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PNEUMONIA
Definition
An inflammatory process in
lung parenchyma associated
with a marked increase in
interstitial and alveolar fluid
Etiology & Risk factors
Bacteria
viruses
mycoplasmas
fungal agents
protozoa
Aspiration of food, fluids, / vomitus
Inhalation of toxic/caustic chemicals
smoke, dusts/gases
Influenza
Risk Factors
Advanced age
• History of smoking
• Upper respiratory infection
• Tracheal intubation
• Prolonged immobility
• Immunosuppressive therapy
• Nonfunctional immune system
• Malnutrition
• Dehydration
• Chronic disease state
Recent viral respiratory infection (common cold, laryngitis, influenza)
Difficulty swallowing (due to stroke, dementia, Parkinson's disease, or
other neurological conditions)
Chronic lung disease (Chronic obstructive pulmonary disease (COPD)
bronchiectasis (brochi damage. Thick wall of bronchi), cystic fibrosis)
Cerebral palsy
Other serious illnesses, such as heart disease, liver cirrhosis, /diabetes
mellitus
Exposure to air pollution
Altered consciousness (Alcoholism, Drug overdose, General
anesthesia, Seizure disorder)
Inhalation of noxious substances
Living in a nursing facility
Impaired consciousness (loss of brain function due to
dementia, stroke, or other neurologic conditions)
Recent surgery or trauma
Immune system problem
Patho-physiology
Offending
organism/agent
Inflammatory
pulmonary response
Lose defense
mechanisms of the
lungs
Allow organisms to
penetrate the sterile
LRT
Develop inflamation
Disruption of the mechanical
defenses (cough & ciliary motility)
Colonization of the
lungs
Inflamed & fluid-filled
alveolar sacs
Alveolar exudates tends to
consolidate
Difficult to expectorate
Staphylococcal pneumonia
Caused by Staphylococcus aureus
Symptoms
fever with multiple chills
pleuritic pain
Rales (high-pitched crackling or rattling sound that can occur when
you inhale
decreased breath sounds
elevated WBC count
dyspnea
blood-streaked purulent sputum
Influenzal pneumonia
Caused by Haemophilus influenza.
Symptoms
high fever
stabbing pleuritic chest pain
malaise.
weakness
weakness
elevated WBC count
tachypnea ( breathe faster and shallower than normal, often due to an
imbalance of oxygen and carbon dioxide in your body)
dyspnea (Shortness of breath)
blood-tinged purulent sputum
Gram-negative bacterial pneumonia:
Caused by Klebsiella pneumonia
Symptoms
fever with multiple chills
pleuritic pain
rales
Cyanosis (Difficulty in the breathing)
elevated WBC count
dyspnea
blood-streaked purulent sputum
Anaerobic bacterial pneumonia
Caused by normal oral flora
Symptoms
low-grade fever
hypertension
crackles
cyanosis
elevated WBC count
dyspnea
foul smelling purulent sputum
tachycardia
Pneumococcal pneumonia
Caused by Streptococcus pneumonia
Symptoms
high fever
stabbing pleuritic chest pain
malaise
weakness
elevated WBC count
tachypnea
dyspnea
blood-streaked purulent sputum
Legionnaires’ disease
Caused by Legionella pneumophila
Symptoms
fever
pleuritic pain
nausea
confusion
elevated WBC count
dyspnea
blood-tinged sputum
Mycoplasma pneumonia
Caused by Mycoplasma microorganisms
Symptoms
slowly rising fever
headache
myalgia
malaise
normal WBC count
mucoid sputum
Viral pneumonia
Caused by Influenza A virus
Symptoms
high fever
headache
myalgia
Dyspnea
normal/slightly WBC count
mucoid sputum
normal breath sounds
Aspiration pneumonia
Caused by aspiration of gastric contents
Symptoms
Tachypnea
Apnea
Cyanosis
Hypotension
Leukocytosis
Adventitious lung sounds
Fever
Clinical manifestations
Fever
Chills
Sweats
Pleuritic chest pain
Cough
Sputum production
Hemoptysis – coughing up of blood
Dyspnea
Headache & fatigue
Diagnostic evaluation
Chest auscultation
Sputum culture analysis
& sensitivity/ serologic
testing
Fiber optic
bronchoscopy/
Transcutaneous needle
aspiration/ biopsy
Skin tests
Blood & urine cultures
Transcutaneous oxygen
level analysis/ ABG
measurements
Chest X-ray examination
Classification
Based on area affected
Segmental pneumonia
Lobar pneumonia air sac filled with pus
Bilateral pneumonia
Basis of location & radiologic
appearance
Bronchopneumonia
Interstitial(
reticular)
pneumonia
.
