Disease Pulmonary TB Pneumonia COPD Pneumothorax AIDS Breast Cancer

Description Primarily targets lung Pneumonia is an
parenchyma; inflammation of the
bronchioles, alveoli,
It can affect other parts interstitial tissues, and on
such as the meninges, occasion the pleura as a
kidneys, bones, and result of infection.
lymph nodes
Classifications:
1. Community-acquired
Occurs either in the
community setting or w/in
the first 48 hours of
hospitalization
Disease state
characterized by airflow
limitation that is not fully
reversible
is a collection of air Acquired Abnormal breast cells
outside the lung but Immunodeficiency grow out of control and
within the pleural cavity. It Syndrome (AIDS) a severe form tumors
occurs when air immunodeficiency caused
accumulates between the by HIV (Human
parietal and visceral Immunovirus), which
pleurae inside the chest. allows normally benign
In short, it is a collapsed organisms to flourish and
lungs. cause disease.

2. Hospital-acquired (AKA
nosocomial)
Onset of pneumonia
symptoms more than 48
hours after admission to
hospital

3. Pneumonia in the
immono-compromised
host
Is seen with greater
frequency because
immunocompromised
hosts represent a growing
portion of the patient
population

4. Aspiration pneumonia
Refers to the pulmonary
consequences resulting
from the entry of
endogenous or exogenous
substances into the lower
airway. Most common
form is bacterial infection.

Etiology Transmission via Transmission via Over time, exposure to It is caused by chest Caused by the Human ● Genetics -
respiratory droplets respiratory droplets lung irritants like tobacco trauma, excess pressure Immuno Virus that is inherited
smoke or chemicals can on the lungs or a lung passed on through body mutations like
 Primary Infectious Agent - Bacteria damage your lungs and disease, such as chronic fluids, blood, seminal fluid, BRCA1
Mycobacterium ● Streptococcus airways. This long-term obstructive pulmonary amniotic fluid, and breast ● Hormonal factrs
Tuberculosis Pneumonia exposure can cause disease (COPD), asthma, fluid. ● Lifestyle choices
● Haemophilus inf. chronic obstructive cystic fibrosis, tuberculosis ● Radiation
● Pseudomonas pulmonary disease or whooping cough. exposure
Fungi (COPD), which includes ● Age & Gender
● Aspergillus chronic bronchitis and ● Family history
fumigatus emphysema. The leading
● Candida albicans cause of COPD is
● Pneumocystis smoking, however 1 in 4
carinii with COPD never smoked.

Risk Factors ● Close contact w/ ● Loss of protective One of the main risk ● Smoking ● Having ● Mutations in
someone who airway reflexes factors for developing ● Genetics condomless anal BRCA genes
has active TB ● Alcohol or drug COPD, people who never ● Connective or vaginal sex ● Individuals
● Immunocompro overdose smoke tissue disorders ● Having another assigned female
mised status ● During ● Activities such sexually at birth
● Substance resuscitation Other risk factors may as scuba diving, transmitted ● Personal and/or
abuse procedures include: high altitudes infection (STI) family history of
● Anyone w/out ● Seriously ill or and flying. such as syphilis, breast or ovarian
adequate health debilitated ● A history of herpes, cancer
care patients childhood chlamydia, ● ↑↑ exposure to
● Pre-existing ● Abnormalities of respiratory gonorrhea and hormones (e.g.,
medical gag and infections bacterial estrogen,
condition (ex. swallowing ● Smoke vaginosis; progesterone)
Diabetes, CDK, reflexes exposure from ● Engaging in ● Advanced age
transplant) ● NGT feeding coal or wood harmful use of
● Immigration ● Obstretic burning stove alcohol and drugs
from country w/ patients ● Exposure to in the context of
high prevalence ● GI conditions secondhand sexual behavior
of TB smoke
● Living area ● People with a
● Healthcare history of
workers asthma
● People who
have
underdevelope
d lungs
● Those who are
age 40 and
older as lung
function
declines as you
age
●
Assessment ● History ● History ● Medical history ● Tracheal 1. Check for the presence ● personal/family
Techniques ● Physical ● Physical ( smoking alignment. of infection. history of breast
examination examination history, ● Expansion of the cancer
exposure to chest. There are no physical signs ● Ages at
lung irritants ● Breath sounds unique to HIV infection, and menarche,
and family ● Percussion of not all patients will display menopause,
history of lung the chest. symptoms. birth of first
disease) Signs of risk factors or mild child
● Physical concomitant opportunistic ● Regularity of
examination ( infections, such as herpetic breast
checking sores on the groin or examinations
sounds of extensive oral candidiasis, ● Characteristics
wheezing, may indicate HIV infection. of lesion, skin
decreased surface, lymph
breath sounds, 2. Observe swollen lymph nodes
abnormal chest nodes.
shape or
movement). Generalized
● Pulmonary lymphadenopathy
function test commonly occurs in
(PFTs) patients with HIV. Swollen
● Imaging tests or abnormal lymph nodes
(X-ray, CT scan ) in the cervical and axillary
● Arterial blood area are the most common.
gas test
● Exercise stress 3. Monitor for significant
test weight loss.
● Laboratory tests
( if there is a HIV weight loss (HIV
signs of wasting syndrome) is a
infection in red sudden loss of more than
blood cells) 10% of body weight. Note if
weight loss is accompanied
by diarrhea, weakness, and
a fever that lasts longer
than 30 days. This is more
common with advanced
HIV/AIDS.

