Zynx Health - Pneumonia Pleurisy Version : 2.0.1
[G] Absence of pulmonary infection
[I] Pulmonary infection signs and symptoms assessment [D] Shortness of breath, fever, cough, increased sputum production, chest discomfort/pain, fatigue
[I] Assess adherence to pharmacologic therapy
[I] Education, antibiotics [D] Complete the entire prescription of antibiotics, even if feeling better [D] If reaction to an antibiotic, call prescriber immediately
[I] Education, symptom management [D] Take medication exactly as directed [D] Get plenty of rest; fatigue may last several weeks after pneumonia [D] Drink plenty of fluids and use cool-mist humidifier to loosen and thin respiratory secretion [D] Use warm compress or heat pad on low setting to relieve chest discomfort/pain [D] Do not smoke and avoid smoke exposure [D] Contact provider promptly if condition is deteriorating or not improving as expected
[I] Education, deep-breathing and coughing exercises [D] Continue deep breathing exercises for 6 to 8 weeks during the convalescent period [D] May use a pillow to splint the chest wall while coughing
[I] Eduction, effective cough technique [D] Directed cough [D] Forced exhalation technique
[I] Education, respiratory hygiene and cough etiquette [P] [W] [D] Cover the nose and mouth with disposable, single-use tissues when coughing, sneezing, wiping, and blowing nose; dispose of used tissues properly [D] If no tissues are available, cough or sneeze into the inner elbow rather than the hand [D] Wear a mask if coughing frequently [D] Keep contaminated hands away from the mucous membranes of the eyes and nose [D] Practice hand hygiene after contact with respiratory secretions and contaminated objects or materials
[I] Education, postdischarge follow-up [D] Blood tests, chest radiograph [P] Viral Pneumonia
[G] Absence of pulmonary infection
[I] Pulmonary infection signs and symptoms assessment [D] Shortness of breath, fever, dry cough, chest discomfort/pain, fatigue
[I] Assess adherence to pharmacologic therapy
[I] Education, antiviral therapy [D] Use to reduce viral shedding [D] Longer treatment duration might be necessary for immunosuppressed persons
[I] Education, symptom management [D] Take medication exactly as directed [D] Get plenty of rest; fatigue may last several weeks after pneumonia [D] Drink plenty of fluids [D] Use warm compress or heat pad on low setting to relieve chest discomfort/pain [D] Do not smoke and avoid smoke exposure [D] Contact provider promptly if condition is deteriorating or not improving as expected
[I] Education, deep-breathing exercises [D] Continue deep breathing exercises for 6 to 8 weeks during the convalescent period [D] May use a pillow to splint the chest wall while coughing
[I] Education, respiratory hygiene and cough etiquette [P] [W] [D] Cover the nose and mouth with disposable, single-use tissues when coughing, sneezing, wiping, and blowing nose; dispose of used tissues properly [D] If no tissues are available, cough or sneeze into the inner elbow rather than the hand [D] Wear a mask if coughing frequently [D] Keep contaminated hands away from the mucous membranes of the eyes and nose [D] Practice hand hygiene after contact with respiratory secretions and contaminated objects or materials
[I] Education, postdischarge follow-up [D] Blood tests, chest radiograph [P] Pleurisy
[G] Absence of pleurisy signs and symptoms
[I] Pleurisy signs and symptoms assessment [D] Shortness of breath, fever, cough, pleuritic chest pain aggravated by breathing
[I] Education, symptom management [D] External splinting of the chest wall [D] Pain medication
[I] Education, pleurisy prevention [D] Treatment of the underlying disease, including heart, lung, liver, kidney, or autoimmune disease [D] Seek early treatment for respiratory infection [D] Avoid inhaling chemical or toxic substances, including cleaning agents
[I] Communicate to prescribing provider [D] For suspected pleural effusion [P] Alcohol Use
[G] Alcohol-use cessation or moderation
[I] Alcohol use assessment [Z]
[I] Education, alcohol-use moderation [Z] [D] Limit alcohol consumption to less than or equal to 1 drink daily for nonpregnant women [D] Limit alcohol consumption to less than or equal to 2 drinks daily for men
[I] Communicate to prescribing provider [D] If heavy drinking; Men: > 5 drinks/day or > 15 drinks/week; Women: > 4 drinks/day or > 8 drinks/week
[I] Behavioral therapy [Z] [P] Dysphagia
[G] Absence of pulmonary infection
[I] Respiratory compromise signs and symptoms assessment
[I] Education, low-risk feeding strategies [P] [D] Appropriate diet consistency [D] Eat from a seated position [D] Reduce distraction during meals [D] Slow feeding rate with small amounts of food per bite
