In healthy individuals, pneumonia is not usually life-threatening and does not require hospitalization. Atelectasis 5) Corticosteroids and bronchodilators are helpful in reducing Abnormal. Order stat ABGs to confirm the SpO2 with a SaO2. Lung abscess. Impaired gas exchange is a nursing diagnosis for a patient suffering current or future problems with oxygen/carbon dioxide balance (unknown, 2012). The nurse suspects which diagnosis? b. What are possible explanations for this behavior? The most important factor in managing allergic rhinitis is identification and avoidance of triggers of the allergic reactions. b. Unstable hemodynamics What accurately describes the alveolar sacs? People with community-acquired pneumonia usually do not need to be hospitalized unless an underlying condition such as chronic obstructive pulmonary disease (COPD), heart disease or diabetes mellitus, or a weakened immune system complicates the disease. Community-acquired pneumonia occurs outside of the hospital or facility setting. Nurses also play a role in preventing pneumonia through education. Use narcotics and sedatives with caution.Narcotics for pain control or anti-anxiety medications should be monitored closely as they can further suppress the respiratory system. Amount of air exhaled in first second of forced vital capacity Touching an infected object and then touching your nose or mouth can also transfer the germs. Priority Decision: Based on the assessment data presented, what are the priority nursing diagnoses? Which actions prevent the dislodgement of a tracheostomy tube in the first 3 days after its placement (select all that apply)? Mixed venous blood gases are used when patients are hemodynamically unstable to evaluate the amount of oxygen delivered to the tissue and the amount of oxygen consumed by the tissues. 2. of . The syringe used to obtain the specimen is rinsed with heparin before the specimen is taken and pressure is applied to the arterial puncture site for 5 minutes after obtaining the specimen. Pneumonia: Bacterial or viral infections in the lungs . To assist in creating an accurate diagnosis and monitor effectiveness of medical treatment. Support (splint) the surgical wound with hands, pillows, or a folded blanket placed firmly over the incision site. f. A physician performs the first tracheostomy tube change 2 days after the tracheostomy. Which immediate action does the nurse take? An ET tube has a higher risk of tracheal pressure necrosis. A knowledgeable patient is more likely to comply with therapy. Nursing Diagnosis related to --- as evidence by---Impaired gas exchange related to inflammation of airways, fluid-filled alveoli, and collection of mucus in the airway as evidenced by dyspnea and tachypnea (Carpenito, 2021). Refer to a community-based smoking cessation program or offer nicotine replacement therapy as needed. Patients who are weak or lack a cough reflex may not be able to do so. Decreased or random breath sounds (e.g., crackles, wheezes) may indicate possible respiratory failure, which would further exacerbate hypoxia and require immediate intervention. A less severe form of bacterial pneumonia is called walking or atypical pneumonia, in which the symptoms are very mild and the infected person can do his/her activities of daily living as normal. A 36-year-old patient with type 1 diabetes mellitus asks the nurse whether an influenza vaccine is necessary every year. For which problem is this test most commonly used as a diagnostic measure? patients will better understand the health teachings if there is a written or oral guide for him/her to look back to. An increased anterior-posterior (AP) diameter is characteristic of a barrel chest, in which the AP diameter is about equal to the side-to-side diameter. d. Normal capillary oxygen-carbon dioxide exchange. The nurse expects which treatment plan? Steroids: To reduce the inflammation in the lungs. Using a sphygmometer, auscultate the patients breath sounds for at least every 4 hours. The patient will have a big chance to remember how to administer or perform any therapeutic regimen if they are given the chance to demonstrate and have him/her verbalize their understanding about it. Acid-fast stains and cultures: To rule out tuberculosis. Hospital associated Nosocomial pneumonias, Pneumonia in the immunocompromised individual, Risk for Infection (nosocomial pneumonia), Impaired Gas Exchange due to pneumonic condition, 5 Nursing care plans for anemia | Anemia nursing interventions, 5 Nursing diagnosis of pneumonia and care plans, Nursing Care Plans Stroke with Nursing Diagnosis. Monitor for respiratory changes.Changes in respiratory rate, rhythm, and depth can be subtle or appear suddenly. Which action does the nurse take next? Post author: Post published: February 17, 2023 Post category: orange curriculum controversy Post comments: toys shops in istanbul, turkey toys shops in istanbul, turkey c. Place the patient in high Fowler's position. Administer