Laboratory with Tuberculin Skin Test Chest X-ray ● Arterial Blood ● CT scan ● Antigen/antibody ● Mammography
Nursing (Mantoux Test) - Inform Gas Analysis ● Chest X-ray test performed by ● Sonography (for
Interventions patient not to scratch test Blood culture ● Complete Blood a lab on blood dense breast
site Count from a vein tissue)
Sputum examination ● Sputum Culture ● Screening for ● Biopsy for
Chest Xray Collect during the morning ● Electrolytes Sexually cytologic
Levels Transmitted evaluation
 Sputum Culture - collect ● Liver and Infections (STIs) ● Estrogen
during the morning Kidney Function ● Physical receptor assay (+
because mucus Test Examination: indicates need
accumulate overnight ● Viral Load Testing for alteration of
● HIV Testing hormonal
Blood tests - Inform ● CD4 Count environment by
patient regarding surgical or
procedure chemical means)
● Tumor markers
CBC - presence of
leukocytes

Anatomy and Normal anaphy: Normal Anatomy: Normal Anatomy: Normal Anatomy: There Normal Anatomy: Sites of metastasis: bone,
Physiology Pluera is not inflamed. No Lungs are not inflamed. are clear lung fields with Aids doesn't involve bone marrow, soft tissue,
presence of fluid or Patient should be able to smooth pleural lines, a alterations in normal lungs, liver and brain.
mucus. Breathing sounds breath smoothly. No Abnormal anatomy: well-defined diaphragm, anatomy; rather, it
is normal. presence of exudate in and a properly positioned represents an advanced Normal Anatomy:
lungs. Breathing sounds heart within the stage of HIV (Human
Abnormal anaphy: should be normal mediastinum. Immunodeficiency Virus)
There is a presence of infection. In a healthy Abnormal anatomy:
crackling or wheezing Abnormal anatomy: Abnormal Anatomy: immune system, white
sounds when auscultated. There is a presence of There may be reduced blood cells, including CD4
crackling, ronchi, and movement of the chest cells, play a crucial role in
Signs of pulmonary wheezing sounds wall, ipsilateral decreased defending against
consolidation (when air in or absent breath sounds. infections.
in the airways is replaced Inflammation of lungs
with fluid) Abnormal Anatomy:
Consolidation of lung The virus targets and
Inflammation of pleura tissue - may present as destroys CD4 cells, key
leading to pleural white patchy infiltrate in components of the immune
effusion. CXR system, leading to severe
immunodeficiency.
Large quantities of mucus Poor ventilation and gas Abnormalities arise in
is present in the lungs. exchange due to exudate various organ systems, and
manifestations include
Lesions may occur in the Presence of pink, frothy weight loss, chronic
airways sputum diarrhea, neurological
disorders, and unusual
infections.

Pathophysiology Begins when a susceptible Inhalation of pathogen • Airflow limitation is 1. Negative pressure. The HIV (Human Immuno Virus)
person inhales (bacteria, virus, fungi) both progressive and negative pressure is 🠋
mycobacteria 🠋 associated with the lung's required to maintain lung Targets our immune system
🠋 Entry to the upper abnormal inflammatory inflation. (Especially CD4 cells)
Bacteria is transmitted respiratory tract response to noxious 🠋
through the airways to 🠋 particles or gasses. 2. Breach. When either Immunodeficiency
 the alveoli where it is Some pathogens bypass • Inflammatory response pleura is breached, air 🠋
deposited and multiplied the defenses and reach the occurs throughout the enters the pleural space. = AIDS
🠋 lower respiratory tract airways, lung
Body responds via 🠋 parenchyma, and 3. Collapse. When positive (Simple pathophysiology)
inflammatory reaction Pathogens adhere to pulmonary vasculature. pressure has entered the
🠋 respiratory epithelial cells • Changes include pleural space, the lung or
Phagocytes engulfs most and invade tissues and increased number of a portion of it collapses.
bacteria & TB-specific alveoli goblet cells and enlarged
lymphocytes destroy the 🠋 submucosal glands, which
bacilli and normal tissues Infection lead to hypersecretion of
🠋 🠋 mucus.
Accumulation of exudate Inflammation • Inflammation causes
in the alveoli 🠋 thickening of the airway
🠋 Accumulation of pus and wall, airway exudates and
bronchopneumonia mucus overall airway narrowing.
🠋 • This ongoing injury and
Alveolar consolidation repair process causes scar
(pleural effusion) tissue formation and
🠋 narrowing of the airway
Impairment of gas lumen.
exchange
🠋
Manifestation of symptoms

