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  1. 1. PneumoniaPneumonia Dr. Walaa NasrDr. Walaa Nasr Lecturer of Adult NursingLecturer of Adult Nursing Second yearSecond year Brought to you
  2. 2. PneumoniaPneumonia  Out linesOut lines  DefinitionDefinition  Classification of pneumoniaClassification of pneumonia  According to causesAccording to causes  According to area involvedAccording to area involved  Mode of transmissionMode of transmission  Predisposing factorsPredisposing factors  PathophysiologyPathophysiology  Clinical manifestationsClinical manifestations  Diagnostic testsDiagnostic tests  Medical managementMedical management  Nursing interventionNursing intervention  Preventive measuresPreventive measures  PrognosisPrognosis  ComplicationsComplications Brought to you
  3. 3. PneumoniaPneumonia DefinitionDefinition Is an inflammatoryIs an inflammatory process of the lungprocess of the lung parenchymaparenchyma that isthat is commonly caused bycommonly caused by infectious agents.infectious agents. Brought to you
  4. 4. Classification of pneumonia According to causesAccording to causes  BacterialBacterial (the most common cause of(the most common cause of pneumonia)pneumonia)  ViralViral pneumoniapneumonia  FungalFungal pneumoniapneumonia  ChemicalChemical pneumonia (ingestion ofpneumonia (ingestion of kerosene or inhalation of irritatingkerosene or inhalation of irritating substance)substance)  InhalationInhalation pneumonia (aspirationpneumonia (aspiration pneumonia)pneumonia) Brought to you
  5. 5. Classification of pneumonia (cont…( According to areas involvedAccording to areas involved  Lobar pneumonia; if one or more lobe is involved  Broncho-pneumonia; the pneumonic process has originated in one or more bronchi and extends to the surrounding lung tissue. Brought to you
  6. 6. PneumoniaPneumonia Mode of transmission Ways you can get pneumonia include:Ways you can get pneumonia include:  Bacteria and viruses living in your nose,Bacteria and viruses living in your nose, sinuses, or mouth may spread to your lungs.sinuses, or mouth may spread to your lungs.  You may breathe some of these germsYou may breathe some of these germs directly into your lungs (droplets infection).directly into your lungs (droplets infection).  You breathe in (inhale) food, liquids, vomit,You breathe in (inhale) food, liquids, vomit, or fluids from the mouth into your lungsor fluids from the mouth into your lungs ((aspiration pneumonia). Brought to you
  7. 7. PneumoniaPneumonia Predisposing factors  Immuno-suppresed patients  Cigarette smoking  Difficult swallowing (due to stroke, dementia,parkinsons disease, or other neurological conditions)  Impaired consciousness ( loss of brain function due to dementia, stroke, or other neurological conditions) Brought to you
  8. 8. PneumoniaPneumonia Predisposing factors  Chronic lung disease (COPD, bronchostasis)  Frequent suction  Other serious illness such as heart disease, liver cirrhosis, and DM  Recent cold, laryngitis or flu Brought to you
  9. 9. PneumoniaPneumonia Pathophysiology  The streptococci reach the alveoli and lead to inflammation and pouring of an exudates into the air spaces.  WBCs migrates to alveoli, the alveoli become more thick due to its filling consolidation, involved areas by inflammation are not adequately ventilated, due to secretion and edema. This will lead to partial occlusion of alveoli and bronchi causing a decrease in alveolar oxygen content. Brought to you
  10. 10. PneumoniaPneumonia Pathophysiology (cont…(  Venous blood that goes to affected areas without being oxygenated and returns to the heart. This will lead to arterial hypoxemia and even death due to interference with ventilation. Brought to you
  11. 11. PneumoniaPneumonia Clinical manifestations  SShaking chillshaking chills  RRapidly rising fever ( 39.5 to 40.5 degree)apidly rising fever ( 39.5 to 40.5 degree)  SStabbing chest pain aggravated by respiration and coughingtabbing chest pain aggravated by respiration and coughing  TTachypnea, nasal flaringachypnea, nasal flaring  PPatient is very ill and lies on the affected side to decrease painatient is very ill and lies on the affected side to decrease pain  UUse of accessory muscles of respiration e.g. abdomen andse of accessory muscles of respiration e.g. abdomen and intercostals musclesintercostals muscles  CCough with purulent, blood tinged, rusty sputumough with purulent, blood tinged, rusty sputum  SShortness of breathhortness of breath  FFlushed cheekslushed cheeks  LLoss of appetite, low energy, and fatigueoss of appetite, low energy, and fatigue  CCyanosed lips and nail bedsyanosed lips and nail beds Brought to you
  12. 12.  History takingHistory taking  Physical examinationPhysical examination  Chest x-rayChest x-ray  Blood testBlood test  Sputum cultureSputum culture Pneumonia Diagnostic tests Brought to you
  13. 13.  Antibiotic, depending on sputum and blood culture  Oxygen therapy  Chest physiotherapy Pneumonia Medical management Brought to you
  14. 14. Pneumonia Nursing interventionNursing intervention  Maintain a patent airway andMaintain a patent airway and adequate oxygenation.adequate oxygenation.  Obtain sputum specimens asObtain sputum specimens as needed.needed.  Use suction if the patient canUse suction if the patient can ’’tt produce a specimen.produce a specimen.  perform chest physiotherapy.perform chest physiotherapy. Brought to you
  15. 15. Pneumonia Nursing intervention (contNursing intervention (cont……((  Provide a high calorie, high protein dietProvide a high calorie, high protein diet of soft foods.of soft foods.  To prevent aspiration during nasogastricTo prevent aspiration during nasogastric tube feedings, check the position of tube,tube feedings, check the position of tube, and administer feedings slowly.and administer feedings slowly.  To control the spread of infection,To control the spread of infection, dispose secretions properly.dispose secretions properly. Brought to you
  16. 16. Pneumonia Nursing intervention (contNursing intervention (cont……((  Provide a quiet, calm environment, with frequent rest periods.  Monitor the patient’s ABG levels, especially if he’s hypoxic.  Assess the patient’s respiratory status. Auscultate breath sounds at least every 4 hours.  Monitor fluid intake and output.  Evaluate the effectiveness of administered medications.  Explain all procedures to the patient and family. Brought to you
  17. 17. Pneumonia Preventive measures  Frequent turning of bed ridden patients and early ambulation as much as possible.  Coughing and breathing techniques.  Sterilization of respiratory therapy equipment  Suctioning of secretion in the unconscious who have poor cough and swallowing reflexes, to prevent aspiration of secretions and its accumulation.Brought to you
  18. 18. Pneumonia Prognosis With treatment, most patients will improve within 2 weeks. Elderly or very sick patients may need longer treatment. Brought to you
  19. 19. Pneumonia Complications  Acute respiratory distress syndrome (ARDS)Acute respiratory distress syndrome (ARDS)  Pleural effusionPleural effusion  Lung abscessesLung abscesses  Respiratory failure (which requires mechanicalRespiratory failure (which requires mechanical ventilator)ventilator)  Sepsis, which may lead to organ failureSepsis, which may lead to organ failure  poM&feature=relatedpoM&feature=related  v=nhUT5BfAFicv=nhUT5BfAFic Brought to you
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