NURS 471 Lecture Notes - Lecture 9: Allergen, Smoking Cessation, Flumazenil
Document Summary
Symptoms: fever (absent in elderly), cough, pleuritic chest pain, dyspnea, tachypnea, tachycardia, nasal flaring, soa, accessory muscle use, cyanosis: elderly- confusion. Diagnosis based on clinical presentation and chest xr which will show infiltrates. Curb 65: helps identify pts to give recommended tx faster. Higher score = increased mortality: one point for each category. Need to look at baseline for confusion- don"t score if hx of confusion/alzheimer"s: confusion, urea > 7, respiratory rate > 30, blood pressure: sbp < 90 or dbp < 60, 65: age of 65, score of: Psi port severity index (drives tx including los: class i iii: tx as outpatient or 23 hr admission, class iv-v: hospitalize. Door-to-dose 4hr rule- give abx as soon as possible- give the abx treating the strain of pneumonia in this community at this time. After culture comes back, change abx if needed. Turn, cough, deep breathe every couple of hours. Residing in long-term care: smoking cessation.
