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% Document Info
\author{harpieee}
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  /Title (pneumonia.pdf)
  /Creator (Cheatography)
  /Author (harpieee)
  /Subject (Pneumonia Cheat Sheet)
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    {\parbox{\dimexpr\textwidth-2\fboxsep\relax}{\noindent
        \hspace*{-6pt}\includegraphics[width=5.8cm]{/web/www.cheatography.com/public/images/cheatography_logo.pdf}}
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    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{Pneumonia Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{harpieee} via \textcolor{DarkBackground}{\uline{cheatography.com/71374/cs/18469/}}}
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\noindent
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  \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}}  \\
  \vspace{-2pt}harpieee \\
  \uline{cheatography.com/harpieee} \\
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  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Published 5th January, 2019.\\
   Updated 5th January, 2019.\\
   Page {\thepage} of \pageref{LastPage}.
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  Measure your website readability!\\
  www.readability-score.com
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\begin{multicols*}{2}

\begin{tabularx}{8.4cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{8.4cm}}{\bf\textcolor{white}{{\bf{PNEUMONIA}}}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{An inflammatory process in the lungs that produces excess fluid and exudate that fill the alveoli} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{Classified as bacterial, viral, fungal, or chemical} \tn 
% Row Count 4 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{Pneumonia is triggered by infectious organisms or by the aspiration of an irritant, such as fluid or a foreign object} \tn 
% Row Count 7 (+ 3)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{Can be a primary disease of a complication of another disease or condition} \tn 
% Row Count 9 (+ 2)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{Young clients, older adult clients, and clients who are immunocompromised are more susceptible} \tn 
% Row Count 11 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{x{4 cm} x{4 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{{\bf{TYPES OF PNEUMONIA}}}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Ventilator associated pneumonia (VAP):}} & Occurs 48 to 72 hr after endotracheal intubation \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
{\bf{Community acquired pneumonia (CAP):}} & The most common type and often occurs as a complication of influenza \tn 
% Row Count 7 (+ 4)
% Row 2
\SetRowColor{LightBackground}
{\bf{Health care acquired pneumonia (HAP):}} & Has a higher mortality rate and is more likely to be resistant to antibiotics. It usually takes more than 48 hr from the time the client is exposed to acquire HAP. \tn 
% Row Count 16 (+ 9)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{x{4 cm} x{4 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{{\bf{CONTRIBUTING FACTORS}}}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Advanced age}} & No pneumococcal vaccination within the last 5 years \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
No influenza vaccine within the last year & Chronic lung disease \tn 
% Row Count 6 (+ 3)
% Row 2
\SetRowColor{LightBackground}
{\bf{Immunocompromised}} & Mechanical ventilation \tn 
% Row Count 8 (+ 2)
% Row 3
\SetRowColor{white}
{\bf{Postoperative}} & Sedation \tn 
% Row Count 9 (+ 1)
% Row 4
\SetRowColor{LightBackground}
Opioid use & {\bf{Prolonged immobility}} \tn 
% Row Count 11 (+ 2)
% Row 5
\SetRowColor{white}
Tobacco use & Enteral tube feeding \tn 
% Row Count 12 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{x{1.6 cm} x{6.4 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{{\bf{EXPECTED FINDINGS}}}}  \tn
% Row 0
\SetRowColor{LightBackground}
Anxiety & Fatigue \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\seqsplit{Weakness} & Chest discomfort due to coughing \tn 
% Row Count 2 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{Confusion from hypoxia is a common manifestation of pneumonia in older adult clients}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{x{4 cm} x{4 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{{\bf{MANIFESTATIONS}}}}  \tn
% Row 0
\SetRowColor{LightBackground}
Fever & Chills \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
Flushed face & Diaphoresis \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
Shortness of breath or difficulty breathing & Tachypnea \tn 
% Row Count 5 (+ 3)
% Row 3
\SetRowColor{white}
Pleuritic chest pain (sharp) & Sputum production (yellow-tinged) \tn 
% Row Count 7 (+ 2)
% Row 4
\SetRowColor{LightBackground}
Crackles & Wheezes \tn 
% Row Count 8 (+ 1)
% Row 5
\SetRowColor{white}
