presentation

1. BRONCHOPNEUMONIA
LINTU THOMAS
MSC NURSING II YR

3. • INTRODUCTION
• DEVELOPMENTAL ANATOMY
at the of 4 weeks ,the respiratory system begins as
an out growth of the foregut ,it is anterior to the
pharynx ,the out growth is called Lung bud or
Respiratory diverticulum

4. • The endoderm lining the respiratory diverticulum
give rise to the epithelium and glands of the trachea
,bronchi and alveoli
• Mesoderm surroundings the respiratory
diverticulum give rise to connective tissue ,cartilage
and smooth muscles of these structures

5. • Respiratory diverticulum elongates and form
tracheal buds divides into bronchial buds ,which
branches repeatedly and develop with bronchi .by
24 weeks respiratory bronchioles have developed
• At 6 -16 weeks all major elements of lungs have
formed .
• Gas exchange started
• During 6 to 26 weeks lung tissue become vascular

6. • 20 weeks surfactant production started very small
amount .
• Sufficient amount produced at 26 to 28 weeks of
gestation
• At 30 weeks mature alveoli will develop

8. DEFINITION
• PNEUMONIA
IT IS AN INFLAMMATORY PROCESS
INVOLVING LUNG PARENCHYMA
BRONCHOPNEUMONIA
IT IS PRIMARILY SPREADING
INFLAMMATION OF A TERMINAL
BRONCHIOLES AND THEIR RELATED
ALVEOLI

11. •CLASSIFICATION OF PNEUMONIA

14. INCIDENCE
• IT IS SEEN IN AROUND 156 MILLION PEOPLE
,MORE SEEN IN CHILDRENS THAN ADULT
,28-34 % DEATH UNDER 5 YEARS ,

15. ETIOLOGY
• BACTERIAL INFECTION
Pneumococcus ,streptococcus ,staphylococcus ,
H .influenza
• Viral infection :influenza virus, adenovirus
• Fungus: Candida, Histoplasma
• Hypostatic pneumonia
• Aspiration of amniotic fluid ,food ,foreign bodies

16. PNEUMONIA PATOGENS IN VARIOUS AGE GROUP
• 1-3 Months :Parainfluenza ,Influenza ,Streptococcus
Pneumoniae ,Chlamydia Trachomatis
• 4 Months To 5 Years :Streptococcus Pneumoniae
,Chlamydia Pneumoniae ,Mycoplasma Pneumoniae
• 5 To 18 Years : Mycoplasma Pneumoniae ,Chlamedia
Pneumoniae ,Steptococcus Pneumoniae

17. CLINICAL FEATURES OF BRONCHOPNEUMONIA
• High fever with respiratory distress ,restlessness , air hunger
and cyanosis
• Grunting
• Nasal flaring
• Retraction of the supra clavicular ,intercostals ,subcostal areas
• Tachypnea
• Tachycardia
• Abdominal distention ,liver enlargement

18. Features of typical and atypical pneumonia
Features Typical Atypical
Onset sudden Gradual
Fever +++ + / _
Cough Productive Dry
Symptoms Pulmonary Systemic
Chest x ray
Localized Diffuse

19. Diagnostic evaluation of bronchopneumonia
• PHYSICAL EXAMINATION
 INSPECTION
Cyanosis ,sub costal ,substernal ,intercostal retraction ,tachypnea ,nasal
flaring
 AUSCULTATION
Wheezes Sound
 PERCUSSION
Dullness over a consolidated area
 PALPATION

20. LABORATORY AND DIAGNOSTIC TESTS
• Pulse Oxymetry
• Chest X Ray
• Sputum Culture
• Blood Examination
• Bronchoscopy
• Lung Biopsy
• Lung Aspiration

24. MANAGEMENT
• PNEUMOCOCCAL PNEUMONIA
• Penicillin G 50,000 units /kg/day ,IV OR IM ,for 5-7
days
• Procaine penicillin 600,000 units IM/DAY
• Allergic to penicillin alternative amoxicillin or ampicillin
,the alternatives are ceftrioxone /cefotaxime
• Oxygen administration

25. • STAPHYLOCOCCAL PNEUMONIA
• Isolation of patient
• Antipyretics for fever
• Maintain hydration with 5% dextrose
• Antibiotics therapy (penicillin ,erythromycin
,cephalosporin)
• Patient not respond soon vancomycin can use

26. • Hemophilus pneumonia
• Ampicillin 100 to 150 mg /kg /day and
chloramphenicol 50 mg /kg /day in a four divided
dose
• Cefotaxime 100 mg/kg /day or ceftrioxone 70
mg/kg /day are alternatively in seriously ill patient

27. • Streptococcal pneumonia
• Penicillin G 50,000 to 10000 units /kg/day for 7 to
10 days
Supportive care
Antipyretics for fever
Oxygen administration
Maintain hydration with iv fluid
Maintain position

28. • NURSING CARE MANAGEMENT

29. HOME CARE MANAGEMENT
• Increase oral intake
• Provide adequate bed rest
• Frequently check temperature
• Maintain position
• Give antipyretics to reduce fever
• High humid atmosphere
• Regular follow up

30. DIET

31. Complication
• Bactermia
• Sepsis
• Breathing problem
• Lung abscess
• Respiratory distress syndrome
• Pleural thickening

32. Nursing diagnosis
• Ineffective airway clearances related to inflammation,
increased secretions ,mechanical obstruction as evidenced
by presences of secretion ,productive cough ,tachypnea
• Ineffective breathing pattern related to inflammation as
evidenced by tachypnea ,increased work of breathing
• Impaired gas exchange related to hyperinflation airway
plugging as evidenced by cyanosis ,decreased oxygen
level and alteration in blood gases

33. • Risk for infection related to presences of infectious
organism as evidenced by fever or presences of
viruses or bacteria on laboratory screening
• Activity intolerances related to high respiratory
demand as evidenced by increased work of
breathing

34. • Fluid volume deficit related to decreased oral intake
• Altered nutritional status less than body requirement
related to feeding difficulty as evidenced by poor
oral intake
• Fear related to difficulty in breathing ,unfamiliar
situation ,procedures as evidenced by crying
,clinging and lack of co operation

35. Prognosis

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