Respiratory infections

Respiratory infection items mix gas exchange with isolation discipline: get oxygen on, collect the right specimens, start drugs, and stop the next case with PPE and swallow safety. Life-threatening airway crises sit in Acute respiratory emergencies. Day-to-day COPD and asthma control sit in Respiratory chronic disease.

Pneumonia: oxygen, cultures, antibiotics

Pneumonia fills alveoli with inflammatory debris so oxygen cannot cross. The first nursing move on a hypoxic stem is to raise FiO2 and position the client for ventilation — usually head up, good lung strategies as appropriate — while you call for help if work of breathing is failing. Confusion in older adults may be the main cue; do not wait for textbook fever in every elder.

When the stem says cultures are ordered and the client is stable enough, draw or collect them before the first antibiotic dose. When the client is crashing, you still oxygenate and escalate; ordered antibiotics are not held hostage to a perfect sputum sample. Report rust-colored or foul sputum, pleuritic pain, and rising oxygen need.

Influenza, COVID patterns, and isolation

Influenza spreads through respiratory droplets. Droplet precautions (surgical mask, eye protection as indicated, private room preferred) are the usual tested package, with hand hygiene always. Teach that antivirals work best when started early in illness for eligible clients, and that vaccination remains prevention. High-risk groups (pregnancy, elders, cardiopulmonary disease) need a lower threshold to escalate dyspnea.

COVID-19 isolation details follow the stem’s current facility cues. Expect PPE before entering, careful aerosol-generating procedure rules, and monitoring for hypoxemia that outpaces how comfortable the client looks. Same nursing spine as other viral pneumonias: oxygenate, prevent spread, support hydration and rest, watch for deterioration.

• Client wears a mask during transport when infectious.
• Visitors and roommates follow the same isolation logic as staff.
• Do not reuse N95s as fashion — fit and seal matter for airborne diseases.

Tuberculosis and RIPE adherence

Active pulmonary TB needs airborne precautions: N95 or higher respirator for staff, negative-pressure room, door closed. The client can usually leave isolation only when criteria in the stem/protocol are met (often clinical improvement plus negative smears pattern as tested). Latent TB is not treated with airborne rooms the same way — know which the stem describes.

Months of multidrug therapy fail when doses are skipped. Directly observed therapy appears on stems for a reason. Teach no alcohol with hepatotoxic regimens, and that “feeling better” at week two is not a reason to stop.

1. Collect early-morning sputum for AFB as ordered.
2. Keep the door closed; post airborne signage.
3. Screen close contacts per public-health cues — nursing reinforces follow-up.

Aspiration pneumonia prevention

Aspiration pneumonia is often preventable. Clients with stroke, seizure, intoxication, anesthesia recovery, or enteral tubes are high risk. Elevate the head of bed for meals and tube feeds, check residual/placement as ordered, provide oral care to cut bacterial load, and do not feed a client who cannot protect the airway. A swallow evaluation beats a hopeful tray.

Priority map