the importance of antibiotic stewardship. It covers the definitions of different types of pneumonia, the limitations of using sputum color to diagnose infections, and the role of nurses in reducing unnecessary antibiotics. The document also includes references to relevant clinical practice guidelines and studies.

Typology: Exams

2021/2022

Uploaded on 09/12/2022

lakshmirnarman
lakshmirnarman 🇺🇸

5

(5)

221 documents

1 / 11

Toggle sidebar

This page cannot be seen from the preview

Don't miss anything!

bg1
Pneumonia 101
For Nurses
Nurses Take Antibiotic Stewardship Action Initiative
This material was supported in part by a U.S. Centers for Disease Control and
Prevention (CDC) contract to Johns Hopkins University.
Disclaimer: The conclusions in this presentation are those of the JHU authors and do not necessarily
represent the views of the Centers for Disease Control and Prevention.
The Department of Antimicrobial
Stewardship, The Johns Hopkins
Hospital:
•Valeria Fabre, MD
•Sara E. Cosgrove, MD, MS
•Elizabeth Zink, MS, RN, CCNS, CNRN
The Office of Antibiotic Stewardship,
Centers for Disease Control and
Prevention:
•Arjun Srinivasan, MD
•Lauri Hicks, DO
•Melinda Neuhausser, PharmD
Proud to be a
NURSE
ANTIBIOTIC
STEWARD
1
pf3
pf4
pf5
pf8
pf9
pfa

Partial preview of the text

Download Pneumonia: Nurse's Guide on Diagnosis, Mimics, and Antibiotics and more Exams Nursing in PDF only on Docsity!

Pneumonia 101

For Nurses

Nurses Take Antibiotic Stewardship Action Initiative

This material was supported in part by a U.S. Centers for Disease Control and

Prevention (CDC) contract to Johns Hopkins University.

Disclaimer: The conclusions in this presentation are those of the JHU authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

The Department of Antimicrobial

Stewardship, The Johns Hopkins

Hospital:

  • Valeria Fabre, MD
  • Sara E. Cosgrove, MD, MS
  • Elizabeth Zink, MS, RN, CCNS, CNRN

The Office of Antibiotic Stewardship,

Centers for Disease Control and

Prevention:

  • Arjun Srinivasan, MD
  • Lauri Hicks, DO
  • Melinda Neuhausser, PharmD NURSE ANTIBIOTIC STEWARD

Pneumonia is diagnosed when the following are present:

  • New lung infiltrate
  • Clinical evidence that the infiltrate is of infectious origin (e.g., associated fever, leukocytosis, purulent secretions, pleuritic chest pain, cough)
  • Decline in oxygenation Proud to be a NURSE ANTIBIOTIC STEWARD Definitions NURSE ANTIBIOTIC STEWARD

PNA Mimics Infiltrates

  • Atelectasis
  • Pulmonary edema
  • Pulmonary hemorrhage
  • Fibrosis
  • Tumor
  • Sarcoidosis Oxygen decline
    • Pulmonary embolism
    • Mucous plugging
    • Atelectasis
    • Pulmonary edema
    • Pleural effusions
    • Aspiration pneumonitis NURSE ANTIBIOTIC STEWARD

The Color Of The Sputum Does Not Indicate Infection

  • 241 patients presenting with acute cough − “Proof of infection”: bacterial growth along with moderate number of leukocytes/LPF − Lack of correlation between sputum color and infection in healthy individuals − There was good correlation for patients with underlying chronic lung disease
  • 3,402 patients with acute or worsened cough − Sputum color was not associated with resolution of symptoms over time − Symptom resolution was not associated with antibiotics NURSE ANTIBIOTIC STEWARD

Tracheobronchitis

  • Defined as fever with no other recognizable cause and new or increased sputum production, positive endotracheal tube aspirate culture (> 6 CFU/ml) and no radiographic evidence of pneumonia
  • It is reasonable to NOT treat ventilator-associated tracheobronchitis with antibiotics
  • Treatment of tracheobronchitis can be considered in patients with copious purulent respiratory secretions despite aggressive suctioning OR those patients with copious purulent secretions that are affecting the ability to extubate

− Treatment is shorter than pneumonia (3-5 days)

− Oral agents should be considered

NURSE ANTIBIOTIC STEWARD

Aiming For Safer Antibiotic Use

  • Every time a patient takes an antibiotic, it is an opportunity for bacteria to become more resistant − This is a disadvantage to the patient as resistant infections are more difficult to treat
  • 1 in 5 patients who receive an antibiotic will experience an adverse event
  • 1 in 3 antibiotics used in the hospital are inappropriate in some way (not needed, given for too long, too broad- spectrum)
  • The goal is for the patient to receive antibiotics only when needed NURSE ANTIBIOTIC STEWARD

Should I Collect a Respiratory Specimen for Bacterial Culture? Algorithm for Adult Patients in the Intensive Care Unit? Should I Collect a Respiratory Specimen for Bacterial Culture? Algorithm for Adult Intensive Care Unit Patients START HERE  Proud to be a NURSE ANTIBIOTIC STEWARD Kalil et al., Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society NO NO YES YES Developed by The Johns Hopkins Hospital Department of Antimicrobial Stewardship

References NURSE ANTIBIOTIC STEWARD Slide 2

  • Kalil et al., Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Slide 5
  • Altiner A, Wilm S, Däubener W, et al. Sputum colour for diagnosis of a bacterial infection in patients with acute cough. Scand J Prim Health Care. 2009;27(2): 70 – 73.
  • Buttler et al. Antibiotic prescribing for discoloured sputum in acute cough/lower respiratory tract infection. European Respiratory Journal. 2011;38, 119-125. Slide 7
  • Stulik L, et al. Low Efficacy of Antibiotics Against Staphylococcus aureus Airway Colonization in Ventilated Patients. Clin Infect Dis. 2017;64(8): 1081 - 1088.
  • Kalil AC, et al. Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis. 2016;63(5):e61-e111. Slide 8
  • Grein JD, Kahn KL, Eells SJ, et al. Infect Control Hosp Epidemiol. 2016;37(3): 319 - 326.
  • Katsios CM, Burry L, Nelson S, et al. Crit Care. 2012.
  • Tamma PD, et al. JAMA Internal Medicine. 2017; 177(9):1308-1315.