Pneumonia is an infectious disease in one or both lungs. Micro-organisms such as bacteria, fungi, and viruses can cause pneumonia. In adults, bacterial pneumonia is most common.
Pneumonia is an infectious disease in one or both lungs. Micro-organisms such as bacteria, fungi, and viruses can cause pneumonia. In adults, bacterial pneumonia is most common.
Pneumonia is an infection of the lungs. The air sacs in the lungs (called alveoli) fill up with pus and other fluid, which makes it hard for oxygen to reach the bloodstream.
Someone with pneumonia may have a fever, cough, or trouble breathing.
Pneumonia is an infection of the lungs. The air sacs in the lungs (called alveoli) fill up with pus and other fluid, which makes it hard for oxygen to reach the bloodstream.
Someone with pneumonia may have a fever, cough, or trouble breathing.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
3. LEARNING OBJECTIVES
By the end of the session, the participants should be able to;
Define pneumonia
Differentiate between the various types of pneumonia
State the causes of pneumonia
Discuss the signs and symptoms of pneumonia
Explain the conservative management of Pneumonia
Outline the treatment of patient with pneumonia based on
nursing process approach
3
5. INTRODUCTION
Pneumonia is an inflammation of the lung parenchyma that is commonly
caused by a microbial agent.
“Pneumonitis” is a more general term that describes an inflammatory
process in the lung tissue that may predispose a patient to or place a
patient at risk for microbial invasion.
Pneumonia is the most common cause of infectious death in children
worldwide and also the most serious for people older than 65 years and
people with health problems or weaken immune system.
It is the seventh leading cause of death in the United States for all ages
and both genders, resulting in almost 70,000 deaths per year.
In persons 65 years of age and older, it is the fifth leading cause of death
(National Centre for Health Statistics, 2000; Minino & Smith, 2001).
5
6. INTRODUCTION Cont.
Although it is usually associated with an acute infection,
pneumonia can also result from radiation therapy, chemical
ingestion or inhalation, or aspiration of foreign bodies or gastric
contents.
It is characterized by cough, fever, headache, chest pain, shortness
of breath, sweating, tachycardia, greyish sputum etc.
Pneumonia caused by infectious agent are mostly contagious
either by direct or indirect contact with an infected person.
Pneumonia is the cause of more than 10% of hospital admissions
each year and is the most common cause of death from infection.
It is treated extensively on both an inpatient and outpatient basis.
6
7. DEFINITION
Pneumonia can be defined as an inflammation of the lung
parenchyma that is commonly caused by a microbial agent
(bacteria, viruses and fungi).
Pneumonia is an inflammatory process affecting the
bronchioles and alveoli usually associated with an acute
infection but can also result from radiation therapy,
chemical ingestion or inhalation, or aspiration of foreign
bodies or gastric contents (American Lung Association,
2007).
It is inflammatory condition of the lung most commonly
due to an infection affecting primarily the microscopic air
sac known as the alveoli.
7
8. CLASSIFICATIONS/TYPES
Pneumonia can be classified based on the following;
Causative factors – bacterial pneumonia, viral pneumonia,
fungal pneumonia, chemical pneumonia
Area of the lung affected – bronchopneumonia & lobar
pneumonia
Where or how it was acquired – hospital acquired
pneumonia, community acquired pneumonia, ventilator-
associated pneumonia, aspiration pneumonia, walking
pneumonia, hypostatic pneumonia.
8
9. TYPES OF PNEUMONIA
BACTERIAL PNEUMONIA – this is the type of pneumonia caused by bacteria.
The common bacteria is Streptococcus pneumoniae; also called
pneumococcal pneumonia. This organism accounts for approximately 90% of
all bacterial pneumonias. It is the most common cause of community-
acquired pneumonia, Other bacteria include Staphylococcus aureus,
Mycoplasmapneumoniae, Escherichia coli, and Pseudomonas aeruginosa,
among others.
VIRAL PNEUMONIA – this is the type of pneumonia caused by viruses.