oxygen with hydration as prescribed. Although inadequately treated -hemolytic streptococcal infections may lead to rheumatic heart disease or glomerulonephritis, antibiotic treatment is not recommended until strep infections are definitely diagnosed with culture or antigen tests. Initially, oxygen is administered at low concentrations, and oxygen saturation is closely monitored. The nurse identifies a nursing diagnosis of impaired gas exchange for a patient with pneumonia based on which physical assessment findings? When F.N. Health perception-health management: Tobacco use history, gradual change in health status, family history of lung disease, sputum production, no immunizations for influenza or pneumococcal pneumonia received, travel to developing countries Symptoms Altered consciousness Anxiety Changes in arterial blood gases (ABGs) Chest Tightness Coughing, with yellow sticky sputum c. The necessity of never covering the laryngectomy stoma c. TLC: (2) Maximum amount of air lungs can contain If the patients condition worsens or lab values do not improve, they may not be receiving the correct antibiotic for the bacteria causing infection. a. Expresses concern about his facial appearance Her nursing career has led her through many different specialties including inpatient acute care, hospice, home health, case management, travel nursing, and telehealth, but her passion lies in educating through writing for other healthcare professionals and the general public. Collaboration: In planning the care for a patient with a tracheostomy who has been stable and is to be discharged later in the day, the registered nurse (RN) may delegate which interventions to the licensed practical/vocational nurse (LPN/VN) (select all that apply)? Changes in behavior and mental status can be early signs of impaired gas exchange. a. Impaired Gas Exchange Thisnursing diagnosis for asthma relates to the decreased amount of air that is exchanged during inspiration and expiration. Pulmonary activities that help prevent infection/pneumonia include deep breathing, coughing, turning in bed, splinting wounds before breathing exercises, walking, maintaining adequate oral fluid intake, and using a hyperinflation device. is now scheduled for a rhinoplasty to reestablish an adequate airway and improve cosmetic appearance. The visceral pleura lines the lungs and forms a closed, double-walled sac with the parietal pleura. Learning to apply information through a return demonstration is more helpful than verbal instruction alone. Attempt to replace the tube. - Manifestations of a lung abscess usually occur slowly over a period of weeks to months, especially if anaerobic organisms are the cause. Shetty, K., & Brusch, J. L. (2021, April 15). a. Carina b. Patients with compromised immune systems such as those with COPD, HIV, or autoimmune diseases should be educated on the risk and how to protect themselves. Report significant findings. A third type is pneumonia in immunocompromised individuals. The patient must understand the importance of seeing an attending physician and not rely on what they see or hear on the internet. d. Inform the patient that radiation isolation for 24 hours after the test is necessary. Air trapping Nursing diagnoses handbook: An evidence-based guide to planning care. Nursing Diagnosis: Ineffective Airway Clearance related to the disease process of bacterial pneumonia as evidenced by shortness of breath, wheeze, SpO2 level of 85%, productive cough, difficulty to expectorate greenish phlegm. Priority Decision: A 75-year-old patient who is breathing room air has the following arterial blood gas (ABG) results: pH 7.40, partial pressure of oxygen in arterial blood (PaO2) 74 mm Hg, arterial oxygen saturation (SaO2) 92%, partial pressure of carbon dioxide in arterial blood (PaCO2) 40 mm Hg. Discuss to him/her the different pros and cons of complying with the treatment regimen. Night sweats Respiratory infection 3. - It requires identification of specific, personalized risk factors, such as smoking, advanced age, and obesity. Popkin, B. M., DAnci, K. E., & Rosenberg, I. H. (2010). What should be the nurse's first action? However, here are some potential NANDA nursing diagnoses that may be applicable: Impaired gas exchange related to decreased lung expansion and ventilation-perfusion imbalance; . If he or she can not do it, then provide a suction machine always at the bedside. a. Hospital acquired pneumonia may be due to an infected. Alveolar sacs are terminal structures of the respiratory tract, where gas exchange takes place. Fine crackles at the base of the lungs are likely to disappear with deep breathing. These techniques mentioned will greatly help the patient to avoid respiratory distress and assist the body to take in oxygen and avoid hypoxia. b. Epiglottis These symptoms are very crucial and the patient must be given immediate care and intervention to avoid hypoxia. What priority discharge teaching should the nurse provide? The palms are placed against the chest wall to assess tactile fremitus. Associated with altered oxygenation and alveolar-capillary membrane changes resulting from the inflammatory process and exudate in the lungs. This also increases the risk for aspiration pneumonia. 