paediatrics for nursing students

1. PNEUMONIA
PAULINE TEMBO (RN,BSC)

2. PNEUMONIA
Introduction
 Pneumonia is an inflammatory
condition of the lung—affecting
primarily the microscopic air sacs
known as alveoli. it is usually caused by
infection with viruses or bacteria and
less commonly other microorganisms,
certain drugs and other conditions
such as autoimmune diseases.

3.  DEFINITIONS
 Pneumonia is an acute inflammation of
the lung parenchyma caused by a
microbial agents (Lewis etal, 2004).

4. CLASSIFICATIONS OF PNEUMONIA
Pneumonia can be classified in several
ways.
 Based on microbiological etiology, it
may be:
 Bacterial (the most common cause of
pneumonia)
 Viral pneumonia

5.  Fungal pneumonia
 Parasitic pneumonia
 Chemical pneumonia (ingestion of
kerosene or inhalation of irritating
substance)
 Inhalation pneumonia (aspiration
pneumonia)

6.  Based on the Location it may be:
 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. It involves distal airways and
alveoli.

7. PREDISPOSING FACTORS TO PNEUMONIA
 Upper respiratory tract infections ie
croup
 Decreased consciousness depresses the
cough reflex
 Tracheal intubation interferes with the
normal cough reflex
 Air pollution or inhaling toxic materials ie
smoke

8. CAUSES OF PNEUMONIA
 Bacteria
 Viruses
 Fungi
 Parasites

9. SIGNS AND SYMPTOMS
 In children under 5 years of age, who have
cough and/or difficult breathing, with or
without fever, pneumonia is diagnosed by
the presence of either fast breathing or
lower chest wall indrawing.
 Fever due to presence of infection
 Failing to suck or feed due to airway
obstruction

10. CONT….
 Cough
 breathing with grunting or wheezing
sounds
 Use of intercostal muscles when
breathing
 Lethargy and restless
 Nasal flaring
 Cyanosis

11. INVESTIGATION
 History taking will reveal the
predisposing factors
 Physical examination will reveal signs
and symptoms like nasal flaring, chest in
drawing etc .
 Chest x-rays disclose infiltrates,
confirming the diagnosis.

12. CONT..
 Culture of the sputum to isolate the
causative organism
 Full Blood Count will reveal raised
leucocytosis
 Blood cultures reflect bacteraemia and
help determine the causative organism

13. TREATMENT
 Antibiotics - depending on the organisms
isolated the following drugs can be given:
 Benzyl penicillin
- Premature infants and neonates 50mg/kg
body weight in 2 divided doses
- Infants 1-4 weeks 75mg/kg body weight in 3
divided doses
 Amoxicillin can be given in mild cases of
pneumonia.
Dosage 125 mg/ 5mls TDS for 5 days.

14.  Bronchodilators therapy- salbutamol 2-
4mg TDS
 Increased fluid intake
 Antipyretics such as calpol 125mg TDS
for 3 days
 Humidified Oxygen therapy

15. COMPLICATIONS
 Pleurisy – Inflammation of the pleura due
to spread of infection.
 Pleural effusion- Accumulation of fluids
in the pleural cavity
 Atelectasis - Collapsed airless lungs
 Lung abscess- Due to presence of
bacteria

16.  Empyema - Accumulation of purulent exudates
in the pleural cavity
 Pericarditis – Results from spread of infecting
organism from an infected pleura or via a
hematogenous route to the pericardium
 Septic shock- This comes as a result of
septicemia
 Respiratory failure -This is the inability of the
respiratory apparatus to maintain adequate
oxygenation of the blood, with or without
carbon dioxide retention as a result of damage