Influenza viruses are the most common cause of viral pneumonia. The
presence of viral pneumonia increases the patient’s susceptibility to a
secondary bacterial pneumonia.
FUNGAL PNEUMONIA – is the type of pneumonia caused by fungi. Candida
and Aspergillus are two types of fungi that can cause pneumonia.
Pneumocystis carinii is a fungus that typically causes pneumonia in patients
with AIDS.
9
10. TYPES OF PNEUMONIA cont.
ASPIRATION PNEUMONIA – is the type of pneumonia caused by
aspiration of foreign substances. This most often occurs in patients with
decreased levels of consciousness or an impaired cough or gag reflex. This
condition can occur with alcohol ingestion, stroke, general anesthesia,
seizures, or other serious illness. Aspiration pneumonia increases the risk
for subsequent bacterial pneumonia.
VENTILATOR–ASSOCIATED PNEUMONIA - A type of aspiration
pneumonia, ventilator-associated pneumonia (VAP), develops in patients
who are intubated and mechanically ventilated. The endotracheal tube
keeps the glottis open, so secretions can be aspirated in to the lungs.
HYPOSTATIC PNEUMONIA - Patients who hypo ventilate because of bed
rest, immobility, or shallow respirations are at risk for hypostatic
pneumonia. Secretions pool in dependent areas of the lungs and can lead
to inflammation and infection.
10
11. TYPES OF PNEUMONIA cont.
COMMUNITY ACQUIRED PNEUMONIA - This develop on
people with limited or no contact with medical institutions or
settings. It occurs either in the community setting or in the first
48 hours after institutionalization
HOSPITAL ACQUIRED PNEUMONIA - This develops typically
after about 2days or more of hospitalization and does not
appear to be incubating at the time of admission.
PNEUMONIA IN THE IMMONOCOMPROMISED PEOPLE - This
occur in people whose immune system is weakened for
example by AIDS, organ transplantation, use of certain drugs
such as corticosteroids, immunosuppressive agents,
chemotherapy, nutritional depletion etc.
11
12. TYPES OF PNEUMONIA cont.
CHEMICAL PNEUMONIA – this type of pneumonia
occur due to Inhalation of toxic chemicals into the lung
causing inflammation and tissue damage in the lungs.
BRONCHOPNEUMONIA – is the type of pneumonia
that can affect areas throughout both lungs. It’s often
localized close to or around the bronchi.
LOBAR PNEUMONIA – is the type of pneumonia that
affects one or more lobes of the lungs. Each lung is
made of lobes, which are defined sections of the lung.
12
13. CAUSES/RISK FACTOR
The causative factors for pneumonia are mainly microbial organisms;
Bacteria such as Streptococcus pneumonia, Mycoplasma pneumonia,
Haemophilus influenza & Legionella pneumophila
Viruses such as nfluenza (flu), rhinoviruses (common cold), human
parainfluenza virus (HPIV) human metapneumovirus (HMPV), SARS-CoV-2
infection (the virus that causes COVID-19)
Fungi such as candida, aspergillus, Pneumocystis jirovecii, Cryptococcus
species, Histoplasmosis species.
Other causes include but not limited
Irritants/foreign bodies
Chemicals
Aspiration
13
14. RISK FACTORS
Anyone can get pneumonia, but some people are at higher risk than
others. Some of the risk factor include the following;
Cigarrete smoking
Alcohol abuse
Infants and aged
Recent viral respiratory infections such common cold, influenza,
laryngitis etc.
Chronic lung disease such COPD, Bronchiectasis, asthma etc
Cerebral palsy
Dysphagia due to neurological conditions
Malnutrition etc
14
15. PATHOPHYSIOLOGY
Pneumonia is an inflammation of the lungs caused by various micro-
organism and or other causative factors.
It arises from patients whose resistance has been altered or from aspiration of
flora present in oropharynx or from blood borne organism that enter
pulmonary circulation and are trapped.
