- Bronchopneumonia is an inflammatory process involving the lung parenchyma that is primarily spreading inflammation of terminal bronchioles and their related alveoli. - It is commonly caused by bacterial, viral, or fungal infections. Common bacteria include streptococcus pneumoniae, staphylococcus, and haemophilus influenzae. - Symptoms include fever, respiratory distress, grunting, and retractions of the ribs. Diagnosis involves physical examination, chest x-rays, and laboratory tests. - Treatment involves antibiotics, oxygen supplementation, maintaining hydration and nutrition, and supportive care. Complications can include sepsis, lung abscesses, and respiratory failure. Nursing care focuses on airway clearance and

1. BRONCHOPNEUMONIA
LINTU THOMAS
MSC NURSING II YR

3. • INTRODUCTION
• DEVELOPMENTAL ANATOMY
at the of 4 weeks ,the respiratory system begins as
an out growth of the foregut ,it is anterior to the
pharynx ,the out growth is called Lung bud or
Respiratory diverticulum

4. • The endoderm lining the respiratory diverticulum
give rise to the epithelium and glands of the trachea
,bronchi and alveoli
• Mesoderm surroundings the respiratory
diverticulum give rise to connective tissue ,cartilage
and smooth muscles of these structures

5. • Respiratory diverticulum elongates and form
tracheal buds divides into bronchial buds ,which
branches repeatedly and develop with bronchi .by
24 weeks respiratory bronchioles have developed
• At 6 -16 weeks all major elements of lungs have
formed .
• Gas exchange started
• During 6 to 26 weeks lung tissue become vascular

6. • 20 weeks surfactant production started very small
amount .
• Sufficient amount produced at 26 to 28 weeks of
gestation
• At 30 weeks mature alveoli will develop

8. DEFINITION
• PNEUMONIA
IT IS AN INFLAMMATORY PROCESS
INVOLVING LUNG PARENCHYMA
BRONCHOPNEUMONIA
IT IS PRIMARILY SPREADING
INFLAMMATION OF A TERMINAL
BRONCHIOLES AND THEIR RELATED
ALVEOLI

11. •CLASSIFICATION OF PNEUMONIA

14. INCIDENCE
• IT IS SEEN IN AROUND 156 MILLION PEOPLE
,MORE SEEN IN CHILDRENS THAN ADULT
,28-34 % DEATH UNDER 5 YEARS ,

15. ETIOLOGY
• BACTERIAL INFECTION
Pneumococcus ,streptococcus ,staphylococcus ,
H .influenza
• Viral infection :influenza virus, adenovirus
• Fungus: Candida, Histoplasma
• Hypostatic pneumonia
• Aspiration of amniotic fluid ,food ,foreign bodies

16. PNEUMONIA PATOGENS IN VARIOUS AGE GROUP
• 1-3 Months :Parainfluenza ,Influenza ,Streptococcus
Pneumoniae ,Chlamydia Trachomatis
• 4 Months To 5 Years :Streptococcus Pneumoniae
,Chlamydia Pneumoniae ,Mycoplasma Pneumoniae
• 5 To 18 Years : Mycoplasma Pneumoniae ,Chlamedia
Pneumoniae ,Steptococcus Pneumoniae

17. CLINICAL FEATURES OF BRONCHOPNEUMONIA
• High fever with respiratory distress ,restlessness , air hunger
and cyanosis
• Grunting
• Nasal flaring
• Retraction of the supra clavicular ,intercostals ,subcostal areas
• Tachypnea
• Tachycardia
• Abdominal distention ,liver enlargement

18. Features of typical and atypical pneumonia
Features Typical Atypical
Onset sudden Gradual
Fever +++ + / _
Cough Productive Dry
Symptoms Pulmonary Systemic
Chest x ray
Localized Diffuse

19. Diagnostic evaluation of bronchopneumonia
• PHYSICAL EXAMINATION
 INSPECTION
Cyanosis ,sub costal ,substernal ,intercostal retraction ,tachypnea ,nasal
flaring
 AUSCULTATION
Wheezes Sound
 PERCUSSION
Dullness over a consolidated area
 PALPATION

20. LABORATORY AND DIAGNOSTIC TESTS
• Pulse Oxymetry
• Chest X Ray
• Sputum Culture
• Blood Examination
• Bronchoscopy
• Lung Biopsy
• Lung Aspiration

24. MANAGEMENT
• PNEUMOCOCCAL PNEUMONIA
• Penicillin G 50,000 units /kg/day ,IV OR IM ,for 5-7
days
• Procaine penicillin 600,000 units IM/DAY
• Allergic to penicillin alternative amoxicillin or ampicillin
,the alternatives are ceftrioxone /cefotaxime
• Oxygen administration

25. • STAPHYLOCOCCAL PNEUMONIA
• Isolation of patient
• Antipyretics for fever
• Maintain hydration with 5% dextrose
• Antibiotics therapy (penicillin ,erythromycin
,cephalosporin)
• Patient not respond soon vancomycin can use

26. • Hemophilus pneumonia
• Ampicillin 100 to 150 mg /kg /day and
chloramphenicol 50 mg /kg /day in a four divided
dose
• Cefotaxime 100 mg/kg /day or ceftrioxone 70
mg/kg /day are alternatively in seriously ill patient

27. • Streptococcal pneumonia
• Penicillin G 50,000 to 10000 units /kg/day for 7 to
10 days
Supportive care
Antipyretics for fever
Oxygen administration
Maintain hydration with iv fluid
Maintain position

28. • NURSING CARE MANAGEMENT

29. HOME CARE MANAGEMENT
• Increase oral intake
• Provide adequate bed rest
• Frequently check temperature
• Maintain position
• Give antipyretics to reduce fever
• High humid atmosphere
• Regular follow up

30. DIET

31. Complication
• Bactermia
• Sepsis
• Breathing problem
• Lung abscess
• Respiratory distress syndrome
• Pleural thickening

32. Nursing diagnosis
• Ineffective airway clearances related to inflammation,
increased secretions ,mechanical obstruction as evidenced
by presences of secretion ,productive cough ,tachypnea
• Ineffective breathing pattern related to inflammation as
evidenced by tachypnea ,increased work of breathing
• Impaired gas exchange related to hyperinflation airway
plugging as evidenced by cyanosis ,decreased oxygen
level and alteration in blood gases

33. • Risk for infection related to presences of infectious
organism as evidenced by fever or presences of
viruses or bacteria on laboratory screening
• Activity intolerances related to high respiratory
demand as evidenced by increased work of
breathing

34. • Fluid volume deficit related to decreased oral intake
• Altered nutritional status less than body requirement
related to feeding difficulty as evidenced by poor
oral intake
• Fear related to difficulty in breathing ,unfamiliar
situation ,procedures as evidenced by crying
,clinging and lack of co operation

35. Prognosis

36. THANK YOU