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Pneumonia

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  • 1. Pneumonia Marnelle Joy S. Pulmano, BSN, RN
  • 2. OVERVIEW
  • 3. Definition• An infection and/or inflammation of the interstitial tissues of the lung• Fluid, WBC, and cellular debris from phagocytosis of the infectious agent accumulate in the alveoli
  • 4. Incidence• Approximately 50% are bacterial 25-30% of all CAP are pneumococcal pneumonia 40,000 deaths annually• Mycoplasma accounts for 20% of cases
  • 5. Onset• Varies according to type of pneumonia
  • 6. Etiology• Causes: Viruses Bacteria Fungi Inhalation of vomitus, food, liquid, gases
  • 7. • TB and other respiratory diseases can also secondarily cause pneumonia
  • 8. Clinical Findings• Fever• Productive cough• Substernal pain and discomfort• Shortness of breath
  • 9. Clinical Findings• Crackles on auscultation• Increased fremitus• Dullness on percussion over affected lobe(s)
  • 10. 3 TYPES OF PNEUMONIA
  • 11. Primary Pneumonia• Caused by inhalation or aspiration of a bacterial or viral pathogen into the lower respiratory tract
  • 12. Secondary Pneumonia• Results from lung injury that was caused by the spread of bacteria from an infection elsewhere in the body• Inhalation of a noxious chemical, which can precipitate ARDS
  • 13. Aspiration Pneumonia• Caused by aspiration of foreign matter such as food, vomitus, or secretions into the bronchial tree• Risk factors: Old age, decreased gag reflex, anesthesia and sedation, debilitation, ALOC
  • 14. NURSING FOCUS
  • 15. • Position patient to facilitate an open airway and ease breathing HOB: 30-45°• Encourage coughing and deep breathing every 2 hours
  • 16. • Suction the airway to clear secretions as needed• Encourage fluids as ordered• If antibiotic therapy is started, closely monitor routine peak and trough levels
  • 17. PATIENT TEACHING
  • 18. • Provide patient and family with literature on pneumonia• Explain the dosages, route, actions, adverse reactions of meds• Stress the importance of limiting activity and resting frequently to avoid fatigue
  • 19. • Explain that combined fluid intake should be at least 3L/day Liquid, soup, jello• Explain that coughing, deep breathing, incentive spirometry promote healing and help prevent recurrence
  • 20. • Teach patient to eat small, frequent meals to maintain adequate nutrition• Provide literature on smoking cessation to patient who smokes• Advise patients over age 65 and those in high risk groups to receive pneumonia vaccine