PNEUMONIA for adult nursing

1. Prepared by:
RN Arpana bhusal
BNS
7/24/2022 1

2. 7/24/2022 2

3. 7/24/2022
3

4. Definition
Pneumonia classification
pathophysiology of pneumonia
Risk factors
Sign and symptoms
7/24/2022 4

5.  Diagnostic tests
 medical management
 Nursing management
 Prevention
 Complication of pneumonia
7/24/2022 5

6. Fig:-Pneumonia
7/24/2022 6

7.  Pneumonia is the infection and inflammation
of the lung parenchyma tissues that impairs gas
exchanges..
 It is the commonest cause of mortality and
morbidity of children below 5 years of age.
 The elderly are also at high risk.
7/24/2022 7

9.  Etiological types
Infective
 viral (influenza)
 Bacterial
(streptococcus
pneumoniae)
 fungal
 mycobacterial
Non-infective
 toxins
 chemicals
 aspiration
7/24/2022 9

10. 7/24/2022 10
Morphological types
 Lobar pneumonia
 Bronchopneumonia
 Interstitial
Duration
 Acute
 Chronic
Clinical
 Primary/Secondary
 Typical/Atypical
 Community acquired/
Hospital acquired

11. 7/24/2022 11

12. 7/24/2022 12

13.  Age- very young age children (up to 5 yrs)
 Poor socio-economic condition
 Malnutrition
 Vitamin A deficiency
 Low birth weight
7/24/2022 13

14.  Lack of breastfeeding
 Previous history of respiratory tract infection
 Passive smoking, immobility
 Indoor and outdoor environmental pollution
 Family history of bronchitis
7/24/2022 14

15.  Sudden onset of fever (102F-104F)
 Chills
 Cough (unproductive to productive with whitish sputum)
 Tachypnoea
 Dyspnoea
 Chest pain
 Chest indrawing
7/24/2022 15

16.  Nasal flaring
 Pallor/Cyanosis
 Behaviour : Irritable, restless, and lethargic
 GI: Anorexia, vomiting, diarrhea, abdominal pain
 Dull on percussion
On auscultation:-
 Diminished breath sounds on affected areas
7/24/2022 16

17. 7/24/2022 17

18.  History taking
 Physical examination
 Chest radiography: patchy infiltration,
consolidation, disseminated infiltration, patchy
clouding
7/24/2022 18

19.  Complete blood cell count (CBC): reveal
leucocytosis
 Blood Cultures, gram stain, sputum culture: reveal
the causative organism
 Positive Anti streptolysin -o (ASO) titre :
diagnostic of streptococcal pneumonia.
7/24/2022 19

20.  Antibiotics are prescribed on the basis of Gram stain
results and antibiotic guidelines (resistance patterns,
risk factors, etiology must be considered).
Combination therapy may also be used.
 Supportive treatment includes hydration, antipyretics
for fever , antitussive medications for treat cough,
antihistamines, or nasal decongestants.
 Bed rest is recommended until infection shows signs
of clearing.
7/24/2022 20

21.  Oxygen therapy is given for hypoxemia.
 Respiratory support includes high inspiratory
oxygen concentrations, endotracheal intubation,
and mechanical ventilation.
 Treatment of atelectasis, pleural effusion, shock,
respiratory failure, or super infection.
 For groups at high risk for CAP, pneumococcal
vaccination is advised
7/24/2022 21

22. Asessment:
 Assess respiratory symptoms: sypmtoms of fever,
chills or night sweats (signs of bacterial
pneumonia)
 Assess clinical manifestations: (bradycardia,
trachypnea, pain)
 Physical assessment :for body temperature, pulse
,amount odor and color of secretions shortness of
breath
7/24/2022 22

23.  Actual diagnosis:
 Impaired gas exchange related to cough
production,
 Ineffective airway clearance related to presence of
inflammation in bronchial walls ,
 Ineffective breathing pattern,
 Knowledge deficit/Deficient knowledge about the
treatment regimen and preventive health measure
7/24/2022 23

24.  Potential diagnosis:
 Risk for infection,
 Risk for nutritional imbalance: less than body
requirements
 Risk for deficient fluid volume related to fever and
dyspnea
7/24/2022 24

25.  Correcting breathing pattern
 Assess for hypoxia, signs of respiratory
distress, shock such as labored breathing, cold
clammy skin, cyanosis, headache, restlessness
and change in mental status
 Monitor vital signs, oximetery, and ABG
analysis for oxygenation.
 Monitor oxygen therapy used to relieve
hypoxemia
7/24/2022 25

26.  Collect sputum specimen for c/s tests in a
sterile container; notify the physician if
organism is resistant to the antibiotics being
given
 Encourage deep breathing and coughing
exercises after chest physiotherapy.
 Instruct patient to cover nose and mouth while
coughing
7/24/2022 26

27.  Rest and sleep
 Patient should be kept in bed rest to reduce oxygen
demand.
 Encourage use of relaxation techniques and
diversional activities.
 Position with head of bed should be slightly
elevated.
 Maintain semi-fowler’s position
7/24/2022 27

28.  Relieving pain
 Watch patient for signs of discomfort and
pain.
 Maintain semi-fowler’s position.
 Ascertain if pain worsens with deep breathing
and coughing: auscultate for friction rub.
 Give prescribed medicine, and monitor for
pain relief and signs of respiratory depression.
7/24/2022 28

29.  Reducing anxiety
 Correct dyspnea and relief physical
discomfort.
 Explain diagnostic procedures and the patients
role : correct misconception.
 Listen to patient concerns; attentive listening
relieves anxiety and reduces emotional
distress.
 Speak calmly and slowly.
7/24/2022 29

30.  Get the flu vaccine each year. People can develop
bacterial pneumonia after a case of the flu
 Get the pneumococcal vaccine
 Practice good hygiene
 Increase fluid intake upto 3liters/ day.
 Plan rest period, balance between rest and activity.
7/24/2022 30

31.  Teach preventive measures:role of nutrition and
fluids, vaccination against streptococcus
pneumonia and influenza.
 Wash your hands regularly, especially after you go
to the bathroom and before you eat.
 Eat right, with plenty of fruits and vegetables.
 Encourage for exercise.
 Get enough sleep.
 Quit smoking.
7/24/2022 31

32.  Pulmonary: Collapse, Delayed Resolution, Lung
Abscess,
 Pleural: Empyema, Pneumothorax, Effusion,
 Airway: Bronchiectasis, Sinusitis
 Cardiovascular: CCF, Shock, Endocarditis
 Extra- Thoracic: Septicemia, Meningitis,
Osteomyelitis, Febrile Convulsion, Acute
Haemolytic Anemia
7/24/2022 32

33.  Mandal G.N, Textbook of medical surgical nursing
(adult nursing) published by Makalu publication
house, 3rd edition, page no. 66-67
 Brunner and siddarth, Textbook of Medical-
Surgical Nursing, 13th edition, page no. 573-582,
605
 https://www.google.com/search?client=firefox-b-
d&q=pneumonia 2078/03/09@8pm
7/24/2022 33

34. 7/24/2022 34