Alveolar(acinar)
pneumonia.
Necrotizing
pneumonia
.
Medical Management
Specific
antibiotic
therapy:
Broad spectrum antibiotics
Respiratory
support
Nutritional
support
Fluid &
electrolyte
management
Respiratory
support
Administer
oxygen
Bronchodilator
medications
Postural
drainage
Chest
physiotherapy
Tracheal
suctioning
Nursing management
Ineffective airway clearance due to excessive secretions & weak
cough.
Ineffective breathing pattern due to tachypnea.
Activity intolerance due to decreased oxygen levels for metabolic
demands.
Deficient fluid volume due to fever,
Nursing management
diaphoresis (Sweating that does not occur due to heat but
follows a sudden chill feeling in the body)
mouth breathing
Imbalanced nutrition: less than body requirements R/t
dyspnea
Pain R/t frequent coughing
Impaired oral mucous membrane R/t mouth breathing &
frequent cough
Possible complications
Respiratory failure
Empyema or lung abscesses ( pus formation)
These are infrequent, but serious, complications of pneumonia
They occur when pockets of pus form inside or around the lung
These may sometimes need to be drained with surgery
Sepsis, a condition in which there is uncontrolled swelling
(inflammation) in the body, which may lead to organ failure
Acute respiratory distress syndrome (ARDS), a severe form of
respiratory failure
Pneumonia At A Glance
Pneumonia is a lung infection that can be caused by different types
of microorganisms, including bacteria, viruses, and fungi
Symptoms of pneumonia include cough with sputum production,
fever, and sharp chest pain on inspiration (breathing in)
Pneumonia is suspected when a doctor hears abnormal sounds in
the chest, and the diagnosis is confirmed by a chest x-ray
Bacteria causing pneumonia can be identified by sputum culture
PNEUMONIA.pptx

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PNEUMONIA.pptx

  • 2. Definition An inflammatory process in lung parenchyma associated with a marked increase in interstitial and alveolar fluid
  • 3. Etiology & Risk factors Bacteria viruses mycoplasmas fungal agents protozoa Aspiration of food, fluids, / vomitus Inhalation of toxic/caustic chemicals smoke, dusts/gases Influenza
  • 4. Risk Factors Advanced age • History of smoking • Upper respiratory infection • Tracheal intubation • Prolonged immobility • Immunosuppressive therapy • Nonfunctional immune system • Malnutrition • Dehydration • Chronic disease state
  • 5. Recent viral respiratory infection (common cold, laryngitis, influenza) Difficulty swallowing (due to stroke, dementia, Parkinson's disease, or other neurological conditions) Chronic lung disease (Chronic obstructive pulmonary disease (COPD) bronchiectasis (brochi damage. Thick wall of bronchi), cystic fibrosis) Cerebral palsy Other serious illnesses, such as heart disease, liver cirrhosis, /diabetes mellitus
  • 6. Exposure to air pollution Altered consciousness (Alcoholism, Drug overdose, General anesthesia, Seizure disorder) Inhalation of noxious substances Living in a nursing facility Impaired consciousness (loss of brain function due to dementia, stroke, or other neurologic conditions) Recent surgery or trauma Immune system problem
  • 8. Offending organism/agent Inflammatory pulmonary response Lose defense mechanisms of the lungs Allow organisms to penetrate the sterile LRT Develop inflamation Disruption of the mechanical defenses (cough & ciliary motility) Colonization of the lungs Inflamed & fluid-filled alveolar sacs Alveolar exudates tends to consolidate Difficult to expectorate
  • 9. Staphylococcal pneumonia Caused by Staphylococcus aureus Symptoms fever with multiple chills pleuritic pain Rales (high-pitched crackling or rattling sound that can occur when you inhale decreased breath sounds elevated WBC count dyspnea blood-streaked purulent sputum
  • 10. Influenzal pneumonia Caused by Haemophilus influenza. Symptoms high fever stabbing pleuritic chest pain malaise. weakness
