NURS 165 Study Guide - Final Guide: Levofloxacin, Bioavailability, Patient Education
• Epidemiology
o Infectious diseases can cause significant morbidity and mortality
o Respiratory and urinary tracts are most common sites
▪ Urinary is most common bacterial site
▪ Bronchitis, pneumonia, etc.
▪ Urethritis, cystitis, pyelonephritis
o Pneumonia
▪ Infection of lung tissue from alveoli to interstitium
▪ Inflammation; impaired gas exchange
▪ )t’s the most common infectious cause of death
• Both the actually disease and related complications
o UTI
▪ Microorganisms present in the urinary tract not accounted for
by contamination
• Asymptomatic bacteria in urine can cause systemic
infection
• More frequent in females until 65 yrs, then equal gender
risk
• Definitions
o Pathogen – a disease-causing microorganism
o Infection – a local shift in favor of bug > host
▪ Toxin production
▪ Invasion of WBCs → inflammation
o Virulence – strength of microorganism’s pathogenicity
o Inoculum – quantity of microorganisms
o RISK FOR INFECTION: (Inoculum * Virulence) / Host Resistance
• Important Pathogens (Blue is G+, Red is G-)
o Upper Respiratory
▪ S. pneumoniae
▪ S. pyogenes
▪ H. influenza
▪ M catarrhalis
o Lower Respiratory
▪ S. pneumoniae
▪ S. aureus
▪ H. influenza
▪ Enterobacter spp.
▪ Ps. aeruginosa
o Urinary tract
▪ Enterococcus sp
▪ E. coli
o CAP vs . HAP
▪ Community-Acquired vs. Hospital-Acquired pneumonia
▪ S. pneumoniae common to both
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▪ S. aureus is inpatient ICU (from CAP)
▪ Gram negatives more likely in HAP
• Like E. Coli
o Positive vs. Negative
▪ Allows you to narrow down what the most likely organism is
that you’re looking at
▪ The more narrow you can get that list, more likely you are to
find right antibiotic to treat that
o Some are atypicals
• Won’t pop up as gram positive or negative
• Present clinically a little atypical
• Includes
o Mycobacteria
o Mycoplasma
o Legionella
o Chlamydia
▪ Can also look at where certain gram positives/negatives are
likely to reside
• Ex. Enterococcus sp. Is often found in urinary tract
• HAP includes
o Ventilator associated
o Healthcare associated
• Stages of Infection
o Incubation
▪ Between exposure and syndromes
o Prodrome
▪ Non-specific symptoms
o Illness
▪ Overt signs/symptoms of infection
o Recovery
▪ Return towards homeostasis
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• Clinical Manifestations
o Pneumonia
▪ Signs/Symptoms
• Fever, chills, dyspnea, productive cough (making gunk
and spitting it out), pleuritic chest pain
▪ Physical Exam
• Tachypnea, tachycardia, dull on percussion, diminished
breath sounds, crackles when breathing in, tactile
fremitus (vibrations)
▪ Other
• Radiography – chest x-ray
• Gram stain on sputum
• Labs – CBC, leukocytosis (WBCs will increase, especially
neutrophils)
▪ CURB-65 Criteria
• Confusion, Uremia, Respiratory rate ( > 30), low Blood
pressure, 65 years or older
o 1 point if each is a yes
o Higher you are, more likely your mortality and
more likely to be admitted to hospital
o Urinary Tract Infection
▪ Upper – bladder
• Fever, chills, flank pain, nausea/vomiting, malaise
• Labs: bacteriuria, pyuria (pus); + for nitrate/leukocytes
▪ Lower – urinary path
• Dysuria, urgency, frequency, nocturia, suprapubic
heaviness, gross hematuria
• Labs: bacteriauria, pyuria, + nitrates/leukocytes,
antibody-coated bacteria
▪ Signs/Symptoms are not diagnostic
• May have asymptomatic UTI
• Organ Dysfunction
o Pneumonia – lungs
▪ Depending on inoculum and virulence, can even get infection
just in alveoli
o
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Epidemiology, infectious diseases can cause significant morbidity and mortality, respiratory and urinary tracts are most common sites, urinary is most common bacterial site, bronchitis, pneumonia, etc, urethritis, cystitis, pyelonephritis, pneumonia, uti. Infection of lung tissue from alveoli to interstitium. Hap: community-acquired vs. hospital-acquired pneumonia, s. pneumoniae common to both, s. aureus is inpatient icu (from cap, gram negatives more likely in hap, like e. coli, positive vs. Negative: allows you to narrow down what the most likely organism is, the more narrow you can get that list, more likely you are to find right antibiotic to treat that that you"re looking at. Some are (cid:498)atypicals(cid:499: won"t pop up as gram positive or negative, present clinically a little atypical. Includes: mycobacteria, mycoplasma, legionella, chlamydia, can also look at where certain gram positives/negatives are likely to reside, ex. Interfere with protein synthesis: aminoglycosides, macrolides, tetracyclines.