Dull chest percussion over areas of consolidation & Coughing \tn 
% Row Count 11 (+ 3)
% Row 6
\SetRowColor{LightBackground}
Decreased oxygen saturation levels & Purulent, blood tinged or rust colored sputum \tn 
% Row Count 14 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{x{3.76 cm} x{4.24 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{{\bf{LABORATORY TESTS}}}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{CBC:}} & Elevated WBC \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
 & (Might not be present in older adult clients) \tn 
% Row Count 4 (+ 3)
% Row 2
\SetRowColor{LightBackground}
{\bf{ABGs:}} & Hypoxemia \tn 
% Row Count 5 (+ 1)
% Row 3
\SetRowColor{white}
 & (PaO2 less than 80 mm Hg) \tn 
% Row Count 7 (+ 2)
% Row 4
\SetRowColor{LightBackground}
{\bf{Blood culture:}} & To rule out organisms in the blood \tn 
% Row Count 9 (+ 2)
% Row 5
\SetRowColor{white}
{\bf{Serum electrolytes:}} & To identify dehydration \tn 
% Row Count 11 (+ 2)
% Row 6
\SetRowColor{LightBackground}
{\bf{Sputum culture and sensitivity:}} & Obtain specimens before starting antibiotic therapy \tn 
% Row Count 14 (+ 3)
% Row 7
\SetRowColor{white}
 & Obtain specimen by suctioning if the client is unable to cough \tn 
% Row Count 17 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{{\bf{DIAGNOSTIC PROCEDURES}}}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Chest x-ray:}} & Will show consolidation (solidification, density) of lung tissue \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
 & Might not indicate pneumonia for a few days after manifestations develop \tn 
% Row Count 6 (+ 3)
% Row 2
\SetRowColor{LightBackground}
{\bf{Pulse oximetry:}} & Clients who have pneumonia usually have oximetry levels less than the expected reference range of 95-100\% \tn 
% Row Count 10 (+ 4)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\begin{tabularx}{8.4cm}{X}
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\mymulticolumn{1}{x{8.4cm}}{\bf\textcolor{white}{{\bf{NURSING CARE}}}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{Position the client to maximize ventilation (high-Fowler's) unless contraindicated} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{Encourage coughing or suction to remove secretions} \tn 
% Row Count 3 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{Administer breathing treatments \& medications} \tn 
% Row Count 4 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{Adminiter oxygen therapy} \tn 
% Row Count 5 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{Monitor for skin breakdown around the ears, nose, and mouth from the oxygen device} \tn 
% Row Count 7 (+ 2)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{Encourage deep breathing with an incentive spirometer to prevent alveolar collapse} \tn 
% Row Count 9 (+ 2)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{Determine the client's physical limitations and structure activity to include periods of rest} \tn 
% Row Count 11 (+ 2)
% Row 7
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{Encourage fluid intake of 2.5 to 3 L/day to promote hydration and thinning of secretions, unless contraindicated due to another condition} \tn 
% Row Count 14 (+ 3)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{Provide rest periods for clients who have dyspnea} \tn 
% Row Count 15 (+ 1)
% Row 9
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{Reassure the client who is experiencing respiratory distress} \tn 
% Row Count 17 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{X}
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\mymulticolumn{1}{x{8.4cm}}{\bf\textcolor{white}{{\bf{MEDICATIONS}}}}  \tn
% Row 0
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\mymulticolumn{1}{x{8.4cm}}{Antibiotics} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{Bronchodilators} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{Anti-inflammatories} \tn 
% Row Count 3 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
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\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{x{2.72 cm} x{5.28 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{{\bf{ANTIBIOTICS}}}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{Antibiotics are given to destroy infectious pathogens.} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{8.4cm}}{Commonly used antibiotics include fluoroquinolone, penicillins, and cephalosporins.} \tn 
% Row Count 4 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{Antibiotics are often initially given via IV and then switched to an oral form as the condition improves.} \tn 
% Row Count 7 (+ 3)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{8.4cm}}{Obtain any culture specimens prior to giving the first dose of an antibiotic. Once the specimen is obtained, the antibiotics can be given while waiting for the results of the culture.} \tn 
% Row Count 11 (+ 4)
% Row 4
\SetRowColor{LightBackground}
