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BronchoPneumoniaBronchoPneumonia
Des 2015
By:By:
Omran Mohammed Alkhaybri.Omran Mohammed Alkhaybri.
Out LineOut Line
 What is PneumOniaPneumOnia?
 PathOPhysiOLOgy
 etiOLOgy & CLiniCaL PiCture
 symPtOms
 hOW tO diagnOsis
 treatment
 Case study
 referenCes
Case study presentaionCase study presentaion
 Bronchopneumonia is a severe type of
pneumonia that is characterized by multiple
areas of acute and isolated consolidation that
affect one or more pulmonary lobes. It is one
of the most serious infection in childrens.The
disease assumes alarming proportion if both
the lungs are affected. Great care has to be
taken if the patient suffers from
bronchopneumonia. If it is left untreated, the
outcome may be fatal.
CrOss seCtiOn Of BrOnChOPneumOniaCrOss seCtiOn Of BrOnChOPneumOnia
affeCted LungsaffeCted Lungs
PATHOPHYSIOLOGYPATHOPHYSIOLOGY
VIRUS ENTER THE RESPIRATORY TRACT
INFLAMMATIONINFLAMMATION
ACCUMULATION OF BRONCHIAL SECRETION
ALVEOLI COLLAPSE
NARROWING OF AIRWAYS
SOB & DOB
BRONCHOPNEUMONIA
etiOLOgyetiOLOgy
Bronchopneumonia is caused by viruses, bacteria , fungi protozoa
and myco plasma
Bacteria
 Streptococcus
 Staphylococcus
 Hemophilus influenza
 Klebsella
Virus
 legionella pneumonia
Fungi
 candida albicans
Other predisposing factors include:
 common in hospitalized patients
 its occur as a complication of some other diseases , eg: in children –
diphtheria, measles, and whooping cough
 In adults- influenza, typhoid and paratyphoid fever
 its caused by organism aspirated from mouth
SIGNS & SYMPTOMSSIGNS & SYMPTOMS
BOOK BASE PATIENT MANIFESTATION
HIGH GRADE FEVER FEVER 38.8° C
COUGH W/ MUCUS PRESENT
CHEST PAIN MILD CHEST PAIN PRESENT
FATIGUE PRESENT
IRRITABILITY NOT PRESENT
DECREASED APETITE PRESENT
DECREASED BREATH SOUND PRESENT
HEADACHE ABSENT
DIAGNOSISDIAGNOSIS
Auscultation of breathing pattern
Chest xray
CBC, Sputum culture , c- reactive
protein
BRONCHOPNEUMONIA IMAGESBRONCHOPNEUMONIA IMAGES
TREATMENTTREATMENT
Advise to drink plenty of fluid
Enough rest
Elevate the head of the bed to
minimize respiratory effort
Administer oxygen, if needed
Use antibiotics as prescribe
Antipyretics as ordered
NURSING CASE STUDY OF A PATIENT WITHNURSING CASE STUDY OF A PATIENT WITH
BRONCHOPNEUMONIABRONCHOPNEUMONIA
NAME : X
AGE : 70YEARS
SEX : fEMAlE
NATIONAlITY : SAUDI
DATE Of ADMISSION :12/10/2015
CHIEf COMPlAINTS : fEvER,COUGH ,
SOB.
DIAGNOSIS : BRONCHOPNEUMONIA
Current illnessCurrent illness
Dyspnea and orthopnea 3 day`s
Increase when she is move
Decreases when lyning on her back
Decreases when setting
GCS 10/15
INVESTIGATIONINVESTIGATION
BIOCHEMESTRY CBC
GUL= 148.9 mg/dl WBC=15.62ul
LDH= 561 IU/L
Sodium=135mmol/l
Potassium=3.5mmol/l
CHEST X-RAY:
Showed focal consolidation in the right lower lobe.
ABG:
PH=7.28
PCo2=55
MEDICAL INTERVENTIONMEDICAL INTERVENTION
Foley catheter.
ETT on M.V.
