respiratory disorder

1. PNEUMONIA

3. Pneumonia
contents
 introduction
 Classification of pneumonia
 According to causes
 According to area involved
 pathophysiology
 Etiology and risk factors
 Clinical manifestations
 Diagnostic tests
 Medical management
 Nursing intervention
 Preventive measures
 Prognosis
 Complications

4. Pneumonia
introduction
Is an inflammatory process of the lung
parenchyma that is commonly caused
by infectious agents.
Pneumonia are mainly affected the
microscopic air sac known as ALVEOLI .
It is cause by streptococcus pneumoniae.
In this condition accumulation of fluid in
alveoli.

6. classification of pneumonia
Pneumonia are classified into four
types…
1Community – acquired pneumonia
2 hospital acquired pneumonia
3 pneumonia in the
immunocompromised host
4 aspiration pneumonia

7. Community acquired pneumonia
 Most people get CAP by breathing in germ that live in the mouth
nose and throat
 Streptococcus pneumonia are the most common cause of the CAP.
 It is gram positive organism.
 Viral pathogen include in pneumonia are –
 Herpes simplex and adenovirus.

8. Hospital acquired pneumonia
 HAP also known as nosocomial pneumonia.
 This type of pneumonia due to exposed to the potential
bacteria from other sources
 Ex. Respiratory therapy device and equipment transmission
of pathogen by the hand of health personnel
 The common organism responsible for HAP include the
pathogen enterobacter species , Escherichia coli , H
influenza and staphylococcus.

9. Pneumonia in the immunocompromised
host
 Pneumonia in the immunocompromised host occurs with use of-
corticosteroid
immunosuppressive agents
 Chemotherapy
 Nutritional depletion
 Use of broad spectrum antimicrobial agents
 AIDS
 genetic disorder
 Bacteria are –
 Pseudomonas , e coli

10. Aspiration pneumonia
 Aspiration pneumonia refers to entry of exogenous or
endogenous substance into the lower airway.
 Gastric contents , exogenous or ingestion may impair in the
lungs
 This lead to bact. growth and resulting pneumonia .

12. Classification of pneumonia (cont…)
According 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.

14. Pneumonia
Mode of transmission
Ways you can get pneumonia include:
 Bacteria and viruses living in your nose, sinuses,
or mouth may spread to your lungs.
 You may breathe some of these germs directly
into your lungs (droplets infection).
 You breathe in (inhale) food, liquids, vomit, or
fluids from the mouth into your lungs (aspiration
pneumonia).

15. Pneumonia
risk factor
Immuno-suppresed patients
Cigarette smoking
Difficult swallowing (due to stroke,
dementia,parkinsons disease, or other
neurological conditions)
Alcoholism
malnutrition

16. Pneumonia
Chronic lung disease {COPD}
Other serious illness such as heart
disease, liver cirrhosis, and DM
Recent cold, laryngitis or flu

18. pathophysiology
Streptococcus pneumonia a major cause of
bacterial pneumonia , generally resides in the
nasopharynx.
 The streptococci reach the alveoli. They
multiply in the alveolus and invade alveolar
epithelium. to inflammation and pouring of an
exudates into the air space.
WBCs migrates to alveoli, become more

21. Pneumonia
Pathophysiology conti…
 This will lead to partial occlusion of alveoli and
bronchi causing decrease in alveolar oxygen
content.
 Venous blood that goes to affected areas
without being oxygenated and return to the
heart. This will lead to arterial hypoxemia and
even death due to interference with
ventilation.

23. Pneumonia
Clinical manifestations
 chills
 Rapidly rising fever ( 39.5 to 40.5 degree)
 Stabbing chest pain aggravated by respiration and
coughing
 Tachypnea, nasal flaring
 Patient is very ill and lies on the affected side to
decrease pain
 Deep breathing

24.  Use of accessory muscles of respiration e.g. abdomen
and intercostal muscles
 Cough with purulent, blood tinged, rusty sputum
 Shortness of breath
 low energy, and fatigue
 Cyanosed lips and nail beds

26. Pneumonia
Diagnostic tests
History taking
Physical examination
Chest x-ray
Blood test
Sputum culture

28. Pneumonia
medical managment
antibiotic, depending on
sputum and blood culture
Oxygen therapy
Chest physiotherapy

31. Fluid and electrolyte
balance
Bronchodilator medication
Nasotrachial suctioning may
be used to maintain airway
patency.

33. Pneumonia
Nursing intervention
 Maintain a patent airway and
adequate oxygenation.
 Obtain sputum specimens as
needed.
 Use suction if the patient can’t
produce a specimen.
 perform chest physiotherapy.

34. Pneumonia
Nursing intervention (cont…)
 Provide a high calorie, high protein diet of soft
foods.
 To prevent aspiration during nasogastric tube
feedings, check the position of tube, and
administer feedings slowly.
 To control the spread of infection, dispose
secretions properly.

36. Pneumonia
Nursing 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.

37. Pneumonia
Preventive measures
 Removing secretion is important because
retained secretion interfere with gas exchange.
 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.

38. Pneumonia
Prognosis
With treatment, most patients will
improve within 2 weeks.
Elderly or very sick patients may need
longer treatment.

39. Pneumonia
Complications
Acute respiratory distress syndrome
(ARDS)
Pleural effusion
Lung abscess
Respiratory failure (which requires
mechanical ventilator)
Sepsis, which may lead to organ failure

41. FOR ANY MISTAKE

42. FOR YOUR ATTENTION
Any Queries
BY -- HARIOM SUMAN
[ bittu ]

43. WISH YOU
ALL THE BEST