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Pneumonia
 Marnelle Joy S. Pulmano, BSN, RN
OVERVIEW
Definition
• An infection and/or inflammation
  of the interstitial tissues of the
  lung
• Fluid, WBC, and cellular debris
  from phagocytosis of the
  infectious agent accumulate in
  the alveoli
Incidence
• Approximately 50% are
  bacterial
   25-30% of all CAP are
     pneumococcal pneumonia
   40,000 deaths annually
• Mycoplasma accounts for 20%
  of cases
Onset
• Varies according to type of
  pneumonia
Etiology
• Causes:
  Viruses
  Bacteria
  Fungi
  Inhalation of vomitus, food,
   liquid, gases
• TB and other respiratory
  diseases can also secondarily
  cause pneumonia
Clinical Findings
•   Fever
•   Productive cough
•   Substernal pain and discomfort
•   Shortness of breath
Clinical Findings
• Crackles on auscultation
• Increased fremitus
• Dullness on percussion over
  affected lobe(s)
3 TYPES OF PNEUMONIA
Primary Pneumonia
• Caused by inhalation or
  aspiration of a bacterial or viral
  pathogen into the lower
  respiratory tract
Secondary Pneumonia
• Results from lung injury that
  was caused by the spread of
  bacteria from an infection
  elsewhere in the body
• Inhalation of a noxious
  chemical, which can precipitate
  ARDS
Aspiration Pneumonia
• Caused by aspiration of foreign
  matter such as food, vomitus, or
  secretions into the bronchial
  tree
• Risk factors:
   Old age, decreased gag
     reflex, anesthesia and
     sedation, debilitation, ALOC
NURSING FOCUS
• Position patient to facilitate an
  open airway and ease breathing
   HOB: 30-45°
• Encourage coughing and deep
  breathing every 2 hours
• Suction the airway to clear
  secretions as needed
• Encourage fluids as ordered
• If antibiotic therapy is started,
  closely monitor routine peak
  and trough levels
PATIENT TEACHING
• Provide patient and family with
  literature on pneumonia
• Explain the dosages, route,
  actions, adverse reactions of
  meds
• Stress the importance of limiting
  activity and resting frequently to
  avoid fatigue
• Explain that combined fluid
  intake should be at least 3L/day
   Liquid, soup, jello
• Explain that coughing, deep
  breathing, incentive spirometry
  promote healing and help
  prevent recurrence
• Teach patient to eat small,
  frequent meals to maintain
  adequate nutrition
• Provide literature on smoking
  cessation to patient who
  smokes
• Advise patients over age 65 and
  those in high risk groups to
  receive pneumonia vaccine
Pneumonia

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Pneumonia

  • 1. Pneumonia Marnelle Joy S. Pulmano, BSN, RN
  • 3. Definition • An infection and/or inflammation of the interstitial tissues of the lung • Fluid, WBC, and cellular debris from phagocytosis of the infectious agent accumulate in the alveoli
  • 4. Incidence • Approximately 50% are bacterial 25-30% of all CAP are pneumococcal pneumonia 40,000 deaths annually • Mycoplasma accounts for 20% of cases
  • 5. Onset • Varies according to type of pneumonia
  • 6. Etiology • Causes: Viruses Bacteria Fungi Inhalation of vomitus, food, liquid, gases
  • 7. • TB and other respiratory diseases can also secondarily cause pneumonia
  • 8. Clinical Findings • Fever • Productive cough • Substernal pain and discomfort • Shortness of breath
  • 9. Clinical Findings • Crackles on auscultation • Increased fremitus • Dullness on percussion over affected lobe(s)
  • 10. 3 TYPES OF PNEUMONIA
  • 11. Primary Pneumonia • Caused by inhalation or aspiration of a bacterial or viral pathogen into the lower respiratory tract
  • 12. Secondary Pneumonia • Results from lung injury that was caused by the spread of bacteria from an infection elsewhere in the body • Inhalation of a noxious chemical, which can precipitate ARDS
  • 13. Aspiration Pneumonia • Caused by aspiration of foreign matter such as food, vomitus, or secretions into the bronchial tree • Risk factors: Old age, decreased gag reflex, anesthesia and sedation, debilitation, ALOC
  • 15. • Position patient to facilitate an open airway and ease breathing HOB: 30-45° • Encourage coughing and deep breathing every 2 hours
  • 16. • Suction the airway to clear secretions as needed • Encourage fluids as ordered • If antibiotic therapy is started, closely monitor routine peak and trough levels
  • 18. • Provide patient and family with literature on pneumonia • Explain the dosages, route, actions, adverse reactions of meds • Stress the importance of limiting activity and resting frequently to avoid fatigue
  • 19. • Explain that combined fluid intake should be at least 3L/day Liquid, soup, jello • Explain that coughing, deep breathing, incentive spirometry promote healing and help prevent recurrence
  • 20. • Teach patient to eat small, frequent meals to maintain adequate nutrition • Provide literature on smoking cessation to patient who smokes • Advise patients over age 65 and those in high risk groups to receive pneumonia vaccine