  • 11. weakness elevated WBC count tachypnea ( breathe faster and shallower than normal, often due to an imbalance of oxygen and carbon dioxide in your body) dyspnea (Shortness of breath) blood-tinged purulent sputum
  • 12. Gram-negative bacterial pneumonia: Caused by Klebsiella pneumonia Symptoms fever with multiple chills pleuritic pain rales Cyanosis (Difficulty in the breathing) elevated WBC count dyspnea blood-streaked purulent sputum
  • 13. Anaerobic bacterial pneumonia Caused by normal oral flora Symptoms low-grade fever hypertension crackles cyanosis elevated WBC count dyspnea foul smelling purulent sputum tachycardia
  • 14. Pneumococcal pneumonia Caused by Streptococcus pneumonia Symptoms high fever stabbing pleuritic chest pain malaise weakness elevated WBC count tachypnea dyspnea blood-streaked purulent sputum
  • 15. Legionnaires’ disease Caused by Legionella pneumophila Symptoms fever pleuritic pain nausea confusion elevated WBC count dyspnea blood-tinged sputum
  • 16. Mycoplasma pneumonia Caused by Mycoplasma microorganisms Symptoms slowly rising fever headache myalgia malaise normal WBC count mucoid sputum
  • 17. Viral pneumonia Caused by Influenza A virus Symptoms high fever headache myalgia Dyspnea normal/slightly WBC count mucoid sputum normal breath sounds
  • 18. Aspiration pneumonia Caused by aspiration of gastric contents Symptoms Tachypnea Apnea Cyanosis Hypotension Leukocytosis Adventitious lung sounds Fever
  • 19. Clinical manifestations Fever Chills Sweats Pleuritic chest pain Cough Sputum production Hemoptysis – coughing up of blood Dyspnea Headache & fatigue
  • 20. Diagnostic evaluation Chest auscultation Sputum culture analysis & sensitivity/ serologic testing Fiber optic bronchoscopy/ Transcutaneous needle aspiration/ biopsy Skin tests Blood & urine cultures Transcutaneous oxygen level analysis/ ABG measurements Chest X-ray examination
  • 21. Classification Based on area affected Segmental pneumonia Lobar pneumonia air sac filled with pus Bilateral pneumonia
  • 22. Basis of location & radiologic appearance Bronchopneumonia Interstitial( reticular) pneumonia . Alveolar(acinar) pneumonia. Necrotizing pneumonia .
  • 23. Medical Management Specific antibiotic therapy: Broad spectrum antibiotics Respiratory support Nutritional support Fluid & electrolyte management
  • 25. Nursing management Ineffective airway clearance due to excessive secretions & weak cough. Ineffective breathing pattern due to tachypnea. Activity intolerance due to decreased oxygen levels for metabolic demands. Deficient fluid volume due to fever,
  • 26. Nursing management diaphoresis (Sweating that does not occur due to heat but follows a sudden chill feeling in the body) mouth breathing Imbalanced nutrition: less than body requirements R/t dyspnea Pain R/t frequent coughing Impaired oral mucous membrane R/t mouth breathing & frequent cough
  • 27. Possible complications Respiratory failure Empyema or lung abscesses ( pus formation) These are infrequent, but serious, complications of pneumonia They occur when pockets of pus form inside or around the lung These may sometimes need to be drained with surgery Sepsis, a condition in which there is uncontrolled swelling (inflammation) in the body, which may lead to organ failure Acute respiratory distress syndrome (ARDS), a severe form of respiratory failure
  • 28. Pneumonia At A Glance Pneumonia is a lung infection that can be caused by different types of microorganisms, including bacteria, viruses, and fungi Symptoms of pneumonia include cough with sputum production, fever, and sharp chest pain on inspiration (breathing in) Pneumonia is suspected when a doctor hears abnormal sounds in the chest, and the diagnosis is confirmed by a chest x-ray Bacteria causing pneumonia can be identified by sputum culture