8. Usually, people with pneumonia preferred their heads elevated with a pillow. Long-term denture use Impaired Gas Exchange Nursing Diagnosis & Care Plan Related Factors Physiological damage to the alveoli Circulatory compromise Lack of oxygen supply Insufficient availability of blood (carrier of oxygen) Subjective Data: patient's feelings, perceptions, and concerns. Maegan Wagner is a registered nurse with over 10 years of healthcare experience. Also called nosocomial pneumonia, this type of pneumonia originates from being admitted in the hospital. c. CO2 combines with water to form carbonic acid, which lowers the pH of cerebrospinal fluid. The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. Volume of air inhaled and exhaled with each breath This produces an area of low ventilation with normal perfusion. Ventilation-perfusion scans and positron emission tomography (PET) scans involve injections, but no manipulation of the respiratory tract is involved. Lack of lung expansion caused by kyphosis of the spine results in shallow breathing with decreased chest expansion. St. Louis, MO: Elsevier. What other assessment should the nurse consider before making a judgment about the adequacy of the patient's oxygenation? d. Place 1 hand on the lower anterior chest and 1 hand on the upper abdomen. Facilitate coordination within the care team to allow rest periods between care activities. c. A nasogastric tube with orders for tube feedings c. TLC Nursing care plan for impaired gas exchange. What keeps alveoli from collapsing? Tachycardia (resting heart rate [HR] more than 100 bpm). Advised the patient that he or she will be evaluated if he or she can tolerate exercise and develop a special exercise to help his or her recovery. Anna Curran. Identify patients at increased risk for aspiration. Aspiration is one of the two leading causes of nosocomial pneumonia. Has been NPO since midnight in preparation for surgery Increase heat and humidity if patient has persistent secretions. Pleurisy, a) 7. Thorough hand hygiene before and after patient contact (even if gloves are worn). c. Terminal structures of the respiratory tract What measures should be taken to maintain F.N. The patient is admitted with pneumonia, and the nurse hears a grating sound when she assesses the patient. c. Place the thumbs at the midline of the lower chest. Keep skin clean and dry through frequent perineal care or linen changes. Priority Decision: The nurse receives an evening report on a patient who underwent posterior nasal packing for epistaxis earlier in the day. Inhalation of toxic fumes/chemical irritants can damage cilia and lung tissue and is a factor in increasing the likelihood of pneumonia. What is the reason for delaying repair of F.N. 1. b. 3. 3. The process of gas exchange, called diffusion, happens between the alveoli and the pulmonary capillaries. Immunosuppression and neutropenia are predisposing factors for the development of nosocomial pneumonia caused by common and uncommon pathogens. Gravity and hydrostatic pressure in this position promote perfusion and ventilation matching. When taking care of a patient with pneumonia, it is important to ensure the environment is well ventilated, conducive for good rest, and accessible when the patient needs assistance or help. 28: Obstructive Pulmonary Diseases. Instruct patients who are unable to cough effectively in a cascade cough. 25: Assessment: Respiratory System / CH. c. Percussion Observing for hypoxia is done to keep the HCP informed. Pleurisy b. After the intervention, the patients airway is free of incidental breath sounds. A Code Blue would not be called unless the patient experiences a loss of pulse and/or respirations. 1# Priority Nursing Diagnosis. Deficient knowledge (patient, family) regarding condition, treatment, and self-care strategies (Including information about home management of COPD) 7. c. Tracheal deviation As an Amazon Associate I earn from qualifying purchases. "You should get the inactivated influenza vaccine that is injected every year." Symptoms of an abscess caused by aerobic bacteria develop more acutely and resemble bacterial pneumonia. Changes in oxygen therapy or interventions should be avoided for 15 minutes before the specimen is drawn because these changes might alter blood gas values. associated with inadequate primary defenses (e.g., decreased ciliary activity), invasive procedures (e.g., intubation), and/or chronic disease Desired outcome: patient is free of infection as evidenced by normothermia, a leukocyte count of 12,000/mm3 or less, and clear to whitish sputum. Patient's temperature 2018.03.29 NMNEC Leadership Council. 