{\bf{Nursing Actions:}} & Observe clients taking cephalosporins for frequent stools \tn 
% Row Count 14 (+ 3)
% Row 5
\SetRowColor{white}
 & Monitor kidney function, especially older adults who are taking penicillins and cephalosporins \tn 
% Row Count 18 (+ 4)
% Row 6
\SetRowColor{LightBackground}
{\bf{Client Education:}} & Encourage clients to take penicillins and cephalosporins with food \tn 
% Row Count 21 (+ 3)
% Row 7
\SetRowColor{white}
 & Some penicillins should be taken 1 hr before meals or 2 hr after \tn 
% Row Count 24 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{x{3.68 cm} x{4.32 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{{\bf{BRONCHODILATORS}}}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{Bronchodilators are given to reduce bronchospasm and reduce irritation.} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{8.4cm}}{Short-acting beta2 agonists, such as albuterol, provide rapid relief.} \tn 
% Row Count 4 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{Cholinergic antagonists (anticholinergic medications), such as ipratropium, block the parasympathetic nervous system, allowing for increased bronchodilator and decreased pulmonary secretions.} \tn 
% Row Count 8 (+ 4)
% Row 3
\SetRowColor{white}
{\bf{Nursing Actions (Albuterol):}} & Increase fluid intake if not contraindicated \tn 
% Row Count 11 (+ 3)
% Row 4
\SetRowColor{LightBackground}
 & Can cause hypokalemia, insomnia, headache, or nausea \tn 
% Row Count 14 (+ 3)
% Row 5
\SetRowColor{white}
 & Monitor for tremors, tachycardia, hypertension, nervousness, palpitations, and dry mouth \tn 
% Row Count 19 (+ 5)
% Row 6
\SetRowColor{LightBackground}
{\bf{Nursing Actions (Ipratropium):}} & Observe for dry mouth and difficulty with urination \tn 
% Row Count 22 (+ 3)
% Row 7
\SetRowColor{white}
 & Monitor heart rate \tn 
% Row Count 23 (+ 1)
% Row 8
\SetRowColor{LightBackground}
 & Adverse effects can include headache, blurred vision, and palpitations, which can indicate toxicity \tn 
% Row Count 28 (+ 5)
% Row 9
\SetRowColor{white}
{\bf{Client Education:}} & Reinforce teaching on how to use a metered-dose inhaler (MDI) \tn 
% Row Count 31 (+ 3)
\end{tabularx}
\par\addvspace{1.3em}

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\begin{tabularx}{8.4cm}{x{3.68 cm} x{4.32 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{{\bf{BRONCHODILATORS}} (cont)}}  \tn
% Row 10
\SetRowColor{LightBackground}
 & Encourage clients to suck on hard candies to moisten dry mouth while taking ipratropium \tn 
% Row Count 5 (+ 5)
% Row 11
\SetRowColor{white}
 & Encourage increased fluid intake unless contraindicated \tn 
% Row Count 8 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\begin{tabularx}{8.4cm}{x{4 cm} x{4 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{{\bf{ANTI-INFLAMMATORIES}}}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{8.4cm}}{Anti-inflammatories decrease airway inflammation.} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\seqsplit{Glucocorticosteroids}, such as fluticasone (MDI) and prednisone (oral), are prescribed to reduce inflammation. & Monitor for immunosuppression, fluid retention, hyperglycemia, hypertension, hypokalemia, and poor wound healing. \tn 
% Row Count 7 (+ 6)
% Row 2
\SetRowColor{LightBackground}
{\bf{Nursing Actions:}} & Monitor for decreased immunity function and infection \tn 
% Row Count 10 (+ 3)
% Row 3
\SetRowColor{white}
 & Monitor for hyperglycemia \tn 
% Row Count 12 (+ 2)
% Row 4
\SetRowColor{LightBackground}
 & Monitor for hypertension \tn 
% Row Count 14 (+ 2)
% Row 5
\SetRowColor{white}
 & Advise the pt to report black, tarry stools \tn 
% Row Count 17 (+ 3)
% Row 6
\SetRowColor{LightBackground}
 & Observe for fluid retention and weight gain \tn 
% Row Count 20 (+ 3)
% Row 7
\SetRowColor{white}
 & Monitor for electrolyte imbalance \tn 
% Row Count 22 (+ 2)
% Row 8
\SetRowColor{LightBackground}
 & Monitor the client's throat and mouth for aphthous lesions (canker sores) \tn 
% Row Count 26 (+ 4)
% Row 9
\SetRowColor{white}
{\bf{Client Education:}} & Drink plenty of fluids to promote hydration \tn 
% Row Count 29 (+ 3)
% Row 10
\SetRowColor{LightBackground}
 & Take \seqsplit{glucocorticosteroids} with food \tn 
% Row Count 31 (+ 2)
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\par\addvspace{1.3em}

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\begin{tabularx}{8.4cm}{x{4 cm} x{4 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{{\bf{ANTI-INFLAMMATORIES}} (cont)}}  \tn
% Row 11
\SetRowColor{LightBackground}
 & Avoid discontinuing \seqsplit{glucocorticosteroids} without consulting provider \tn 
% Row Count 4 (+ 4)
% Row 12
\SetRowColor{white}
 & Use MDI \tn 
% Row Count 5 (+ 1)
% Row 13
\SetRowColor{LightBackground}
 & Rinse mouth and gargle after inhaled glucocorticoids to reduce the risk of dysohonia and candidiasis \tn 