NGT
MedicationMedication
Meropenem Antibiotic Action with
gram +and-
bacteria
1g IV BID
Clarithromycin Antibiotic Wide
spectrum
gram +and-
bacteriaof
500mg IV BID
Lasix Diuretic Congestive
H.F and
edema
40mg IV BID
Clexane Anticoagulant Prevent and
treat deep
vein
thrombosis
40mg S/C OD
Omeprazole Proton pump
inhibitor
Interaction
is high
40mg IV OD
SUBJECTIVE DATASUBJECTIVE DATA
RESPIRATORY
Dyspnea,Cough
CARDIOVASCULAR
Heart rate
RENAL
Polyuria
OBJECTIVE DATAOBJECTIVE DATA
 RESPIRATORY
RR= 20/MIN
BREATH SOUND: Crackles
 CARDIOVASCULAR
V/S = BP= 114/70, HR= 119/min TEMP=
38.8C
EDEMA
HEART SOUND = S1 + S2 +murmur
 GASTRO
Mouth lesions.
FAMILY HISTORYFAMILY HISTORY
Her father died and has D.M and
H.T.N
Lifestyle
Houswife, Secondhand smoking.
CARE PLANCARE PLAN
 NURSING DIAGNOSISNURSING DIAGNOSIS
1. INEFFECTIVE AIRWAY CLEARANCE
 Related to increased sputum production .
 Goal to improve airway clearance.
 Objective breathing normally without effort
within 3 hours.
 NURSING INTERVENTION
 Assess rate and depth of breathing and chest
movement.
 Frequent suction.
 EVALUATION
 No sing of diffcaluty breathing.
 No abnormal lung sound.
CARE PLANCARE PLAN
 NURSING DIAGNOSISNURSING DIAGNOSIS
2- RISK FOR INFECTION
 Related to chest infection.
 Goal to reduces risk of infection.
 Objective no sing of infection during
hospitalization.
 NURSING INTERVENTIONNURSING INTERVENTION
 Monitor V/S .
 Limit visitor.
 Isolation precautions as needed.
 EVALUATIONEVALUATION
 Achieve timely resolution of current infection
without compliction.
ReferencesReferences
Midical surgical nursing texbook
American Lung Association
www.lungusa.org
 NANDA International
http://www.nanda.org/
Case study BronchoPneumonia

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Case study BronchoPneumonia

  • 2. Out LineOut Line  What is PneumOniaPneumOnia?  PathOPhysiOLOgy  etiOLOgy & CLiniCaL PiCture  symPtOms  hOW tO diagnOsis  treatment  Case study  referenCes
  • 3. Case study presentaionCase study presentaion  Bronchopneumonia is a severe type of pneumonia that is characterized by multiple areas of acute and isolated consolidation that affect one or more pulmonary lobes. It is one of the most serious infection in childrens.The disease assumes alarming proportion if both the lungs are affected. Great care has to be taken if the patient suffers from bronchopneumonia. If it is left untreated, the outcome may be fatal.