3) Treatment usually includes macrolide antibiotics. Assess the patients vital signs and characteristics of respirations at least every 4 hours. Help the patient get into a comfortable position, usually the half-Fowler position. Usual PaO2 levels are expected in patients 60 years of age or younger. St. Louis, MO: Elsevier. Add heparin to the blood specimen. f) 2. The parietal pleura is a membrane that lines the chest cavity. d. The need to use baths instead of showers for personal hygiene, What is the most normal functioning method of speech restoration for the patient with a total laryngectomy? c. Take the specimen immediately to the laboratory in an iced container. a. Select all that apply. If he or she cannot do it alone, make sure to place suction secretions at the bedside to use anytime. Those at higher risk, such as the very young or old, patients with compromised immune systems, or who already have a respiratory comorbidity, may require inpatient care and treatment. A repeat skin test is also positive. 2. Assess the need for hyperinflation therapy. Periorbital and facial edema reduced by about half since second hospital day Cough and sore throat Awakening with dyspnea, wheezing, or cough. The home health nurse provides which instruction for a patient being treated for pneumonia? Fluids help the kidneys filter and flush waste products preventing renal and urinary infections. Impaired gas exchange is a condition that occurs when there is an insufficient amount of oxygen in the blood. e. Teach the patient about home tracheostomy care. b. Finger clubbing One way to have a good prognosis and help fasten recovery is to comply with the prescribed treatment. She received her RN license in 1997. There is no redness or induration at the injection site. a. Physical examination of the lungs indicates dullness to percussion and decreased breath sounds on auscultation over the involved segment of the lung. What is the significance of the drainage? b. Copious nasal discharge Dont forget to include some emergency contact numbers just in case there is an emergency. What is the most appropriate action by the nurse? a. Thoracentesis c. Determine the need for suctioning. Normal venous blood gas values reflect the normal uptake of oxygen from arterial blood and the release of carbon dioxide from cells into the blood, resulting in a much lower PaO2 and an increased PaCO2. impaired Gas Exchange may be related to decreased oxygen-carrying capacity of blood, reduced RBC life span, abnormal RBC structure, increased blood viscosity, predisposition to bacterial pneumonia/pulmonary infarcts, possibly evidenced by dyspnea, use of accessory muscles, cyanosis/signs of hypoxia, tachycardia, changes in mentation, and . It may also cause hepatitis. This type of pneumonia can spread through droplet transmission, that is, when an infected person sneezes or coughs, and the other person breathes the air droplets through the nasal or oral airways. They will further understand the topic since they already have an idea of what is it about. For best yield, blood cultures should be obtained before antibiotics are administered. b. Partial obstruction of trachea or larynx Assist the patient with position changes every 2 hours. Base to apex Bilateral ecchymosis of eyes (raccoon eyes) Select all that apply. - A nurse should be aware of some of the common side effects of antitubercular drugs like rifampin, one of which is orange discoloration of body fluids such as urine, sweat, tears, and sputum. However, it is highly unlikely that TB has spread to the liver. symptoms. 6. Nursing diagnosis Related factors Defining characteristics Examples of this type of nursing diagnosis include: Decreased cardiac output Chronic functional constipation Impaired gas exchange Problem-focused nursing diagnoses are typically based on signs and symptoms present in the patient. b. Surfactant Buy on Amazon, Gulanick, M., & Myers, J. L. (2022). However, with increasing respiratory distress, respiratory acidosis may occur. NurseTogether.com does not provide medical advice, diagnosis, or treatment. Subjective Data Oral hygiene moisturizes dehydrated tissues and mucous membranes in patients with fluid deficit. If there are some questions or clarifications when it comes to their medicines, make sure to find time to explain to him/her so that this will ensure compliance with the treatment. The following signs and symptoms show the presence of impaired gas exchange: Abnormal breathing rate, rhythm, and depth Nasal flaring Hypoxemia Cyanosis in neonates decreases carbon dioxide Confusion Elevated blood pressure and heart rate A headache after waking up Restlessness Somnolence and visual disturbances Looking For Custom Nursing Paper? These interventions help ensure that the patient has the appropriate knowledge and is able to perform these activities. The greatest chance for a pneumothorax occurs with a thoracentesis because of the possibility of lung tissue injury during this procedure. Tuberculosis frequently presents with a dry cough. d. Comparison of patient's current vital signs with normal vital signs. 