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Dr / amany lotfy

 pneumonia
Definition :- Asthma is an intermittent, reversible,   
obstructive airway disease, it is
manifested by a narrowing of airway resulting in
dyspnea, cough and wheezing.
Asthma can begin at any age about half of the 
cases develop in childhood and anther third
before age 40.
Asthma is often characterized as allergic, 
idiopathic Or mixed
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 and
as eye drops for glaucoma) .
Enzymes- including those in laundry detergents..
' Chemicals- toluene and others used in solvents,       
paints, and plastics
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 the
chest.
Cyanosis secondary to sever hypoxia. 
Symptoms of carbon dioxide retention 
- sweating, tachycardia.
Un Status asthmatics occurs in which therapeutic     
measures fail &the
patient has repeated attacks or continuous asthma.
Allergic reaction eczema, urticaria, edema. 
1-Acomplete history. 
2- Reaction skin test. 
3-Assessment of environmental factors, including 
seasonal changes, mold and pollens. Climate
changes.
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
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- Mast
cell inhibitors: broncho-dilatition g.cromolyn sodium.
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. 


                                                
Pneumonia is an inflammatory       
illness of the lung. Frequently,
it is described as lung
parenchyma/alveolar
inflammation and abnormal
alveolar filling with fluid
Classification according to the causative 
   agent:
1-' Bacterial pneumonia (common * 
streptococcus;)
2- Viral Pneumonia 
3- Mycoplasma Pneumonia 
4-Aspiration pneumonia's syndrome             


5-Chemical pneumonia, after ingestion         
of kerosene or irritation gases
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- respiratory
depression
Associated with congestive heart failure 
diabetes, alcoholism
   Classification
    ◦ 1.1 Early classification schemes
    ◦ 1.2 Combined clinical classification
       1.2.1 Community-acquired
        pneumonia
       1.2.2 Hospital-acquired pneumonia
 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.
pneumonia by clinical 
them into characteristics, dividing
1-"acute" (less than three weeks 
duration) Streptococcus
pneumonia
2- "chronic" pneumonias. 
is infectious pneumonia in a person who   
has not recently been hospitalized.
Streptococcus pneumonia is 
the most common cause of
community-acquired
pneumonia
called Nosocomial 
pneumonia, is pneumonia
acquired during or after
hospitalization for another
illness or procedure with
onset at least 72 hrs after
admission.
risk factors for pneumonia, 
including mechanical ventilation,
prolonged malnutrition, underlying
heart and lung diseases,
decreased amounts of stomach
acid, and immune disturbances.
1- Pneumonia arises from aspiration of 
flora present in the oropharynx. &
blood borne organisms that enter the
pulmonary circulation
 2-An inflammatory reaction can occur 
alveoli, producing exudates that in the
affect on ventilation 3-White blood
cells, mostly neutrophils, migrate into
the alveoli. Areas of the lung are not
adequately ventilated because of
secretions and mucosal edema that
cause partial occlusion of the bronchi
4- Venous blood entering the 
pulmonary circulation to the
left side of the heart poorly
oxygenated. The mixing of
oxygenated and unoxygenated
blood eventually results in
arterial hypoxemia.
Pneumonia 
Clinical manifestations: 
1-Cough producing greenish or yellow sputum,      
2- high fever that may be accompanied by
shaking chills. 3- Shortness of breath4-
pleuritic chest pain, a sharp or stabbing pain,
either experienced during deep breaths or
coughs or worsened by them.
5- cough up blood, 6-headaches, or develop 
sweaty and clammy skin.7- Other symptoms
are loss of appetite, fatigue, blueness of the
skin, nausea, vomiting, mood swings, and joint
pains or muscle aches.
 1-Medical  intervention
Diagnosis:- patient's symptoms and 
findings from physical examination,
chest X-ray and blood tests are
helpful, and sputum cultures chest CT
scan or other tests may be needed to
distinguish pneumonia from other
illnesses. A complete blood count
indicating the presence of an infection
or inflammation, in some people with
immune system problems
Management:   




1-Administration of appropriate  




antibiotics as Penicillin
Typically, oral antibiotics, rest, 
fluids, and home care
2-people with other medical 
problems and the elderly may need
treatment that is more advanced. 
  3-If the symptoms worse, the 
pneumonia does not improve with
home treatment, or complications
occur, the person will often have to
be hospitalized.
    
