PNEUMONIA

Pneumonia
Pneumonia
An acute infection of
the lungs that occurs
when infectious agent
enters and multiplies in
the lungs of a
susceptible person
Etiology:
Bacterial Pneumonia
common cause of CAP is Streptococcus
pneumoniae
also called pneomococcal pneumonia
accounts for 90% of all bacterial pneumonia
other causes:
Staphylococcus aureus
Mycoplasma pneumoniae
Hospital-acquired pneumoniae (HAP) are more
often more often serious
causes:
Escherichia coli
Haemophilus influenzae
Pseudomonas aeroginosa
Viral Pneumonia
most common cause are influenza viruses
patients will viral pneumonia are less ill than with
bacterial but they are ill for a longer period of time
because antibiotic is ineffective to virus
Fungal Pneumonia
causes:
Candida
Aspergillus
Pneumocystis carinii
a fungus that typically causes pneumonia in
patients with AIDS
Aspiration Pneumonia
most often occurs in patients with decreased
levels of consciousness or an impaired cough or
gag reflex
can occur with:
alcohol ingestion
stroke
general anesthesia
seizures/other serious illnesses
Ventilator-Associated
Pneumonia (VAP)
develops in the
patients who are
intubated and
mechaincally
ventilated
Endotracheal tube
keeps the glottis open
allowing secretions to
be aspirated into the
lungs
Hypostatic Pneumonia
occurs to patient who hypoventilate because of
bedrest, immobility, or shallow respiration
🡻
secretion pools in dependent areas of the lungs
🡻
inflammation of lung parynchema and infection
Chemical Pneumonia
inhalation of toxic chemicals causing inflammation
and tissue damage
Example
▪ Pneumonoultramicroscopicsilicovolcanoconiosis
✔ Inhalation of silica dusts from volcanic ashes
Complications:
Most common:
Pleurisy
Pleural effusion
• generally resolve
Atelectasis
within 1-2 weeks
Atelectasis
Diagnostic Tests
CXR examination
Sputum and blood
culture
Management:
Broad-spectrum antibiotics before culture
results are completed
For viral: rest and fluids
Expectorants
Bronchodilators
Analgesics
Nursing Management
Nursing Assessment
1. Assess respiratory symptoms. Symptoms of fever, chills, or
night sweats in a patient should be reported immediately to
the nurse as these can be signs of bacterial pneumonia.
2. Assess clinical manifestations. Respiratory assessment should
further identify clinical manifestations such as pleuritic pain,
bradycardia, tachypnea, and fatigue, use of accessory
muscles for breathing, coughing, and purulent sputum.
3. Physical assessment. Assess the changes in temperature
and pulse; amount, odor, and color of secretions; frequency
and severity of cough; degree of tachypnea or shortness of
breath; and changes in the chest x-ray findings.
4. Assessment in elderly patients. Assess elderly patients for
altered mental status, dehydration, unusual behavior,
excessive fatigue, and concomitant heart failure.
Diagnosis
1. Ineffective airway clearance related to copious
tracheobronchial secretions.
2. Activity intolerance related to impaired respiratory
function.
3. Risk for deficient fluid volume related to fever and a
rapid respiratory rate.
Nursing Care Planning & Goals
1. Improve airway patency.
2. Rest to conserve energy.
3. Maintenance of proper fluid volume.
4. Maintenance of adequate nutrition.
5. Understanding of treatment protocol and preventive
measures.
6. Absence of complications.
Nursing Priorities
1. Maintain/improve respiratory function.
2. Prevent complications.
3. Support recuperative process.
4. Provide information about disease process, prognosis, and
treatment.
Nursing Interventions
To improve airway patency:
1. Removal of secretions. Secretions should be removed because retained secretions

interfere with gas exchange and may slow recovery.
2. Adequate hydration of 2 to 3 liters per day thins and loosens pulmonary secretions.
3. Humidification may loosen secretions and improve ventilation.
4. Coughing exercises. An effective, directed cough can also improve airway
patency.
5. Chest physiotherapy. Chest physiotherapy is important because it loosens and
mobilizes secretions.
To promote rest and conserve energy:
1. Encourage avoidance of overexertion and possible exacerbation of symptoms.
2. Semi-Fowler’s position. The patient should assume a comfortable position to

promote rest and breathing and should change positions frequently to enhance
secretion clearance and pulmonary ventilation and perfusion.
To promote fluid intake:
Fluid intake. Increase in fluid intake to at least 2L per day to replace insensible fluid losses.
To maintain nutrition:
Fluids with electrolytes. This may help provide fluid, calories, and electrolytes.
Nutrition-enriched beverages. Nutritionally enhanced drinks and shakes can also help
restore proper nutrition.
To promote patient’s knowledge:
1. Instruct patient and family about the cause of pneumonia, management of

symptoms, signs, and symptoms, and the need for follow-up.
2. Instruct patient about the factors that may have contributed to the development
of the disease.
Evaluation
1. Expected patient outcomes include the following:
2. Demonstrates improved airway patency.
3. Rests and conserves energy by limiting activities and remaining in bed while
symptomatic and then slowly increasing activities.
4. Maintains adequate hydration.
5. Consumes adequate dietary intake.
6. States explanation for management strategies.
7. Complies with management strategies.
8. Exhibits no complications.
9. Complies with treatment protocol and prevention strategies.
Discharge and Home Care Guidelines
1. Oral antibiotics. Teach the patient about the proper administration, potential side
effects, and symptoms to report.
2. Breathing exercises. Teach the patient breathing exercises to promote secretion

clearance and volume expansion.
3. Follow-up check up. Strict compliance to follow-up checkups is important to

check the latest chest x-ray result or physical examination findings.
4. Smoking cessation. Smoking should be stopped because it inhibits

tracheobronchial ciliary action and irritates the mucous cells of the bronchi.

PNEUMONIA

Uploaded by

Copyright:

Available Formats

PNEUMONIA

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

PNEUMONIA

Uploaded by

Copyright:

Available Formats

Pneumonia

1. Removal of secretions. Secretions should be removed because retained secretions

1. Encourage avoidance of overexertion and possible exacerbation of symptoms.

2. Semi-Fowler’s position. The patient should assume a comfortable position to

1. Instruct patient and family about the cause of pneumonia, management of

2. Breathing exercises. Teach the patient breathing exercises to promote secretion

3. Follow-up check up. Strict compliance to follow-up checkups is important to

4. Smoking cessation. Smoking should be stopped because it inhibits

You might also like

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.