's nasal packing is removed in 24 hours, and he is to be discharged. d. Ventilate the patient with a manual resuscitation bag until the health care provider arrives. When does the nurse record the presence of an increased anteroposterior (AP) diameter of the chest? RN, BSN, PHNClinical Nurse Instructor, Emergency Room Registered NurseCritical Care Transport NurseClinical Nurse Instructor for LVN and BSN students. A relative increase in antibody titers indicates viral infection. These values may be adequate for patients with chronic hypoxemia if no cardiac problems occur but will affect the patients' activity tolerance. 3) Illicit drug intake Report weight changes of 1-1.5 kg/day. Nursing care plan pneumonia - Nursing care plan: Pneumonia Pneumonia is an inflammation of the lung - Studocu care plan pneumonia nursing care plan: pneumonia pneumonia is an inflammation of the lung parenchyma, associated with alveolar edema and congestion that impair Skip to document Ask an Expert Sign inRegister Sign inRegister Home Discussion Questions b) 6. Viral pneumonia. - Pertussis is a highly contagious infection of the respiratory tract caused by the gram-negative bacillus Bordetella pertussis. a. Undergo weekly immunotherapy. A patient develops epistaxis after removal of a nasogastric tube. Skin breakdown allows pathogens to enter the body. Arterial blood gases measure the levels of oxygen and carbon dioxide in the blood. h. Absent breath sounds c. a throat culture or rapid strep antigen test. A) Sit the patient up in bed as tolerated and apply Treatment for pneumonia needs to be complied with completely to ensure a good prognosis and improve health. a. Assess the patients vital signs at least every 4 hours. Assess the patients knowledge about Pneumonia. Because antibody production in response to infection with the tuberculosis (TB) bacillus may not be sufficient to produce a reaction to TB skin testing immediately after infection, 2-step testing is recommended for individuals likely to be tested often, such as health care professionals. Which medication therapy does the nurse anticipate will be prescribed? d) 8. b. RV: (7) Amount of air remaining in lungs after forced expiration Risk - Examines the patient's vulnerability for developing an undesirable response to a health condition or life process. Teach the patient to splint the chest with a pillow, folded blanket, or folded arms. The bacteria causing hospital-acquired pneumonia may be antibiotic-resistant, rendering this disease more difficult to treat than community-acquired pneumonia. c. CO2 combines with water to form carbonic acid, which lowers the pH of cerebrospinal fluid. cancer patients or COPD patients). Finger clubbing and accessory muscle use are identified with inspection. . 6) The patient is infectious from the beginning of the first stage Smoking does not directly affect filtration of air, the cough reflex, or reflex bronchoconstriction, but it does impair the respiratory defense mechanism provided by alveolar macrophages. Nursing diagnosis: Deficient knowledge about the disease process and treatment of pneumonia related to lack of information as evidenced by failure to comply with treatment. 6. On inspection, the throat is reddened and edematous with patchy yellow exudates. a. Trachea e. FVC Notify the health care provider. Priority Decision: A patient's tracheostomy tube becomes dislodged with vigorous coughing. Buy on Amazon, Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Signs and Symptoms of impaired gas exchange dyspnea, SOB cough hemoptysis: coughing up blood abnormal breathing patterns: tachypnea, diabetic ketoacidosis, kusbal respirations (diabetic ketoacidosis leads to hypoxemia through kusbal resp trying to get rid of extra CO2) hypoventilation hyperventilation cyanosis (late sign) b. Nutritional-metabolic Note: A risk diagnosis is not evidenced by signs and symptoms as the problem has not yet occurred and the goal of nursing interventions is aimed at prevention. d. A tracheostomy tube and mechanical ventilation, What should the nurse include in discharge teaching for the patient with a total laryngectomy? She earned her BSN at Western Governors University. Impaired gas exchange occurs due to alveolar-capillary membrane changes, such as fluid shifts and fluid collection into interstitial space and alveoli. Adjust the room temperature. A patient started treatment for sputum smear-positive tuberculosis (TB) 1 week prior to the home health nurse's visit. COPD ND3: Impaired gas exchange. 