  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 Haemophilus
influenza and Streptococcus pneumonia in
the first year of life.
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 
   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
 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.
   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 COMPLICATIONS
7- PROMOTING HOME AND COMMUNITY- 
BASED CARE      &Teaching Patients
Self-Care.
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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Peumonia

  • 1. Prepared by:- Dr / amany lotfy pneumonia
  • 2. Definition :- Asthma is an intermittent, reversible,  obstructive airway disease, it is manifested by a narrowing of airway resulting in dyspnea, cough and wheezing. Asthma can begin at any age about half of the  cases develop in childhood and anther third before age 40. Asthma is often characterized as allergic,  idiopathic Or mixed
  • 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 and as eye drops for glaucoma) . Enzymes- including those in laundry detergents.. ' Chemicals- toluene and others used in solvents,  paints, and plastics
  • 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 the chest. Cyanosis secondary to sever hypoxia.  Symptoms of carbon dioxide retention  - sweating, tachycardia.
  • 5. Un Status asthmatics occurs in which therapeutic  measures fail &the patient has repeated attacks or continuous asthma. Allergic reaction eczema, urticaria, edema. 
  • 6. 1-Acomplete history.  2- Reaction skin test.  3-Assessment of environmental factors, including  seasonal changes, mold and pollens. Climate changes. 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. 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- Mast cell inhibitors: broncho-dilatition g.cromolyn sodium.
  • 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. Pneumonia is an inflammatory  illness of the lung. Frequently, it is described as lung parenchyma/alveolar inflammation and abnormal alveolar filling with fluid
  • 10. Classification according to the causative  agent: 1-' Bacterial pneumonia (common *  streptococcus;) 2- Viral Pneumonia  3- Mycoplasma Pneumonia  4-Aspiration pneumonia's syndrome  5-Chemical pneumonia, after ingestion  of kerosene or irritation gases
  • 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- respiratory depression Associated with congestive heart failure  diabetes, alcoholism
  • 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.  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. pneumonia by clinical  them into characteristics, dividing 1-"acute" (less than three weeks  duration) Streptococcus pneumonia 2- "chronic" pneumonias. 
  • 15. is infectious pneumonia in a person who  has not recently been hospitalized. Streptococcus pneumonia is  the most common cause of community-acquired pneumonia
  • 16. called Nosocomial  pneumonia, is pneumonia acquired during or after hospitalization for another illness or procedure with onset at least 72 hrs after admission.
  • 17. risk factors for pneumonia,  including mechanical ventilation, prolonged malnutrition, underlying heart and lung diseases, decreased amounts of stomach acid, and immune disturbances.
  • 18. 1- Pneumonia arises from aspiration of  flora present in the oropharynx. & blood borne organisms that enter the pulmonary circulation 2-An inflammatory reaction can occur  alveoli, producing exudates that in the affect on ventilation 3-White blood cells, mostly neutrophils, migrate into the alveoli. Areas of the lung are not adequately ventilated because of secretions and mucosal edema that cause partial occlusion of the bronchi
  • 19. 4- Venous blood entering the  pulmonary circulation to the left side of the heart poorly oxygenated. The mixing of oxygenated and unoxygenated blood eventually results in arterial hypoxemia.
  • 20. Pneumonia  Clinical manifestations:  1-Cough producing greenish or yellow sputum,  2- high fever that may be accompanied by shaking chills. 3- Shortness of breath4- pleuritic chest pain, a sharp or stabbing pain, either experienced during deep breaths or coughs or worsened by them. 5- cough up blood, 6-headaches, or develop  sweaty and clammy skin.7- Other symptoms are loss of appetite, fatigue, blueness of the skin, nausea, vomiting, mood swings, and joint pains or muscle aches.
  • 21.  1-Medical intervention Diagnosis:- patient's symptoms and  findings from physical examination, chest X-ray and blood tests are helpful, and sputum cultures chest CT scan or other tests may be needed to distinguish pneumonia from other illnesses. A complete blood count indicating the presence of an infection or inflammation, in some people with immune system problems
  • 22. Management:  1-Administration of appropriate  antibiotics as Penicillin Typically, oral antibiotics, rest,  fluids, and home care 2-people with other medical  problems and the elderly may need treatment that is more advanced.  3-If the symptoms worse, the  pneumonia does not improve with home treatment, or complications occur, the person will often have to be hospitalized. 
  • 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 Haemophilus influenza and Streptococcus pneumonia in the first year of life.
  • 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. 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.  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. 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 COMPLICATIONS 7- PROMOTING HOME AND COMMUNITY-  BASED CARE &Teaching Patients Self-Care.
  • 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. 