[I] Education, airway protection strategies
[I] Education, oral hygiene care [P] [P]
[I] Communicate to prescribing provider [D] For suspected aspiration pneumonia
[I] Swallowing therapy [P] [D] Compensatory strategies [D] Direct swallowing exercises, including deliberate swallowing, supraglottic swallowing technique [D] Indirect swallowing exercises, including head-raising exercises, range-of-motion exercises of the neck [D] Postural advice
[I] Nutritional assessment and nutrition plan
[G] Absence of aspiration
[I] Respiratory compromise signs and symptoms assessment
[I] Education, low-risk feeding strategies [P] [D] Appropriate diet consistency [D] Eat from a seated position [D] Reduce distraction during meals [D] Slow feeding rate with small amounts of food per bite
[I] Education, airway protection strategies
[I] Education, oral hygiene care [P] [P]
[I] Communicate to prescribing provider [D] For suspected aspiration pneumonia
[I] Swallowing therapy [P] [D] Compensatory strategies [D] Direct swallowing exercises, including deliberate swallowing, supraglottic swallowing technique [D] Indirect swallowing exercises, including head-raising exercises, range-of-motion exercises of the neck [D] Postural advice
[I] Nutritional assessment and nutrition plan
[G] Knowledge of aspiration prevention techniques
[I] Education, low-risk feeding strategies [P] [D] Appropriate diet consistency [D] Eat from a seated position [D] Reduce distraction during meals [D] Slow feeding rate with small amounts of food per bite
[I] Education, airway protection strategies
[I] Education, oral hygiene care [P] [P] [P] Infection Risk
[G] Absence of infection
[I] Infection risk assessment [P] [P] [D] Smoking, alcohol abuse, malnutrition, chronic illness, previous infection, poor dental hygiene, immunosuppressive therapy, functional impairment, environmental exposure, regular contact with children
[I] Infection signs and symptoms assessment
[I] Review immunization records
[I] Education, immunizations [P]
[I] Education, infection prevention - general [D] Wash hands with soap and water before food preparation, after touching pets, after restroom use, after cough/sneeze, after touching infected skin or an item that has directly contacted a draining wound [D] Disinfect home environment, particularly if a family member has been sick [D] Keep vaccinations up-to-date, especially when having regular contact with children or sick people [D] Avoid locations with inadequate air filtration during cold and flu season
[I] Education, infection prevention - travel precautions [D] Need for pretravel vaccines [D] Prophylaxis against specific infections [D] Airborne, waterborne, and zoonotic infection prevention
[I] Education, avoid airway irritant exposure [D] Stop smoking or avoid environmental smoke exposure [D] Use appropriate protective devices in case of occupational exposure
[G] Knowledge of infection prevention and control measures
[I] Education, immunizations [P]
[I] Education, infection prevention - general [D] Wash hands with soap and water before food preparation, after touching pets, after restroom use, after cough/sneeze, after touching infected skin or an item that has directly contacted a draining wound [D] Disinfect home environment, particularly if a family member has been sick [D] Keep vaccinations up-to-date, especially when having regular contact with children or sick people [D] Avoid locations with inadequate air filtration during cold and flu season
[I] Education, infection prevention - travel precautions [D] Need for pretravel vaccines [D] Prophylaxis against specific infections [D] Airborne, waterborne, and zoonotic infection prevention
[I] Education, avoid airway irritant exposure [D] Stop smoking or avoid environmental smoke exposure [D] Use appropriate protective devices in case of occupational exposure [P] Malnutrition
[G] BMI within specified parameters
[I] Body weight monitoring
[I] Malnutrition screening [D] Measure body weight, calculate BMI and percentage unintentional weight loss
[I] Nutritional assessment [D] Assess caloric counts [D] Review diet history, levels of serum protein, electrolytes, and blood count [D] Nutritional intake (eg, daily food intake, eating habits, access to healthful and nutrient-dense foods, financial and economic issues, appetite and changes in eating patterns, dental health, supplement use) [D] Assess factors contributing to poor oral intake (eg, poor dental health, smoking, swallowing problems, taste/smell disorders, GI motility issues)
[I] Nutrition counseling and support [P] [P] [D] Include nutritional supplementation