5. A pulmonary angiogram involves the injection of an iodine-based radiopaque dye, and iodine or shellfish allergies should be assessed before injection. If there is airway obstruction this will only block and cause problems in gas exchange. Saunders comprehensive review for the NCLEX-RN examination. To help alleviate cough and allow the patient to rest, cough suppressants may be given at low doses. Early small airway closure contributes to decreased PaO2. Aspiration precautions include maintaining a 30-degree elevation of the HOB, turning the patient onto his or her side rather than back, and using continuous rather than bolus feeding when the patient is enteral. Place the patient in a comfortable position. Major nursing care planning goals for COVID-19 may include: Establishing goals, interventions. Macrolide antibiotics such as azithromycin and clarithromycin are commonly used as first-line drugs for pneumonia. c. SpO2 of 90%; PaO2 of 60 mm Hg Findings may show hypoxemia (PaO2 less than 80 mm Hg) and hypocarbia (PaCO2 less than 32-35 mm Hg) with resultant respiratory alkalosis (pH greater than 7.45) in the absence of underlying pulmonary disease. A) Seizures j. Coping-stress tolerance: Dyspnea-anxiety-dyspnea cycle, poor coping with stress of chronic respiratory problems Impaired gas exchange related to alveolar-capillary membrane changes as evidenced by shortness of breath, low SPO2, and bacteria found in sputum culture. A) Admit the patient to the intensive care unit. When planning care for a patient with pneumonia, the nurse recognizes that which is a high-priority intervention? Alveolar-capillary membrane changes (inflammatory effects) What is included in the nursing care of the patient with a cuffed tracheostomy tube? Sputum for Gram stain and culture and sensitivity tests: Sputum is obtained from the lower respiratory tract before starting antibiotic therapy to identify the causative organisms. Monitor and document vital signs (VS) every 2 to 4 hours or as the patients condition requires. Frequent suctioning increases risk of trauma and cross-contamination. Watch for signs and symptoms of respiratory distress and report them promptly. c. Remove the inner cannula if the patient shows signs of airway obstruction. oxygen. Immunocompromised people are more susceptible to fungal pneumonia than healthy individuals. Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Impaired gas improved or presence of retained secretions client: exchange ventilation and adventitious sound -Demonstrated adequate improved wheezes oxygenation of -Decrease of ventilation and tissues by ABG of: -Palpate for fremitus vibratory tremors adequate pH:7.35-7.45 suggest fluid oxygenation of What Are Some Nursing Diagnosis for COPD? e. Sleep-rest: Sleep apnea. d. treatment with medication only if the pharyngitis does not resolve in 3 to 4 days. document.getElementById("ak_js_1").setAttribute("value",(new Date()).getTime()); This site uses Akismet to reduce spam. The position of the oximeter should also be assessed. The patient will also be able to demonstrate and verbalize understanding about the desired therapeutic regimen. Bacterial Pneumonia. Proper nutrition promotes energy and supports the immune system. The patient receives 1 point for each criterion: confusion (compared to baseline); BUN greater than 20 mg/dL; respiratory rate greater than or equal to 30 breaths/min; systolic BP of less than 90 mm Hg; and age greater than or equal to 65 yrs. The pH is also decreased in mixed venous blood gases because of the higher partial pressure of carbon dioxide in venous blood (PvCO2). Hospital-Acquired Pneumonia (Nosocomial Pneumonia) and Ventilator-Associated Pneumonia: Overview, Pathophysiology, Etiology. Bacterial infections are indications for antibiotic therapy, but unless symptoms of complications are present, injudicious administration of antibiotics may produce resistant organisms. Consider using a closed suction system; replace closed suction system according to agency guidelines. d. An ET tube is more likely to lead to lower respiratory tract infection. c. A tracheostomy tube allows for more comfort and mobility. Priority Decision: F.N. Monitor cuff pressure every 8 hours. Use of accessory respiratory muscles (scalene, sternocleidomastoid, external intercostal muscles), decreased chest expansion due to pleural pain, dullness when tapping on affected (consolidated) areas. Doing activities at the same time will only increase the demands of oxygen in the body, and patients with pneumonia cannot tolerate it. 1. 8 . Select all that apply. Blood culture and sensitivity: To determine the presence of bacteremia and identify the causative organism. 2. 26: Upper Respiratory Problems / CH. Which respiratory defense mechanism is most impaired by smoking? 1. c. "An annual vaccination is not necessary because previous immunity will protect you for several years." Impaired gas exchange is a risk nursing diagnosis for pneumonia. While the nurse is feeding a patient, the patient appears to choke on the food. During assessment of the patient with a viral upper respiratory infection, the nurse recognizes that antibiotics may be indicated based on what finding? How should the nurse document this sound? b. The 150 mL of air is dead space in the trachea and bronchi.
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