Signs and Systematic and pulmonary ● Rusty green ● Chronic cough ● Bluish color of ● Fever ● Mostly
Symptoms symptoms are chronic* sputum ● Shortness of the skin due to ● Chills asymptomatic
● Low grade fever ● Chills Breath lack of oxygen. ● Rash ● Palpable lump if
● Cough ● Fever ● Wheezing ● Chest tightness. ● Night sweats >2cm
(nonproductive/ ● Headache (squeaky ● Lightheadedness ● Muscle aches ● Visible breast
mucopurulent ● Pleuritic chest sound) and near ● Sore throat changes
sputum) pain ● Chest Tightness fainting. ● Fatigue - Sweeling of 1
● Night sweats ● Tachypnea ● Fatigue ● Easy fatigue. ● Swollen lymph breast
● Fatigue ● Respiratory ● Frequent ● Abnormal nodes - Thickening of
● Weight loss distress Respiratory breathing ● Mouth ulcers breast sin
● Hemoptysis (Shortness of Infections patterns or ● Diarrhea - Nipple
breath) ● Blueness of Lips increased effort discharge
● Bradycardia or Fingernail of breathing. - Nipple
● Upper Beds (Cyanosis) ● Rapid heart rate. inversion
respiratory tract ● Decreased ● Shock and - “Peau d
infection (Nasal Exercise collapse orange”
congestion, sore Tolerance
throat) ● Sputum
● Myalgia Production
● Pharyngitis
● Mucopurulent
sputum

Nursing Actual: Ineffective airway
Diagnosis clearance relate to thick,
viscous, or bloody
secretion
Potential: Activity
intolerance related to
imbalance between
oxygen supply and
demand
Nursing 1. Promote adherence to
Intervention medication and
with Rationale treatment
Compliance is a common
problem. This will inform
the patient the
importance of the
treatment for her
recovery and preventing
transmission.
2. Monitor vital signs
This is done to detect
signs of complications
3. Promote adequate
hydration
This is to regulate body
temperature, to prevent
dehydration which can be
exacerbated by fever and
night sweats, to support
body’s immune system
4. Monitor weight
everyday for weight loss
Weightloss is a common
sign of TB. this is done to
● Orthopnea -
shortness of
breath while
reclining in
supine position
● Poor appetite
Actual: Impaired gas
exchange r/t decreased
ventilation secdonray to
inflammation or infection
involving distal airspaces
Potential: Risk for
imbalance nutrition related
to difficulty eating due to
fatigue
1. Increase fluid intake
This is to liquify and
expectorate mucus
2. Oxygen therapy as
ordered
To ensure patient recieves
sufficient oxygen
3. Chest physiotherapy
To help clear respiratory
secretions and maintain
airway patency
4. Endotracheal suctioning
if necessary
To help maintain airway
clearance
5. Splint chest wall with a
pillow when coughing
To minimize pain and
discomfort
6. Encourage to turn,
cough, and deep breathing
To expand lung volume,
improve ventilation, and
Actual: Actual: Impaired Gas Actual: Imbalanced Acute pain related to
Exchange nutrition, less than body inflammation and
requirements related to compression as evidenced
decreased oral intake. by facial grimacing.
Potential: Potential: Risk for Trauma Potential: The risk for
related to ongoing infection related to altered
disease. immune protection
1. 1. Apply oxygen as 1. Administer antiretroviral 1.
2. ordered. therapy (ART). 2.
3. Air can reabsorb into the Antiretroviral therapy (ART) 3.
4. pleural space and is the most effective 4.
5. supplemental oxygen can management of HIV. 5.
increase reabsorption.
2. Encourage treatment
2. Monitor ABG levels. adherence.
This enables healthcare
providers to monitor the Patients must strictly
progress of the condition adhere to their medication
and determine the regimen as prescribed.
patient’s respiratory Patients who adhere to
status. their treatment plan can
maintain control of the
3. Assist with chest tube virus and may never
thoracostomy. progress to AIDS.
Chest tubes are essential
as they help drain air and 3. Encourage frequent
fluid from the pleural handwashing.
space. This will help
reduce lung compression. Instruct patients on
handwashing principles to
4. Encourage deep prevent infection. Patients
breathing exercises. with HIV should also be
Patients with a instructed to wash their
pneumothorax will need hands after touching
to relieve pressure on the animals, as a potential OI
 detect any changes. promote airway clearance lungs to enable optimal called toxoplasmosis is
Sudden changes may lung expansion. While it found in the feces of birds,
indicate disease 7. Monitor VS may be painful, encourage rodents, and cats.
progression or inadequate To monitor for the patient to perform
nutritional intake abnormalities which may deep breathing exercises 4. Promote safe sex
indicate complications and use a device such as practices.
5. Promote airway an incentive spirometer to
clearance 8. Administer medication inflate the lung and Teach the patient the
Instruct the patient about as ordered prevent atelectasis. importance of using latex
correct positioning to Important for recovery condoms to prevent
facilitate drainage transmission of HIV.