  • 4. CrOss seCtiOn Of BrOnChOPneumOniaCrOss seCtiOn Of BrOnChOPneumOnia affeCted LungsaffeCted Lungs
  • 5. PATHOPHYSIOLOGYPATHOPHYSIOLOGY VIRUS ENTER THE RESPIRATORY TRACT INFLAMMATIONINFLAMMATION ACCUMULATION OF BRONCHIAL SECRETION ALVEOLI COLLAPSE NARROWING OF AIRWAYS SOB & DOB BRONCHOPNEUMONIA
  • 6. etiOLOgyetiOLOgy Bronchopneumonia is caused by viruses, bacteria , fungi protozoa and myco plasma Bacteria  Streptococcus  Staphylococcus  Hemophilus influenza  Klebsella Virus  legionella pneumonia Fungi  candida albicans Other predisposing factors include:  common in hospitalized patients  its occur as a complication of some other diseases , eg: in children – diphtheria, measles, and whooping cough  In adults- influenza, typhoid and paratyphoid fever  its caused by organism aspirated from mouth
  • 7. SIGNS & SYMPTOMSSIGNS & SYMPTOMS BOOK BASE PATIENT MANIFESTATION HIGH GRADE FEVER FEVER 38.8° C COUGH W/ MUCUS PRESENT CHEST PAIN MILD CHEST PAIN PRESENT FATIGUE PRESENT IRRITABILITY NOT PRESENT DECREASED APETITE PRESENT DECREASED BREATH SOUND PRESENT HEADACHE ABSENT
  • 8. DIAGNOSISDIAGNOSIS Auscultation of breathing pattern Chest xray CBC, Sputum culture , c- reactive protein
  • 10. TREATMENTTREATMENT Advise to drink plenty of fluid Enough rest Elevate the head of the bed to minimize respiratory effort Administer oxygen, if needed Use antibiotics as prescribe Antipyretics as ordered
  • 11. NURSING CASE STUDY OF A PATIENT WITHNURSING CASE STUDY OF A PATIENT WITH BRONCHOPNEUMONIABRONCHOPNEUMONIA NAME : X AGE : 70YEARS SEX : fEMAlE NATIONAlITY : SAUDI DATE Of ADMISSION :12/10/2015 CHIEf COMPlAINTS : fEvER,COUGH , SOB. DIAGNOSIS : BRONCHOPNEUMONIA
  • 12. Current illnessCurrent illness Dyspnea and orthopnea 3 day`s Increase when she is move Decreases when lyning on her back Decreases when setting GCS 10/15
  • 13. INVESTIGATIONINVESTIGATION BIOCHEMESTRY CBC GUL= 148.9 mg/dl WBC=15.62ul LDH= 561 IU/L Sodium=135mmol/l Potassium=3.5mmol/l CHEST X-RAY: Showed focal consolidation in the right lower lobe. ABG: PH=7.28 PCo2=55
  • 14. MEDICAL INTERVENTIONMEDICAL INTERVENTION Foley catheter. ETT on M.V. NGT
  • 15. MedicationMedication Meropenem Antibiotic Action with gram +and- bacteria 1g IV BID Clarithromycin Antibiotic Wide spectrum gram +and- bacteriaof 500mg IV BID Lasix Diuretic Congestive H.F and edema 40mg IV BID Clexane Anticoagulant Prevent and treat deep vein thrombosis 40mg S/C OD Omeprazole Proton pump inhibitor Interaction is high 40mg IV OD
  • 17. OBJECTIVE DATAOBJECTIVE DATA  RESPIRATORY RR= 20/MIN BREATH SOUND: Crackles  CARDIOVASCULAR V/S = BP= 114/70, HR= 119/min TEMP= 38.8C EDEMA HEART SOUND = S1 + S2 +murmur  GASTRO Mouth lesions.
  • 18. FAMILY HISTORYFAMILY HISTORY Her father died and has D.M and H.T.N Lifestyle Houswife, Secondhand smoking.
  • 19. CARE PLANCARE PLAN  NURSING DIAGNOSISNURSING DIAGNOSIS 1. INEFFECTIVE AIRWAY CLEARANCE  Related to increased sputum production .  Goal to improve airway clearance.  Objective breathing normally without effort within 3 hours.  NURSING INTERVENTION  Assess rate and depth of breathing and chest movement.  Frequent suction.  EVALUATION  No sing of diffcaluty breathing.  No abnormal lung sound.
  • 20. CARE PLANCARE PLAN  NURSING DIAGNOSISNURSING DIAGNOSIS 2- RISK FOR INFECTION  Related to chest infection.  Goal to reduces risk of infection.  Objective no sing of infection during hospitalization.  NURSING INTERVENTIONNURSING INTERVENTION  Monitor V/S .  Limit visitor.  Isolation precautions as needed.  EVALUATIONEVALUATION  Achieve timely resolution of current infection without compliction.
  • 21. ReferencesReferences Midical surgical nursing texbook American Lung Association www.lungusa.org  NANDA International http://www.nanda.org/