1)Disease: ARDS Page656 AKA stiff lung, white lung, shock lung stiff=fibrotic changes!

Definition: A severe form of acute lung injury characterized by sudden and progressive pulmonary edema, increasing bilateral infiltrates, refractory hypoxemia, and reduced lung compliance. Pathophysiology/Mode of transmission: An acute lung injury occurs, the inflammatory response is triggered (releases cytokines &histamines), the alveolar capillary membrane gets damaged, leakage occurs into places where it shouldnt (alveolar interstitial spaces & capillary bed), 02 has no room to fill alveoli, CO2 mixes with fluid & cant come out, alveoli collapse. (alveoli collapse=U cant breathe!) Organ systems involved: Respiratory,Circulatory,Nervous,Immune Diagnostic tests/labs: Xray, pulse ox, bedside pulmonary fxn test, sputum cultures, ABGs, WBCs (sepsis) Platelets (DIC) Signs and symptoms: severe, acute onset dyspnea, refractory hypoxemia, tachycardia, rapid shallow breathing, retractions, wheezing, crackles, restlessness, respiratory acidosis Medications,physician orders:Antibiotics-sepsis, diuretics-pulmonary edema, High5 vent, high PEEP Nursing interventions/management: Obtain history, Treat the underlying cause & symptoms, frequent assessment, monitor labs, monitor O2 levels, monitor I&O, decrease anxiety, repositioning (if not on High5 vent), promote rest

2)Disease: SARS page 643 Definition:Viral respiratory illness caused by coronavirus. Pathophysiology/Mode of transmission:Transmitted by respiratory droplets deposited on mucus membranes of another person (eyes, nose, mouth), or indirectly touching another infected surface & then your mucus membrane. Researchers are working on the virus genetic material, RNA, & how it replicates. (AKA pathophysiology unknown) Organ systems involved: Respiratory, Immune Diagnostic tests/labs:WBCs, sputum cultures, ABGs, chest xray, monitor antibiotic levels Signs and symptoms: fevers over 104, HA, body ache, generalized pain, malaise Medications,physician orders: antibiotics, antipyretics, oxygen, negative pressure isolation room Nursing interventions/management:obtain history, monitor v/s, give meds as ordered, frequent assessment, maintain isolation , limit transmission, teach pt stay@home 10 days after fever, notify CDC

3)Disease: Tuberculosis page 643 Definition: An infectious disease caused by tubercle bacillus. Usually affects the lungs; if miliary can affect the rest of body: lymph nodes, bones, joints, spine, brain, kidneys, etc. Pathophysiology/Mode of transmission: Tubercle bacillus breathed in, goes to lungs, macrophages attack, encapsulate the germ, forms tubercle/Ghon complex, person either become infected & symptomatic or a carrier until they become immunosuppressed. Transmission: airborne, droplet through anytime you use your mouth (talking, singing, laughing, coughing, sneezing) Organ systems involved:Respiratory, Immune, Cardiovascular, if miliary Skeletal, integumentary, GI,GU, nervous, endocrine, reproductive Diagnostic tests/labs:Chest Xray, Tuberculin Skin test, sputum collection (AFB) WBCs, CBC-liver enzymes, kidney function, antibiotic-therapeutic ranges Signs and symptoms: Cough >3wks, low grade fever, night sweats, anorexia, weight loss, fatigue, hemoptysis Medications,physician orders: 1st line INH, rifampin, pyrazinamide, ethambutol 2nd line cycloserine, aminoglycosides, quinolones, AFB isolation Nursing interventions/management: History, assessment, promote airway clearance, hydration & nutrition, promote activity, give high calorie small meals, pre medicate with antiemetic or cough medication before eating, monitor v/s,I&O, teach how disease is spread

4)Disease: Sarcoidosis page 667 Definition: A multisystem granulomatous disease. Unknown etiology. Pathophysiology/Mode of transmission: Hypersensitivity response to one or more agents that creates granuloma infiltration and fibrotic changes of the affecting organ or tissue. Organ systems involved: Can affect almost any organ or tissue SO ALL OF THEM except reproductive Diagnostic tests/labs:Chest Xray, CT, B scope, pulmonary fxn test, ABGs Signs and symptoms:eye problems, irregular heart beat, wheezing= it depends what it affects for lungs dyspnea, cough, hemoptysis, congestion Medications,physician orders:corticosteroids, immunosuppressants, prednisone, immuran, folic acid, methyltrexate Nursing interventions/management:History, treat symptoms, prevent complications

5)Disease: Avian Flu page2489 Definition: An infection caused by influenza viruses that infect birds and poultry (H5N1 strain) Pathophysiology/Mode of transmission:Virus contagious among wild birds, domesticated birds get infected, we eat the infected bird, or come into contact with excretions through inhalation or direct contact. Organ systems involved: Respiratory, Immune...Circulatory, Nervous if you get ARDS Diagnostic tests/labs: cultures, WBC, CBC, CMP, to rule out other causes, obtain baseline (there is not any in book or notes so I pulled this out of my butt) Signs and symptoms:cough,fever,muscle aches, pneumonia, ARDS Medications,physician orders: Tamiflu, Relenza, antipyretics Nursing interventions/management: History, monitor V/S, I&O, labs, frequent assessment, contact precautions hand hygiene & masks (does not specify type of isolation)

6)Disease: Coccidiodomycosis page 2275 Definition: Fungal infection caused by inhalation of coccidioides immitis, a soil fungus. (c.immitus) Pathophysiology/Mode of transmission:Caused by inhalation of c.immitus spores in the air. The spores initially infect the lungs causing respiratory symptoms, may enter the bloodstream. Organ systems involved:Respiratory, Cardiovascular, Immune, Nervous, Integumentary Diagnostic tests/labs: Fungal culture, chest Xray, MRI, serum test, lumbar puncture if nervous system symptoms (encephalitis) Signs and symptoms: malaise, weight loss, cough, fever 104, joint pain, RASH, rib cage pain, HA, change in LOC Medications,physician orders: Fluconazole & Amphotecerin B Nursing interventions/management: Obtain history, assessment, Monitor v/s, I&O, labs, implement seizure precautions if necessary

7)Disease: HPS page 2511 Definition: A cardiopulmonary illness caused by a member of the Hantavirus family of viruses. Pathophysiology/Mode of transmission: Humans get infected when coming into direct or indirect contact with infected rodent. Can become infected from inhalation. Organ systems involved:Cardiovascular, Respiratory, Immune Diagnostic tests/labs: Chest Xray, MRI, serology, antibody test checking for RNA, UA, WBC increased Platelets decreased Signs and symptoms: cough, pneumonia,pleural effusion, HA, fatigue, dyspnea, crackles, low cardiac output, hypotension, cardiogenic shock Medications,physician orders: Broad spectrum antibiotics, mechanical ventilation, IV solutions, Dopamine to maintain BP, Virazole Nursing interventions/management:TEACH prevention, wet barn floors, let air out before sweeping, keep rodents out of everything, use 10% bleach to clean, use mask. Obtain history, assessment, monitor v/s, I&O, labs, respiratory status