Pneumonia Sssssss

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PNEUMONIA

Prepared by: Rosemarie M. Guiang & Michael D. Valdez


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DEFINITION:

An inflammatory process in lung parenchyma usuallyassociated with a marked increase in interstitial and

alveolar fluid.

OTHER NAME:

Pneumonitis


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PATHOGNOMONIC SIGN

Rusty or prune juice like colored

sputum

INCUBATION PERIOD

1 to 3 days with a sudden onset of

shaking chills, rapidly rising fever and

stabbing chest pain


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CAUSATIVE AGENT:

Streptococcus Pneumoniae

Staphylococcus Aureus

Haemophilus Influenzae

Klebsiella Pneumoniae(Friedlanders Bacilli)


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ETIOLOGY

Bacteria

Viruses

Mycoplasmas Fungal Agents

Protozoa

Others:Aspiration of Foods, Fluids, or vomitus or

from inhalation of toxic or caustic

chemicals, smoke, dusts or gases.


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RISK FACTORS

Advanced age History of Smoking

Upper Respiratory Infection

Tracheal Intubation Prolonged immobility

Immunosuppresive Therapy

Non-functional Immune system

Malnutrition

Dehydration

Homelessness

Chronic disease States (e.g. Diabetes and Heart


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MODE OF TRANSMISSION

1. Droplet infection droplets from themouth and nose of an infected person via

the nasopharynx carry the infectious disease

and the disease is transmitted throughintimate contact with carriers

2. Indirect contact throughcontaminated objects


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CLASSIFICATION

1. According to place and how the

client was exposed to the disease

2. According to anatomical location

3. General classification


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According to place and how the

client was exposed to the disease:

1. Community-acquired pneumonia

Acquired in the course of ones days life-at

work, at school or at the gym

Streptococcus pneumoniae (pneumococcus) -

the most common bacterial cause of

community-acquired pneumonia.

2. Nosocomial pneumonia develops whilethe client is in the hospital


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3. Aspiration pneumonia occurs when aforeign matter is inhaled (aspirated) into thelungs most commonly the gastric contents

entering the lungs after vomiting. Clients Prone to Aspiration Pneumonia

- Decreased LOC

- Clients with poor gag reflex

- Elderly

- Very young


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ANATOMICAL CLASSIFICATION

OF PNEUMONIA: (base on location and radiologicappearance)

Bronchopneumonia (Bronchial

Pneumonia)

Interstitial Pneumonia (Reticular

Pneumonia)

Alveolar Pneumonia (Acinar Pneumonia)

Necrotizing Pneumonia


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General classification:

1. Primary pneumonia

Direct result of inhalation or aspiration of

pathogens or noxious substances

Includes some cases of pneumococcal

pneumonia, mycoplasma pneumonia and

pneumonia caused by tubercle bacilli

2. Secondary pneumonia-Due to complication of a disease


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Bronchopneumonia vs. Lobar

Pneumonia


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signs and symptoms:

Sudden onset of chills with rising fever

Rusty/ prune juice like color sputum

Labored respiration and dyspnea

increased sputum production

Cough

Wheezing/ rales/ Rhonchi

consolidation

Hypoxemia

chest pain

dullness

difficulty to expectorate exudates

alveolar exudate tends to consolidate

inflamed and fluid/ pus filled alveolar sacs cannot exchange Oxygen and Carbon

Dioxide effectively

producing inflammation (systemic infection)and consolidation alonglobar compartments

multiply in the alveolus and invade alveolar epithelium through the pores ofthe Kohn.

infect type II Alveolar cells

Microorganism inhaled to alveoli


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CLINICAL MANIFESTATIONS

1. Hypertrophy of Mucous Membrane Increased sputum production

Wheezing

Dyspnea Cough

Rales/crackles

2. Increased Capillary Permeability Consolidation

Hypoxemia


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3. Inflammation of the Pleura

Stabbing chest pain

Pleural effusion

Dullness

Decreased breath sounds

4. Hypoventilation

Decreased chest expansion

Respiratory acidosis


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Other clinical manifestations:

Increased WBC

Increased RR

Increased PR and bounding pulse

Fever

Body malaise

Diaphoresis


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DIAGNOSTIC PROCEDURES

1.Chest X-Ray

2. Sputum Analysis, Smear, and

Culture

3. Blood/serologic exam


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Nursing Diagnosis And

Interventions

IMPAIRED GAS EXCHANGE

Titrate Oxygen delivery rates to maintain oxygen

saturation above 92%

OUTCOME:

Improved gas exchange, as evidenced by maintained

oxygen saturation over 92% on decreasing amounts of

inspired oxygen, having no manifestations of pallor orcyanosis retaining baseline mental status.


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Nursing Interventions

INEFFECTIVE AIRWAY CLEARANCE Increase fluid intake, teaching and encouraging

effective cough and breathing techniques andfrequent turning.

Use incentive spirometer every 2 hours while awake. Clients w/ altered level of consciousness should be

turned at least every 2 hours and should be placed inside lying position.

Only thickened liquids should be given

Bronchodilators OUTCOMES:

Maintain effective airway clearance as evidenced bykeeping a patent airway and clearing secretions


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INEFFECTIVE BREATHING PATTERN

Raise head of bed at 45 degree

Teach patient to splint the chest wall with pillow

Administer cough suppressants and analgesicsCAUSIOUSLY.

OUTCOMES;

Improved breathing pattern as evidenced by 1

respiratory rate within normal 2adequate chest

expansion 3clear breath sounds 4 decreased dyspnea


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ACTIVITY TOLERANCE

Teach client to avoid conditions that increaseoxygen demand, such as smoking, temperatureextremes, weight gain, and stress. Pursed-Lipand diaphragmatic breathing, which improveairflow, as well as techniques to lower energyuse, should be reinforced. Activities that are tiringshould be interpersed with rest

OUTCOMES: Improved activity tolerance as evidenced by ability to

perform activities of daily living and a progressiveincrease in physical activity without dyspnea andfatigue.


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Drug Therapy

Antibiotics- depending on type of

microorganisms involved (e.g. cotrimoxazole,

cephalosphorins, Cotrimoxazole)

Mucolytics or expectorants Bronchodilators aminophylline

Pain relievers for pleuritic pain


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Complication

Otitis media (children)

Pleural effusion

Pericarditis

Atelectasis

Date post:	04-Apr-2018
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Pneumonia Sssssss

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