[I] Coordinate with social services [D] For issues related to food access and financial status
[I] Coordinate with speech language pathologist [D] For issues related to swallowing [P] Oral Health Issues
[G] Improved dental/oral health status
[I] Assess intraoral and dental issues
[I] Education, oral preventive care to reduce caries and gingival disease [P] [P] [D] Regular visits to dental professionals for routine examination and cleaning [D] Tooth brushing after each meal [D] Use properly fitted dentures and remove and clean dentures at night [D] Oral hygiene performed by an assistant once a week in frail elderly [D] Early interventions for intraoral changes or dental complications [D] Smoking cessation [D] Avoid sugar-containing gum and soft drinks
[I] Education, xerostomia management [D] Use alcohol-free oral rinses or saliva substitutes [D] Consume low-sucrose diet [D] Avoid caffeine [D] Avoid spicy and highly acidic foods [D] Smoking cessation [D] Keep oral cavity moist by drinking plenty of fluids
[I] Communicate with dentist/periodontist on follow-up recommendations [P] Physical Functioning - Impaired
[G] Able to achieve maximum level of physical functioning
[I] Functional status assessment [D] Mobility and self-care ability using a standardized tool (eg, FIM at a minimum) [D] Assess level of assistance required for mobility (eg, bed mobility, transfers, sitting, walking)
[I] Education, energy conservation [D] Activity to tolerance level [D] Allow for rest periods [D] Avoid straining [D] Pace activities [D] Place items within reach [D] Schedule activities for periods with greater energy [D] Use assistive devices
[I] Education, functional status promotion [P] [D] Maintain independence in daily activities [D] Maintain routine exercise program [D] Perform regular daily routine [D] Stay out of bed as able
[I] Physical therapy evaluation and treatment [P] [D] Exercise capacity assessment [D] Range-of-motion exercises [D] Aerobic training [D] Upper-limb and lower-limb strength training [D] Flexibility and stretches
[I] Self-care exercises [P]
[I] Communicate to durable medical equipment services [D] For issues related to walking assistive devices, mobility aids, or ADL adaptive devices
[I] Referral to pulmonary rehabilitation program [P] [P]
[G] Knowledge of management strategies
[I] Education, energy conservation [D] Activity to tolerance level [D] Allow for rest periods [D] Avoid straining [D] Pace activities [D] Place items within reach [D] Schedule activities for periods with greater energy [D] Use assistive devices
[I] Education, functional status promotion [P] [D] Maintain independence in daily activities [D] Maintain routine exercise program [D] Perform regular daily routine [D] Stay out of bed as able [P] Tobacco Use/Tobacco Exposure
[G] Tobacco use abstinence
[I] Assess smoking cessation readiness
[I] Education, relationship between smoking and the risk of respiratory disease
[I] Education, avoid secondhand smoke
[I] Tobacco use cessation counseling [Z] [D] Brief smoking cessation counseling (ie, ask/assess, advise, assist/counsel, arrange) [D] Practical counseling, social support of family and friends as part of treatment, and social support outside of treatment are effective counseling types
[I] Education, nicotine replacement therapy
[I] Education, alternative interventions [Z] [D] Consider alternative interventions for smoking cessation (eg, acupuncture, aversive stimulation, biomedical risk assessment, exercise programs, hypnotherapy, self-help aids, stress management) in conjunction with smoking cessation counseling, other nonpharmacologic interventions, and/or smoking cessation medications
[I] Communicate to prescribing provider [D] If pharmacologic therapy is desired
[I] Referral to tobacco cessation program [Z]
[G] Knowledge of tobacco use cessation methods
[I] Education, relationship between smoking and the risk of respiratory disease
[I] Education, avoid secondhand smoke
[I] Tobacco use cessation counseling [Z] [D] Brief smoking cessation counseling (ie, ask/assess, advise, assist/counsel, arrange) [D] Practical counseling, social support of family and friends as part of treatment, and social support outside of treatment are effective counseling types
[I] Education, nicotine replacement therapy
[I] Education, alternative interventions [Z] [D] Consider alternative interventions for smoking cessation (eg, acupuncture, aversive stimulation, biomedical risk assessment, exercise programs, hypnotherapy, self-help aids, stress management) in conjunction with smoking cessation counseling, other nonpharmacologic interventions, and/or smoking cessation medications
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