NLE Respiratory Nursing — Upper & Lower Respiratory InfectionsConcept Map

Concept

Upper Respiratory Tract Infections

Sub Concepts

• Sinusitis
• Pharyngitis
• Clinical manifestations
• Management principles

Relationship To Central

Infections affecting structures above the larynx; generally milder, self-limiting; foundational to understanding respiratory infection spectrum

Concept

Lower Respiratory Tract Infections

Sub Concepts

• Pneumonia
• Tuberculosis
• Influenza
• Acute bronchitis
• Severity spectrum

Relationship To Central

Infections affecting bronchi, bronchioles, and lung parenchyma; more serious, requiring intensive nursing intervention; include pneumonia and tuberculosis

Concept

Pneumonia

Sub Concepts

• Community-acquired pneumonia
• Hospital-acquired pneumonia
• Aspiration pneumonia
• Pathophysiology and consolidation
• Diagnostic modalities
• Antibiotic pharmacology
• Complications

Relationship To Central

A prioritized lower respiratory infection requiring immediate airway and oxygenation management; leading cause of morbidity in Philippines

Concept

Tuberculosis

Sub Concepts

• Pathophysiology and granuloma formation
• Latent vs active TB
• Diagnostic methods
• National TB Control Program
• DOTS strategy
• RIPE drug regimen
• Drug toxicities
• Infection control

Relationship To Central

High-yield NLE topic; Philippine national priority; requires understanding of DOTS, GeneXpert, RIPE regimen, and airborne precautions

Concept

Nursing Priorities and Interventions

Sub Concepts

• Airway management
• Oxygenation and positioning
• Infection control protocols
• Medication administration
• Patient education
• Monitoring and assessment
• Complication prevention

Relationship To Central

Core nursing process application addressing immediate life threats (airway, oxygenation), infection control, adherence, and patient education

Concept

Pharmacology in Respiratory Infections

Sub Concepts

• First-line antibiotics for CAP
• TB drug regimen RIPE
• Macrolide side effects
• Fluoroquinolone toxicities
• Antiviral therapy for influenza
• Supportive medications

Relationship To Central

Understanding antimicrobials, antivirals, and supportive medications essential for safe practice and NLE success

Concept

Infection Control and Prevention

Sub Concepts

• Airborne precautions for TB
• Droplet precautions for influenza
• Standard precautions
• Vaccination programs
• Contact tracing
• Environmental controls

Relationship To Central

Critical to protect patients, healthcare workers, and community; airborne vs droplet precautions; vaccination strategies

To

Lower Respiratory Infections

From

Upper Respiratory Infections

Strength

strong

Relationship

Upper RTI can progress to lower RTI if untreated or in immunocompromised patients; understanding both establishes severity spectrum

To

Airway and Oxygenation Priority

From

Pneumonia

Strength

strong

Relationship

Pneumonia causes alveolar consolidation and exudate leading to hypoxemia; nursing priority is maintaining patent airway and adequate oxygenation

To

National TB Control Program

From

Tuberculosis

Strength

strong

Relationship

TB management in Philippines mandated through DOTS strategy by NTP; GeneXpert is first-line diagnostic under Philippine NTP protocol

To

Drug Toxicity Monitoring

From

RIPE Regimen

Strength

strong

Relationship

Each TB drug has signature toxicity requiring specific nursing monitoring; hepatotoxicity shared across R, I, P requires liver function assessment

To

Pyridoxine Vitamin B6

From

Isoniazid

Strength

strong

Relationship

Pyridoxine MUST be given with isoniazid to prevent peripheral neuropathy; this is a high-yield NLE combination item

To

Oral Contraceptive Efficacy

From

Rifampicin

Strength

moderate

Relationship

Rifampicin enzyme inducer reduces oral contraceptive effectiveness; barrier method recommended; important counseling point

To

Vision Monitoring

From

Ethambutol

Strength

strong

Relationship

Ethambutol causes optic neuritis with red-green color blindness and decreased acuity; baseline and periodic vision checks essential

To

N95 Respirator Use

From

TB Airborne Transmission

Strength

strong

Relationship

TB is airborne requiring N95 respirator for healthcare workers; not droplet; critical NLE distractor prevention

To

Adherence and MDR TB Prevention

From

DOTS Strategy

Strength

strong

Relationship

Directly observed therapy ensures complete treatment adherence; incomplete treatment is primary driver of multidrug-resistant TB development

