BATAAN PENINSULA STATE UNIVERSITYMain Campus, City of Balanga, Bataan

COLLEGE OF NURSING AND MIDWIFERY

Presented to the faculty of the College of Nursing and MidwiferyIn Partial Fulfillment Of The course requirements in

Care of Mother, Child and Family at High-risk or with problem(Nursing Care Management -102)

CASE STUDY:

BRONCHOPNEUMONIA

Presented by:

Group J – MTW

Marvin Marquez

Monica Manabat

Cherie Manalo

Ivy Manlutac

Jayson Manuel

Jose Cedney Mayo

Jacquelline Marcos

Jenice Emkar Menta

Ritzchelle Maninang

Mica Jenery Mendoza

Liezel Morales

Bronchopneumonia or also known as lobular pneumonia or bronchial pneumonia is one

type of bacterial pneumonia, (according to its gross anatomic distribution), usually characterized

by bacterial invasion of the parenchymal cells of the lungs evokes exudative solidification which

is typically caused by Staphylococcus aureus, Streptococcus pneumoniae, Pneumococcus and

Haemophilus influenzae that affects the lobular region of the respiratory system especially the

bronchioles and the surrounding alveoli. About 95 % of all cases are mostly caused by

Streptococcus pneumoniae.

Bronchopneumonia is a classification of Pneumonia according to its distribution of

inflammation is usually common in younger children and also for adult. An estimated 45 million

cases of infectious pneumonia occur annually in the United States, with up to 50,000 deaths

directly attributable to it. The prevalence rate of cases with bronchopneumonia is 0.8-1.5% per

year, highest rates at the extremes of age and during winter months (WHO, 1994). It is the

leading cause of morbidity in the Philippines as of year 2004 -2005 with a total no of incidence

of 690, 566 and rate of 809.9 per 100,000 populations and the 4th leading causes of mortality with

a total no. of incidence of 36, 510 and rate of 42.8 per 100,000 populations. People usually died

in this disease by its further complications (DOH website, 2005).

The organisms disseminate through the bloodstream and colonize the bronchial or

bronchiolar epithelium, but then quickly cause acute inflammatory responses which extend

outside the airway into adjacent alveoli. The initial inflammatory response consists largely of

polymorphonuclear leukocytes which limit the extent of infection to the peribronchiolar region.

Bacterial pneumonia is classified by gross anatomic distribution of consolidation. In bacterial

pneumonia, invasion of the lung parenchyma by bacteria produces an inflammatory immune

response. This response leads to a filling of the alveolar sacs with exudates. The loss of air space

and its replacement with fluid is called lung consolidation. In bronchopneumonia, there are

multiple foci or patches of isolated, acute consolidation, affecting one or more pulmonary lobes.

There is initial terminal bronchiolitis that then spreads to peribronchial lung tissue.

Bronchioles are plugged by the swollen mucosa and their secretion. As a result, the air cannot

enter the alveoli. The imprisoned air in the alveoli is absorbed causing collapse of the alveoli.

Collapsed areas are surrounded by areas of compensatory emphysema. Consolidated areas are

surrounded, from inside outwards, by areas of congestion, infilfamatory cells, collapse and

emphysema. Resolution of the exudate usually restores normal lung structure. Organization may

occur and result in fibrous scarring in some cases or Aggressive disease may produce abscesses.

I. INTRODUCTION

Lesions may be more extensive that often fuses together resembling lobar pneumonia (confluent

bronchopneumonia).

The major manifestations of this type of pneumonia are fever, malaise cough productive

sputum (usually greenish or yellow) rapid and shallow breathing, shortness of breath, headache,

loss of appetite, fatigue. If pleuritis is present, pleuritic pain and pleuritic friction rub is also

experienced. In radiological findings, lungs show focal opacity in patchy consolidation.

In order to diagnosis this illness, a physician may order a chest X-ray, may test a sample

of the sputum, may do a CBC to get a count of the white blood cells in the blood, may take a

CAT scan, and/or may take a pleural fluid culture of the fluid surrounding the lungs.

The clinical picture is dramatically modified by the administration of antibiotics. The

identification of organism and determination of its antibiotic sensitivity are the keystones of the

appropriate therapy. If the patient is suffering from dehydration or has a severe case of

bronchopneumonia, he or she may be treated in the hospital where the illness can be more

closely monitored. With appropriate treatment, most people recover fully within a couple weeks.

Fewer than 10% of patients with pneumonia, now succumb and more instances, death

may be attributed either to complication such as empyema, meningitis, endocarditis or

pericarditis.

II. PERSONAL DATA

III. PRESENT HEALTH HISTORY

IV. PAST HEALTH HISTORY

V. Family Health History

VI. Theoretical Framework

VII. Physical Assessment

VIII. Anatomy and Physiology

IX. Pathophysiology

X. Drug Study

XI. Nursing Care Plan

XII. Laboratory/ Diagnostic Test