PNEUMONIA

PREPARED BY:Flezle Dace S. DiaoJayson B. Villarojo

Pneumonia is an inflammatory process in lung parenchyma usually associated with a marked increase in interstitial and alveolar fluid. Advances in antibiotic therapy have led to the perception that pneumonia is no longer a major health problem in the United States. Among all nosocomial infections, pneumonia is the second most common, but has the highest mortality.

INTRODUCTION OFPNEUMONIA

Five main causes of pneumonia:

1. Bacteria a. Streptococcus pneumonia b. Staphylococcus aureus c. Hemophilus influenza d. Klebsiela pneumonia

CAUSATIVEAGENT

2. Viruses

3. Mycoplasma

4. Other infectious agents, such as fungi

5. Various chemicals

CAUSATIVEAGENT

The incubation period ranges from one to three days

INCUBATIONPERIOD

1. Droplet infection

- Droplets from the mouth and nose of an infected person via the nasopharynx carry the infectious disease

2.Indirect contact

-Contaminated objects may possibly carry the infectious disease

MODE OFTRANSMISSION

Pneumonia is sometimes classified according to where and how the client

is exposed to the disease:1. Community-acquired pneumonia

- is a pneumonia acquired in the course of one’s daily life- at work, at school or at the gym.- Streptococcus pneumonia is the most common bacterial cause.

CLASSIFICATION OFPNEUMONIA

2.Nosocomial pneumonia- is a pneumonia that develops while the

client is in the hospital. Such pneumonia reflects the kind of nursing care given to the client.3. Aspiration pneumonia

- occurs when a foreign matter is inhaled (aspirated) into the lungs, most commonly when a gastric content enters the lungs after vomiting.

CLASSIFICATION OFPNEUMONIA

4. Pneumonia caused by opportunistic organisms

- This type of pneumonia strikes people with compromised immune system.

CLASSIFICATION OFPNEUMONIA

1. Bronchopneumonia (Lobular or Catarrhal pneumonia)

-This is the most common type of pneumonia.

-Infection usually starts from the bronchus and the bronchioles and spreads to the alveoli of the periphery.

-The lobules are inflamed and consolidated.

ANATOMICAL CLASSIFICATION

-This pneumonia is caused by pneumococcus, Klebsiela pneumonia and Hemophilus influenza.

-The onset of this type of pneumonia is slow and the fever is lower.

-The period of communicability remains unknown

ANATOMICAL CLASSIFICATION

2.Lobar pneumonia (Croupous pneumonia)

-This is a consodilation of the entire lobe.

-As the disease progresses, the prune juice color of the sputum maybe replaced by thinner or yellowish color.

ANATOMICAL CLASSIFICATION

3.Primary atypical pneumonia (Virus pneumonia)

-It is solidification of the lungs that comes in patches.

-Cough is often delayed in appearing and greenish to whitish secretions are often raised on coughing on the 3rd and 5th day.

ANATOMICAL CLASSIFICATION

1. Primary pneumonia

- is produced as direct result of inhalation or aspiration of pathogen or noxious substances. It includes some cases of pneumococcal pneumonia, mycoplasma pneumonia and pneumonia caused by tubercle bacilli.

GENERAL CLASSIFICATION

2. Secondary pneumonia- develops as a complication to disease. There are 3 types of secondary pneumonia:

A. Primary pulmonary infection, which is usually viral, predisposed to superinfection with an unrelated organism.

B. Secondary bacterial infection may follow damage from an initial noxious-chemical insult to the lungs, or following aspiration of gastric content.

GENERAL CLASSIFICATION

GENERAL CLASSIFICATION

c.Hematogenous spread of bacterial pathogens from a distant focus may result in secondary pneumonia.

PATHOPHYSIOLOGY

• Chills• Fever• Chest pain• Paroxysmal cough• Rusty sputum• Pain on the abdomen• Herpes may appear on lips• Body malaise• Labored respiration• Pulse is rapid and bounding• Diaphoresis• Convulsion and vomiting in children

CLINICALMANIFESTATION

Diagnostic procedures1. Chest X-ray- used to detect and

help evaluate the severity of lung infection

2. Sputum Analysis- The color of the mucus (sputum) sample coughed up from the lungs can reveal the severity of the disease.

MEDICALMANAGEMENT

3. Blood/serologic exam- The following blood tests may be performed:

A. White blood cell count (WBC).

B. Blood cultures

MEDICALMANAGEMENT

Modalities of treatment

1. Antimicrobial therapy

a. Streptococcus- macrolides 7-10 days

b. Klebsiela- aminoglycosides and cephalosporin

2. Supportive measures

- humidified oxygen therapy, mechanical ventilation, absolute bed rest

MEDICALMANAGEMENT

3. Bronchodilators

- aminophylline maybe some benefit

4.Expectorants

5.Pain relievers

MEDICALMANAGEMENT

AssessmentNursing assessment is critical in detecting pneumonia. A fever chills, or night sweats in a patient who also has respiratory symptoms should alert the nurse to the possibility of bacterial pneumonia.

NURSINGMANAGEMENT

PlanningThe major goals for the patient may include improved airway patency, rest to conserve energy, maintenance of proper fluid volume, maintenance of adequate nutrition, an understanding of the treatment protocol and preventive measures, and absence of complications.

NURSINGMANAGEMENT

Nursing Diagnosis1. Ineffective airway clearance2. Activity intolerance3. Sleep pattern disturbance4. Altered tissue perfusion5. Altered nutrition: Less than the body requirement

NURSINGMANAGEMENT

INTERVENTION

NURSING MANAGEMENT

Evaluation

NURSING MANAGEMENT

• Novales, Dionesia. Handbook of Common Communicable and Infectious Diseases. Quezon City: C & E Publishing Inc. 2008

• Longworth, David. Handbook of Infectious Disease. Springhouse, Pennsylvania: Springhouse Corporation. 2001

• Cuevas, Frances Pricilla, et. Al., Public Health Nursing in the Philippines. Publications Committee, National League of the Philippine Government Nurses, Inc.2007.

REFERENCE

• Porth,C.M.(2005). Pathophysiology: Concept of Altered Health States, Lippincott Williams and Wilkins

• Karch, A.M.(2012). Nursing Drug Guide. Lippincott Williams and Wilkins

• Black, J.M & Hawks, J.H.(2009). Medical-Surgical Nursing: Clinical Management foe Positive Outcomes. Singapore: Elsevier Pte Ltd.

REFERENCE