2. LEARNING OBJECTIVES
• Definition
• Mode of transmission
• Classification of pneumonia
• Causes
• Signs and symptoms
• investigations
• Management
• Nursing care
• compliactions
3. Definition
• It’s the inflammation of the pulmonary parenchyma
• Is common but occurs more frequently in early child hood.
• Clinically pneumonia may occur either as a primary disease or as a
complication of another illness.
4. Mode of transmission
• The causative agent is either inhaled into the lungs directly or comes
from blood stream.
5. Classification of pneumonia
• The most useful classification of pneumonia is based on the etiologic
agent(viral,bacterial,mycoplasmal or aspiration of foreign substances)
• It could be classified on the part of the lung affected (as lobar or
Broncho pneumonia)
• A pneumonia infection can also be classified based on how it is
acquired and can be categorized into ( community-
acquired, hospital-acquired, healthcare-acquired, or aspiration
pneumonia).
6. Cont
• Neonates: Group B streptococci,gram negative enteric
bacteria,cytomegalo virus,C trachomatis
• Infants: RSV,para influenza,virus influenza,adeno virus,S.pneumonia
• Pre school children:RSV,para influenza,influenza virus,M .tuberculosis
• School age children:M.pneumonia,chlamydia pnuemoniae and
respiratory viruses.
8. Clinical manifestation
• The clinical manifestation of pneumonia depend on the etiologic
agent, the child’s age,the child’s systemic reaction to the infection,
the extent of the lesions and the degree of bronchial and bronchiolar
obstruction.
• The causative agent is identified from the clinical history,the child’s
age,the general health history,the physical examination ,radiography
and laboratory investigationn.signs and symptoms include:
• Cough(unproductive to productive with whitish sputum)
• Tachypnea
• Breath sounds:crackles,decreased breath sounds
9. cont
• Dullness with percussion
• Chest pain
• Sweating
• Checking chills
• fever
• dyspnea
• Retractions
• Nasal flaring
• Pallor to cyanosis(depends of severity)
• Chest radiography:Diffuse or patchy infiltration with peribronchial distribution
• Behaviour:malaise,irritability,restlessness,malaise,lethargy
11. Investigations
• CBC to R/o bacterial infection
• Chest X ray
• Pulse oximetry to measure the level of oxygen in blood
• Sputum analysis
• Bronchoscopy to check for airway blockages and other problems
• Arterial blood gases
• A CT scan to get a more detailed image of your lungs
• A pleural fluid culture, in which the doctor removes a small amount of fluid
from the tissues around your lungs to look for bacteria that might cause
pneumonia
12. Management
• Management depends on the clinical manifestion.This will include
• Admit infant on a pead ward or SCU
• Administration of oxygen using a CPAP
• Administer corticosteriods such as IV hydrocortizone
• IV antibiotics e.g ceftriaxone,cefotaxime 1omg/kg
• Anti pyretics for fever such as rectal cetamol 125mg
• Adminnister prescribed analgesia such as cetamol
• Broncho dilators such as salbutamol 2.5mls in 3mls of NS is administered through
nebulization
• Monitering oxygen circulation using a pulse oximetry
• Monitor vital observations such as T,P,R and Bp
• Provision of warmth
13. cont
• D10 5mls /kg to prevent hydration
• Insert Ng tube for feeding
• Cord cleaning if neonate has a cord
• Hydration with IV fluids to prevent dehydration and electrolyte
imbalance with NNC (5mls /kg)
• Sunctioning of secretions or clearing airway to maintain a patent
airway esp with infants with ineffectual; cough or difficulty in
handling secretions
14. Nursing care mgt
• Respiratory assessment
• Proper positioning of the infant or patient in semi erect position to
allow lung expansion
• Administration of oxygen
• Administration of prescribed medication and IV fluids
• Monitor proper function of chest tubes and drainage devices if a
patient has them.
• Encourage child to move out of bed to improve respiratory function.
15. complications
• Acute respiratory distress syndrome (ARDS). This is a severe form of
respiratory failure.
• Lung abscesses. These are pockets of pus that form inside or around
the lung.
• Empyema
• Pleural effusion
• Respiratory failure. This requires the use of a breathing machine or
ventilator.
• Sepsis.
16. prevention
• Vaccination with pneumococcal vaccine
• Adequate nutrition
• Good personal hygiene
• Social life style change like avoid smoking during pregnancy
• Get flu vaccine each year to avoid flu infections