Once the organism or particles enters the lungs, an inflammatory reaction
occur in the alveoli producing fever.
The irritation of the pleura following the inflammatory reaction produces
chest pain and exudate formation that interferes with the diffusion of oxygen
and carbon-dioxide causing difficulty in breathing.
The presence of exudate and mucus interfere with gaseous exchange and
triggers the cough reflex causing constant coughing.
If treatment is not instituted empyema, septicaemia, pleural effusion and
atelectasis may occur as complications.
15
16. CLINICAL MANIFESTATION
Although symptoms may vary greatly depending on the presence
of other underlying condition, common symptoms include;
Cough
Fever
Shortness of breath
Chest pain (pleuritis pain)
Nausea and vomiting
Sweating/diaphoresis
Tachycardia
Fatigue
Headache
Muscle pain
Purulent sputum
Anorexia
Tachypnoea
16
18. DIAGNOSTIC EVALUATION
History taking
Physical examination – Ausculation will reveal
crepitation, percussion will reveal dullness in the
affected part.
Sputum and blood culture to identify the causative
organism
Pleural fluid test
Chest X-ray to reveal the area of consolidation
Pulse oximetry
Bronchoscopy
18
20. CONSERVATIVE MANAGEMENT
The aim of the conservative management is
to relief symptoms, promote healing and
prevent complications. The conservative
management is categorized into:
Home remedy
Medical/pharmacologic management
Nursing management
20
21. Home remedy
Although home remedies don’t actually treat pneumonia, there are some
things you can do to help ease symptoms.
Coughing is one of the most common symptoms of pneumonia, Natural
ways to relieve a cough include gargling salt water or drinking
peppermint tea or honey with hot water.
Steam inhalation reduces congestion
Drinking warm water or having a nice warm bowl of soup can help with
chills.
You can help your recovery and prevent a recurrence by getting a lot of
rest and drinking plenty of fluids.
Although home remedies can help ease symptoms, it’s important to stick
to your treatment plan. Take any prescribed medications as directed.
21
22. Medical treatment
Antibiotics – the choice of antibiotics depend on the result of
the sensitivity test. Common group used are penicillins such as
ampicillin, amoxicillin, augumentin, xtaphen etc others include
streptomycin, septrin and chloramphenicol.
Analgesics – paracetamol, aspirin, chymoral are used to relief
pain and pyrexia
Cough syrups/expectorant – Benylin cough mixtures
Vitamins – vitamin C and B complex are used as adjuvant
therapy
Iv fluid therapy to replace fluid loss in severe cases
22
23. Nursing management
Encourage the patient to adhere to the medication regimen
Rest should be advocated especially during the acute phase of
the disease.
Reducing stress requires physical and psychological
modifications
Help patient identify and manage stressful situations
Admitting patient in fowlar’s position promote lung expansion
Biofeedback or behavior modification may be helpful
23
24. Nursing management cont.
Strongly encouraged to stop smoking
High nourishing diet
Maintaining fluid intake and output balance
chart
Providing passive and active exercise
including breathing exercise is essential
Oxygen administration in severe cases is
also helpful
24
25. NURSING DIAGNOSIS
Ineffective breathing pattern r/t alveolar congestion aeb patient
difficulty in breathing and respiratory circle of 10c/m
Acute pain (chest pain) r/t pleural irritation or inflammatory
process aeb patient verbalization
Hyperthermia r/t inflammatory process aeb temperature
reading 39 decree celcius
Deficient fluid volume r/t vomiting aeb loss of skin turgor
Imbalanced nutrition: less than body requirements r/t nausea &
vomiting aeb weight loss
Anxiety r/t unknown disease prognosis aeb patient’s
verbalisation/asking questions
25
27. PREVENTION OF RECURRENCE
A number of steps can be taken to help prevent getting
pneumonia include;
Adheres to treatment regimen
Stop smoking
Avoid respiratory infections
Regular hand hygiene
Avoid extreme exposure to cold
Pneumococcal conjugate vaccine (PCV) where available
27