6. Monitor breath sounds

To detect crackling or
wheezing sounds which
may indicate respiratory
distress

7. Encourage frequent
rest periods
To reduce overexertion
which sould worsen
symptoms

8. Initiate screening for

all family members or
close contacts
Early detection allows for
timely treatment

Medical Primarily treated with Administration of antibiotic ● Quit smoking ● Bed rest ● Antiretroviral ● Radiation
Management anti-TB agents for 6-12 is determined by gram ● Medications ● Oxygen therapy therapy (ART). therapy/chemot
months. stain. ● Bronchodilators ● Observation ART involves herapy
( short acting: ● Simple taking a ● Biologic therapy:
5 first line of defense: Medication: albuterol, aspiration combination of trastuzumab
1. Rifampin ● Macrolide ipratropium, ● Closed HIV medicines (herceptin)
2. INH (Isoniazid) ● Doxycyline levalbuterol) intercostal tube (called an HIV
3. Pyrazinamide ● Flouroquinolone (long acting: drainage and treatment
4. Ethambutol with enhance aclidinium, tube regimen) every
5. streptomycin activity against S. arformoterol, thoracostomy day. ART is
Pneumoniae formoterol) recommended for
RIPES ● Antipyretic ● Inhaled steroids everyone who has
● Bronchodilators (fluticasone, HIV.
It is treated as well with budesonide)
Directly Observed Oxygen therapy and ● Combination of
Therapy, Short-course assisted ventilation if inhalers (
 (DOTS) adequate ABG values fluticasone and
cannot be maintained vilanterol,
fluticasone and
budesonide )
● Oral steroids

Surgical Surgical treatment is Only for severe cases ● Lung volume Surgery for pneumothorax N/A ● Mastectomy
Management rarely necessary ● Chest tube reduction is typically considered ● Lumpectomy
drainage surgery when conservative No surgery for AIDS
Types of surgical ● Lobectomy - ● Lung transplant measures are insufficient
treatment removal or ● Bullectomy or if there's a recurrence.
● Collapse affected lung Two main surgical options
therapy part exist:
● Pulmonary ● Video-Assisted
resection Thoracoscopic
● Lung Surgery (VATS):
decortication ● Thoracostomy
● Drainage
procedures

Complications ● Extensive lung ● Shock and ● Acute ● Tension ● Opportunistic ● Lymphedema

destruction respiratory exacerbation of Pneumothorax Infections ● Fatigue
● Acute failure COPD ● Recurrence ● Malignancies ● Pain
respiratory ● Atelectasis and ● Acute and/or ● Pleural Effusion ● Neurological ● Emotional and
distress pleural effusion chronic ● Subcutaneous Complications Physiological
syndrome ● Superinfection respiratory Emphysema ● HIV-Associated Effects
● Empyema ● Lung abscess failure ● Hemorrhage Nephropathy ● Early
● Underlying ● Empyema ● Pulmonary ● Infection (HIVAN) menopause
condition ● Necrotizing hypertension ● Cardiovascular ● Brain
(Spontaneous pneumonia ● Cor pulmonale Disease complications
Pneumothorax) ● Weight loss ● Metabolic
● Bacterial Complications
infections ● Immune
● Adverse Reconstitution
reactions to Inflammatory
glucocorticoids Syndrome (IRIS)
● Hepatitis
Co-Infections
● Skin Disorders
● Respiratory
Complications