% Row Count 10 (+ 5)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{8.4cm}}{\bf\textcolor{white}{{\bf{INTERPROFESSIONAL CARE}}}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{Consult with respiratory services for inhalers, breathing treatments, and suctioning for airway management.} \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{Consult with nutritional services for weight loss or gain related to medications or diagnosis.} \tn 
% Row Count 5 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{Consult with rehabilitation care if the client has prolonged weakness and needs assistance with increasing level of activity.} \tn 
% Row Count 8 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{8.4cm}}{\bf\textcolor{white}{{\bf{CLIENT EDUCATION}}}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{Continue medications for treatment of pneumonia} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{Rest as needed} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{Maintain hand hygiene to prevent infection} \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{Avoid crowded areas to reduce the risk of infection} \tn 
% Row Count 5 (+ 2)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{Receive immunizations for influenza and pneumonia} \tn 
% Row Count 6 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{Stop smoking} \tn 
% Row Count 7 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{x{4 cm} x{4 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{{\bf{COMPLICATIONS OF PNEUMONIA}}}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Atelectasis:}} & Airway inflammation and edema lead to alveolar collapse and increase the risk of hypoxemia \tn 
% Row Count 5 (+ 5)
% Row 1
\SetRowColor{white}
 & The pt reports shortness of breath and exhibits findings of hypoxemia \tn 
% Row Count 9 (+ 4)
% Row 2
\SetRowColor{LightBackground}
 & The pt has diminished or absent breath sounds over the affected area \tn 
% Row Count 13 (+ 4)
% Row 3
\SetRowColor{white}
 & A chest x-ray shows an area of density \tn 
% Row Count 15 (+ 2)
% Row 4
\SetRowColor{LightBackground}
{\bf{Bacteremia (sepsis):}} & This occurs if pathogens enter the bloodstream from the infection in the lungs \tn 
% Row Count 19 (+ 4)
% Row 5
\SetRowColor{white}
{\bf{Acute respiratory distress syndrome:}} & Hypoxemia persists despite oxygen therapy \tn 
% Row Count 22 (+ 3)
% Row 6
\SetRowColor{LightBackground}
 & Dyspnea worsens as bilateral pulmonary edema develops that is non cardiac related \tn 
% Row Count 27 (+ 5)
% Row 7
\SetRowColor{white}
 & A chest x-ray shows an area of density with a ground-glass appearance \tn 
% Row Count 31 (+ 4)
\end{tabularx}
\par\addvspace{1.3em}

\vfill
\columnbreak
\begin{tabularx}{8.4cm}{x{4 cm} x{4 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{8.4cm}}{\bf\textcolor{white}{{\bf{COMPLICATIONS OF PNEUMONIA}} (cont)}}  \tn
% Row 8
\SetRowColor{LightBackground}
 & Blood gas findings demonstrate high arterial blood levels of carbon dioxide (hypercarbia) and pulse oximetry shows decreased saturation \tn 
% Row Count 7 (+ 7)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{8.4cm}}{\bf\textcolor{white}{{\bf{APPLICATION EXERCISES}}}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{{\bf{1. A nurse is monitoring a group of clients for increased risk for developing pneumonia. Which of the following clients should the nurse expect to be at risk? (select all that apply)}}} \tn 
% Row Count 4 (+ 4)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{A. client who has dysphagia} \tn 
% Row Count 5 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{B. client who has AIDS} \tn 
% Row Count 6 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{C. client who received vaccines for pneumoccocus and influenza 6 months ago} \tn 
% Row Count 8 (+ 2)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{D. client who is ambulatory after receiving a local anesthesia} \tn 
% Row Count 10 (+ 2)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{E. client who has a closed head injury} \tn 
% Row Count 11 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{F. client who has myasthenia graves} \tn 
% Row Count 12 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{{\bf{2. A nurse is caring for a client who has pneumonia. Data collection findings include temperature 37.8 C (100 F), respirations 30/min, blood pressure 130/76, heart rate 100/min, and SaO2 91\% on room air. Which of the following actions is the nurse's priority?}}} \tn 
% Row Count 18 (+ 6)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{A. administer antibiotics} \tn 
% Row Count 19 (+ 1)
% Row 9
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{B. administer oxygen therapy} \tn 
% Row Count 20 (+ 1)
% Row 10
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{C. perform a sputum culture} \tn 
% Row Count 21 (+ 1)
% Row 11
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{D. administer antipyretic medication to promote client comfort} \tn 
% Row Count 23 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}


% That's all folks
\end{multicols*}

\end{document}