To

Active TB Reactivation

From

Latent TB Infection

Strength

strong

Relationship

Latent TB (infected but not infectious) can reactivate to active TB under immunosuppression (HIV, diabetes, malnutrition); granuloma breakdown occurs

To

TB Diagnosis and Rifampicin Resistance

From

GeneXpert MTB/RIF

Strength

strong

Relationship

GeneXpert is Philippine NTP first-line diagnostic detecting TB AND rifampicin resistance simultaneously in 2 hours; replaced sputum smear microscopy

To

TB Screening Trigger

From

Cough Greater Than 2 Weeks

Strength

strong

Relationship

Any cough persisting 2 weeks or longer is TB screening indicator in Philippine context; key for early identification

To

Amoxicillin First Line Antibiotic

From

Community Acquired Pneumonia

Strength

strong

Relationship

Streptococcus pneumoniae most common CAP cause; amoxicillin or macrolide first-line empiric therapy before culture results

To

Pneumococcal Pneumonia

From

Rust Colored Sputum

Strength

moderate

Relationship

Classic presentation of pneumococcal pneumonia is rust-colored (blood-tinged) sputum; helps guide diagnosis and antibiotic selection

To

Atypical Presentation

From

Elderly Patient Pneumonia

Strength

strong

Relationship

Elderly often present with confusion or falls rather than fever as primary pneumonia symptom; blunted fever response; high-yield NLE point

To

Complete Antibiotic Course

From

Group A Beta Hemolytic Streptococcus

Strength

strong

Relationship

GABHS pharyngitis must be treated with full antibiotic course to prevent rheumatic fever and acute glomerulonephritis complications

To

48 Hour Treatment Window

From

Influenza Oseltamivir Treatment

Strength

strong

Relationship

Antiviral oseltamivir most effective when started within 48 hours of symptom onset; timing is critical for efficacy

To

Viral Self Limiting

From

Acute Bronchitis

Strength

moderate

Relationship

Acute bronchitis is usually viral and self-limiting; antibiotics NOT indicated; overuse drives antibiotic resistance

To

Lung Expansion Oxygenation

From

High Fowler Positioning

Strength

strong

Relationship

High-Fowler's position maximizes lung expansion by gravity, facilitating better ventilation and oxygenation in respiratory infections

To

Airway Clearance

From

Deep Breathing Coughing

Strength

strong

Relationship

Encourages mobilization and expectoration of respiratory secretions; prevents atelectasis; reduces risk of complications

To

Sputum Loosening

From

Hydration 2-3 Liters Daily

Strength

moderate

Relationship

Adequate fluid intake loosens secretions promoting expectoration; essential nursing intervention for respiratory infections

To

Alcohol Avoidance

From

Hepatotoxic TB Drugs

Strength

strong

Relationship

Alcohol compounds hepatotoxicity of R, I, P; must teach patient strict avoidance during and after TB treatment

To

TB Control and Prevention

From

Household Contact Screening

Strength

strong

Relationship

Family members of active TB cases must be screened and managed; part of disease control strategy to prevent community spread

To

Prevention Strategy

From

Pneumococcal and Influenza Vaccines

Strength

moderate

Relationship

Vaccination of high-risk groups (elderly, chronic disease) prevents pneumonia and influenza; primary prevention approach

To

TB Infection Detection

From

Mantoux Skin Test

Strength

strong

Relationship

Mantoux PPD read at 48-72 hours measuring induration indicates TB infection/exposure; positive in active and latent TB and prior BCG vaccination

To

Impaired Swallowing and Decreased LOC

From

Aspiration Pneumonia

Strength

strong

Relationship

High risk for aspiration pneumonia when swallowing impaired or consciousness decreased; aspiration of gastric contents and secretions

To

Resistant Organisms

From

Hospital Acquired Pneumonia

Strength

strong

Relationship

HAP caused by more resistant Gram-negative bacteria and MRSA; requires broader-spectrum empiric therapy than CAP

To

Pneumonia Complication

From

Pleural Effusion

Strength

moderate

Relationship

Fluid accumulation in pleural space can occur with pneumonia; may require drainage; complication of consolidation

To

Assessment Planning Implementation Evaluation

From

Nursing Process

Strength

strong

Relationship

Core framework for all respiratory infection management integrating patient data collection diagnosis planning interventions and outcome evaluation

To

Airway Oxygenation Priority

From

Maslow Hierarchy

Strength

strong

Relationship

Physiological needs (breathing) are base of Maslow hierarchy; airway and oxygenation are top nursing priority in respiratory infections