TREATMENTGeneral measures consist of
complete bed rest and administering sufficient
fluids to maintain a urinary output of at least
1500 ml daily. Penicillin G is the antibiotic of
choice with usual does of 600,000 units every 12
hours IM. Tetracycline and erythromycin are
alternatives when a patient is hypersensitive to
penicillin. Ventilation and oxygenation are of a
distinct value. The patient should be fed a liquid
diet initially, and when improvement occurs, a
normal diet as tolerated.
Other Bacterial Pneumonias
Other primary bacterial pneumonias are
caused by single bacterial species other than
pneumococcus. To treat the pneumonia properly,
the specific etiologic agent must be identified.
Treatment is generally the same as for
pneumococcal pneumonia except that a broad-
spectrum antibiotic is used.
This is an especially severe pneumonia with
a 60 percent mortality rate. It is caused by aspira-
tion of the gastric contents and inhalation of
hydrocarbons. Treatment is the same as for other
Vigorous antibiotic therapy is
Primary Atypical Pneumonia
This type of pneumonia is caused by a variety
of viral and mycoplasmal agents. The symptoms
include a gradually increasing fever with a history
of URI; a nonproductive cough; hoarseness;
headache and malaise; and extreme fatigue. The
treatment is similar to other pneumonias.
Acute bronchitis is an inflammation of the
bronchial tree caused by infections and physical
and chemical agents. Bronchitis may appear as
a primary disorder or as a prominent finding in
many pulmonary diseases. The symptoms include
dry, scratchy throat; hoarse, husky voice; fever;
cough that produces mucopurulent sputum; and
musical rhonchi and wheezing.
TREATMENTGeneral measures consist of
bed rest, forcing fluids to prevent dehydration,
and discontinuing smoking. Using steam or mist
inhalators is frequently beneficial in helping to
Severe coughing may be
controlled with antitussives. Antihistamines
should be administered to help relieve inflamma-
tion. Headaches, sore throats, and fever may be
treated with aspirin. In patients with impaired
respiratory or cardiac function, or in patients
debilitated by other diseases, antibiotic therapy
should be used to prevent secondary infections.
One of the complications is pneumonia.
Chronic bronchitis is marked by a normally
nonproductive cough of long duration. If the
cough is productive, the sputum is usually very
thick. There are usually no other symptoms of
TREATMENTAs in the treatment for acute
bronchitis, the patient with chronic bronchitis
should be advised to discontinue smoking and to
avoid other sources of lung irritation such as
fumes. If the patients cough is nonproductive,
suppress it with antitussives. If it is productive,
liquify it by adequate fluid intake, inhalation, and
expectorants. Other treatment is as indicated for
Asthma is a bronchial hypersensitivity disorder
characterized by reversible airway obstruction. It
is produced by the combination of mucosal
edema, hypertrophy of the bronchial musculature,
and excessive secretion of mucus, which causes
SYMPTOMSThe patient experiences re-
peated attacks of wheezing, dyspnea, and
coughing with mucoid sputum produced.
Nocturnal coughing and wheezing on exertion is
common. The patient usually has a history of
frequent colds and displays nasal symptoms, such
as itching and congestion.
TREATMENTThe first step is to eliminate
the source of any known allergies. Maintain
adequate rest and reassure the patient to relieve
his or her apprehensions. Treat respiratory infec-
tions with antibiotics. Force fluids to prevent
dehydration and help break up or liquify secre-
tions. Epinephrine is the drug of choice, but may
be replaced by aminophylline if not effective.
Epinephrine should be administered cautiously in
patients with angina or hypertension. Oxygen
therapy is indicated in all cases of moderate to
severe symptoms. Status asthmatics is a con-
tinued, severe wheezing to a life-threatening point.
The patient with this condition should be
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