Peumonia

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Peumonia

  1. 1. Prepared by:-Dr / amany lotfy pneumonia
  2. 2. Definition :- Asthma is an intermittent, reversible, obstructive airway disease, it ismanifested by a narrowing of airway resulting indyspnea, cough and wheezing.Asthma can begin at any age about half of the cases develop in childhood and anther thirdbefore age 40.Asthma is often characterized as allergic, idiopathic Or mixed
  3. 3. Exercise Stress or emotional upset Medications  Aspirin and non steroid anti-inflammatory chugs (NSAlDs), beta-blockers (including eye drops),cholinergic drugs (to promote bladder contraction andas eye drops for glaucoma) .Enzymes- including those in laundry detergents.. Chemicals- toluene and others used in solvents, paints, and plastics
  4. 4. The common symptoms of asthma are cough, dyspnea & wheezing.Asthma attacks frequently occur at night.Attacks starts suddenly with coughing & a sensation of tightness in thechest.Cyanosis secondary to sever hypoxia. Symptoms of carbon dioxide retention - sweating, tachycardia.
  5. 5. Un Status asthmatics occurs in which therapeutic measures fail &thepatient has repeated attacks or continuous asthma.Allergic reaction eczema, urticaria, edema. 
  6. 6. 1-Acomplete history. 2- Reaction skin test. 3-Assessment of environmental factors, including seasonal changes, mold and pollens. Climatechanges.4-Occupation- related chemicals & compounds (metal salts, wood & vegetable dust,pharmacological a gents, industrial chemicals,biologic enzymes - including laundry detergents 5-5-Chest X-ray.6- Sputum examination. Pulmonary function studies
  7. 7. There are five categories of drugs used in the treatment of asthma:Beta antagonist brortchodilatots:eg pinephrine. Methylxanthines - bronchodilator e.g aminophylline Ant cholinergic - broncho-dilatition effect e.g. tropine. Corticosteroids - reduce inflammation & broncho- constrictione.g. hydrocortisone prednisone.5- Mastcell inhibitors: broncho-dilatition g.cromolyn sodium.
  8. 8. Assessment :-ASSESS THE PATIENT RFOR :- History of asthma onset & duration Precipitating factors Current medications Medications used to relieve asthma symptoms Any recent changes in medication regimen , Self-care methods used to relieve symptoms: Assess General appearance. Assess vital signs. Assess laboratory findings.  
  9. 9. Pneumonia is an inflammatory illness of the lung. Frequently,it is described as lungparenchyma/alveolarinflammation and abnormalalveolar filling with fluid
  10. 10. Classification according to the causative  agent:1- Bacterial pneumonia (common * streptococcus;)2- Viral Pneumonia 3- Mycoplasma Pneumonia 4-Aspiration pneumonias syndrome 5-Chemical pneumonia, after ingestion of kerosene or irritation gases
  11. 11. Risk factor/groups: Patients with conditions that produce bronchial obstruction -cancer Immunosuppressed patients Smokers Bed ridden patients Very ill patients who are on nothing by mouth ,Over dose of sedatives- respiratorydepressionAssociated with congestive heart failure diabetes, alcoholism
  12. 12.  Classification ◦ 1.1 Early classification schemes ◦ 1.2 Combined clinical classification  1.2.1 Community-acquired pneumonia  1.2.2 Hospital-acquired pneumonia
  13. 13.  A lobar pneumonia is an infection that only involves a single lobe, or section, of a lung. Lobar pneumonia is often due to Streptococcus pneumonia (though Klebsiella pneumonia is also possible.) Multilobar pneumonia involves more than one lobe, and it often causes a more severe illness.
  14. 14. pneumonia by clinical them into characteristics, dividing1-"acute" (less than three weeks duration) Streptococcuspneumonia2- "chronic" pneumonias. 
  15. 15. is infectious pneumonia in a person who has not recently been hospitalized.Streptococcus pneumonia is the most common cause ofcommunity-acquiredpneumonia
  16. 16. called Nosocomial pneumonia, is pneumoniaacquired during or afterhospitalization for anotherillness or procedure withonset at least 72 hrs afteradmission.
  17. 17. risk factors for pneumonia, including mechanical ventilation,prolonged malnutrition, underlyingheart and lung diseases,decreased amounts of stomachacid, and immune disturbances.