Health Teachings 1. Inform patient that TB 1. Encourage smoking ● Smoking - Educate individuals on When discussing AIDS, ● Teach monthly
is a communicable cessations cessations recognizing symptoms like emphasize practicing safe breast
disease; and advise the ● Avoid sudden chest pain and sex, using condoms self-examination
patient to wear a mask 2. Explain the importance second-hand difficulty breathing. consistently, getting regular ● Encourage
 when going outside the
room
2. Educate patient that
taking medication is the
most effect means of
preventing transmission
and recovery.
3. Instruct patient to
cough and sneeze into
tissues and to dispose of
all secretions in a separate
trash can
4. Remind patient to take
lots of rest and to eat
balanced meals to aid
recovery
5. Advise patient to watch
out for adverse effects of
medications and to report
them to the physician
immediately
Goals and ● To be able to
Achievements expectorate
sputum
● The patient
should be able
to understand
health teaching
● To avoid
transmission of
TB to family
members
● To feel relief
from symptoms
to taking medication as smoke exposure HIV testing, and promoting intake of low fat
ordered. Emphasize the ● Reduce - Stress the importance of open communication about foods, and foods
importance of completing exposure to seeking immediate sexual health. Encourage that rich in
the full course of other harmful medical attention for understanding that immune-stimula
antibiotics even if agents ( prompt diagnosis and HIV/AIDS doesn't spread ting substances
symptoms improved asbestos, treatment. through casual contact and (Vit A,C,E,
beryllium, - Explain risk factors, such combat stigma through mineral
3. Stress the importance of carbon dust, as smoking and underlying education. selenium)
getting adequate rest to unvented coal lung conditions.
support healing process stoves)
● Education on - Emphasize the
4. Enroucare imporatnace inhaler use significance of avoiding
of hydration to help liquify techniques activities that can worsen
and exportate mucus ● Education and pneumothorax, like
reinforcement smoking or high-altitude
5. Promote a balanced diet on the exposure.
to support immune system. importance of
Encourage small, frequent inhaler Overall, promoting
meals if patient has a ● Compliance awareness, early
reduced appetite with follow up detection, and adherence
● Adherence to to medical advice
6. Encourage patient to the treatment
cover their mouth and plan
nose with a tissue to ● Pulmonary
prevent transmisssion rehabilitation
7. Discuss the importance
of vaccination to prevent
future respiratory
infections
● To be able to ● Lessen airflow ● Relief of Goals for addressing AIDS ● Expresses
adhere to limitation Symptoms include raising awareness, acceptance of
medication as ● Prevent and ● Re-expansion of promoting prevention body image
ordered treat secondary the Lung through safe sex education, ● Identifies
● To understand medical ● Prevention of and increasing accessibility precautions
health teachings complications ( Recurrence to testing and treatment. necessary to
● To improve hypoxemia, ● Complication Achievements may involve prevent injury
breathing pattern infection) prevention reducing new HIV ● Maintain
and relief from ● Decreased infections, improving strength and
breathing respiratory antiretroviral therapy mobility of arm
difficulty symptoms and access, and combating on affected side
● To manage pain improve quality stigma surrounding ● Discuss feelings
and discomfort of life. HIV/AIDS. Efforts to support with healthcare
through affected communities, providers,
techniques and advance research for a cure family, sexual
 positioning or vaccine, and establish partner
● Education patient sustainable healthcare ● Demonstrates
on using a mask systems also contribute to and continues to
to prevent successful outcomes in the perform
transmission fight against AIDS. Global ● monty breast
collaboration, public health self-examination
campaigns, and policies
that prioritize HIV
prevention and care further
enhance the potential for
achieving these goals.

Results and ● Prevention of The patient was able: ● Successful Progress in AIDS
Conclusion transmission ● To understand Resolution management includes
● Patient was importance of ● Recurrence increased access to
educated on health teachings Prevention antiretroviral therapy,
proper such as breathing ● Complication extending life expectancy.
medication, exercises and Avoidance Efforts to reduce new
disposal, positioning ● Patient infections show promise,
isolation, and ● To understand Education but stigma and healthcare
exercise importance of ● Long-Term Lung disparities persist. While
● Patient was able hydration Health there's no cure, ongoing
to feel an ● Feel research offers hope.
improvement in improvement in Global collaboration is
breathing relief from essential to strengthen
● Patient was able symptoms prevention, treatment, and
to expectorate ● To expectorate support initiatives. In
phlegm phlegm conclusion, despite
● To practice advancements, the fight
proper against AIDS necessitates
prevention of sustained efforts to ensure
transmission universal access to care,
combat discrimination, and
advance medical
breakthroughs.