  18. 18. 1- Pneumonia arises from aspiration of flora present in the oropharynx. &blood borne organisms that enter thepulmonary circulation 2-An inflammatory reaction can occur alveoli, producing exudates that in theaffect on ventilation 3-White bloodcells, mostly neutrophils, migrate intothe alveoli. Areas of the lung are notadequately ventilated because ofsecretions and mucosal edema thatcause partial occlusion of the bronchi
  19. 19. 4- Venous blood entering the pulmonary circulation to theleft side of the heart poorlyoxygenated. The mixing ofoxygenated and unoxygenatedblood eventually results inarterial hypoxemia.
  20. 20. Pneumonia Clinical manifestations: 1-Cough producing greenish or yellow sputum, 2- high fever that may be accompanied byshaking chills. 3- Shortness of breath4-pleuritic chest pain, a sharp or stabbing pain,either experienced during deep breaths orcoughs or worsened by them.5- cough up blood, 6-headaches, or develop sweaty and clammy skin.7- Other symptomsare loss of appetite, fatigue, blueness of theskin, nausea, vomiting, mood swings, and jointpains or muscle aches.
  21. 21.  1-Medical interventionDiagnosis:- patients symptoms and findings from physical examination,chest X-ray and blood tests arehelpful, and sputum cultures chest CTscan or other tests may be needed todistinguish pneumonia from otherillnesses. A complete blood countindicating the presence of an infectionor inflammation, in some people withimmune system problems
  22. 22. Management: 1-Administration of appropriate antibiotics as PenicillinTypically, oral antibiotics, rest, fluids, and home care2-people with other medical problems and the elderly may needtreatment that is more advanced.  3-If the symptoms worse, the pneumonia does not improve withhome treatment, or complicationsoccur, the person will often have tobe hospitalized. 
  23. 23.  Prevention  1-treating underlying illnesses (such as AIDS)  2-Smoking cessation  3-Testing pregnant women for Group B Streptococcus and Chlamydia trachomatis, and then giving antibiotic treatment  4 Suctioning the mouth and throat of infants with meconium-stained amniotic fluid decreases the rate of aspiration pneumonia. 5-Vaccination is important for preventing pneumonia in both children and adults.Vaccinations against Haemophilusinfluenza and Streptococcus pneumonia inthe first year of life.
  24. 24. Assessment: .   The nurse should monitor the - following:  • Changes in temperature and pulse  • Amount, odor, and color of secretions  • Frequency and severity of cough  • Degree of Tachypnea or shortness of breath  • Changes in physical assessment findings (primarily assessed by inspecting and auscultation the chest)• Changes in the chest x-ray findings 
  25. 25.  NURSING DIAGNOSES Based on the assessment data, the patient’s major nursing diagnose smay include: -  •1- Ineffective airway clearance related to copious tracheobronchial secretions  •2- Activity intolerance related to impaired respiratory function  • 3-Risk for deficient fluid volume related to fever and dyspnea  • 4-Imbalanced nutrition: less than body requirements• 5-Deficient knowledge about the treatment regimen and preventive health
  26. 26.  Planning and Goals :- The major goals for the patient may include 1- improved airway patency, rest to conserve energy, 2- maintenance of proper fluid volume, maintenance of adequate nutrition, 3- an understanding treatment protocol and preventive measures, 4- absence of complications.
  27. 27.  Nursing Interventions:- 1- IMPROVING AIRWAY PATENCY 2- PROMOTING REST AND CONSERVING ENERGY. 3- PROMOTING FLUID INTAKE 4- MAINTAINING NUTRITION 5- PROMOTING THE PATIENT’S KNOWLEDGE 6- MONITORING AND MANAGING POTENTIAL COMPLICATIONS7- PROMOTING HOME AND COMMUNITY- BASED CARE &Teaching PatientsSelf-Care.
  28. 28. EXPECTED PATIENT OUTCOMES  a -Has normal vital signs, pulse oximetry, and arterial blood gas measurements b. Reports productive cough that diminishes over time c. Has absence of signs or symptoms of shock, respiratory failure, or pleural effusion d. Remains oriented and aware of surroundings e. Maintains or increases weight 8. Complies with treatment protocol and prevention strategies.

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