Pneumonia is an inflammatory lung condition caused by various pathogens and risk factors like age, smoking, and chronic diseases. Clinical manifestations include fever, cough, and difficulty breathing, while diagnosis may involve sputum tests and chest x-rays. Management typically includes antibiotics, supportive care, and nursing interventions to improve airway clearance and breathing patterns.

1. PNEUMONIA
-By Pinky Rathee
M.Sc (H) Nursing

2. DEFINITION
 Pneumonia
(pneumonitis) is
an inflammatory
process in lung
parenchyma
usually
associated with a
marked increased
in interstitial and
alveolar fluid.

3. ETIOLOGY AND RISK FACTORS
 MANY CAUSES- bacteria, viruses,
mycoplasmas, fungal agents and
protozoa.
 ASPIRATION – of fluid, food, or
vomitus, inhalation of toxic or
caustic chemicals, smoke, dust, or
gases.

4. MAJOR RISK FACTORS-
 Advanced age
 History of
smoking
 Upper
respiratory
infection
 Tracheostomy
intubation

5. CONT.
 Immuno -suppressive therapy
 Non-functional immune system
 Malnutrition
 Dehydration
 Chronic disease states like DM, heart
failure, chronic lung disease, cancer,

6. ADDITIONAL RISK FACTORS-
 Exposure to air pollution
 Altered consciousness (from alcohol,
drug overdose, general anesthesia,
seizures).
 Inhalation of noxious substance
 Aspiration of food, liquid, foreign or
gastric materials.

7. CLASSIFICATION OF PNEUMONIA

8. 1. BASED ON AREA INVOLVEMENT
2. BASED ON CAUSATIVE AGENT
BACTERIAL
PNEUMONIA
AYPICAL OR
NON-BACTERIAL
PNEUMONIA

9. PATHOPHYSIOLOGY
Risk factors /Major /Additional risk factors
↓
Inflammatory Pulmonary response to offending
organs /agent
↓
Defensive mechanism of lungs lost
↓
Organisms penetrate he sterile lower respiratory tract
↓
Decreased mechanical defences of cough and cilliary
motility
↓

10. CONT.
Colonization of agent in lungs
↓
Infection / inflammation and fluid filled alveolar sacs
↓
Ineffective exchange of CO2 and O2
↓
Lung exudate with consolidate
↓
Ventilation / perfusion mismatch
↓
PNEUMONIA

11. CLINICAL MANIFESTATIONS
 Fever, chills, sweats- pleuritic chest
pain, cough, sputum production,
hemoptysis, dyspnea, headache and
fatigue.
 Chest auscultation- Bronchial breath
sound over consolidate lung areas,
crackling sounds (from fluid in
interstitial and alveolar sac).

12. CONT.
 Increased tactile fremitus over areas
of pneumonia, where as percussion
sounds are dulled.
 Unequal chest wall expansion during
inspiration.
 Whispered pectoriloquy
(transmission of sound whispered
words through the chest) heard over
affected areas.

14. HYPOSTATIC PNEUMONIA
 Serious illness occurs in bedridden
patient as they are deprived of the
opportunity to move normally and
even turn from side to side causes
deterioration in ventilation and
sputum accumulation in bronchi
occurs which results inflammation
develops in the organs causing
hypostatic pnemonia.

15. SIGN AND SYMPTOM OF HYPOSTATIC
PNEUMONIA
 Shortness of breath and hard
breathing.
 Febrile state, rapid heart rate,
coughing with blood.
 Increased sweating and chills.

16. DIAGNOSIS
 Sputum culture analysis and sesitivity or
serologic test.
 Fibroptic bronchoscopy or
transcutaneous needle aspiration
cytology.
 Chest X-ray
 Additional diagnostic tests-
1. Skin test for TB
2. Blood and uric culture
3. ABG

17. MEDICAL MANAGEMENT
 Broad spectrum Antibiotics
(ampicillin,
Cefuroxime, augmentin).
 Respiratory support.
 Bronchodilator medicine, chest
physiotherapy.
 Fluid and electrolyte management.
 Symptomatic treatment for fever and
to reduce pain by analgesics and
antipyretics are given.

18. NURSING MANAGEMENT OF PNEUMONIA
ASSESSMENT-
 History of contact with
similar infection.
 Rule out other disease i.e.
pulmonary embolism,
 Lowered level of consciousness.
 Presence of TB, chest pain, cough,
sputum.

19. NURSING DIAGNOSIS
 Ineffective airway clearance related to
decrease cough reflex secondary to
disease process.
 Increase fluid intake.
 Encourage and teach effective coughing
and deep breathing exercises.
 Side lying position
 Bronchodilating agents
 Chest physiotherapy, artificial airway.

20. CONT.
 Ineffective breathing pattern related to
tachypnea secondary to disease process.
 Raise head of bed to 45 degree.
 Teach client how to splint chest.
 Cough suppressants and analgesic.
 Monitor ABG, chest auscultation.
 Incentive spirometry.

21. CONT,.
 Activity intolerance related to decreased
oxygen level for metabolic demands
secondary to disease process.
 Reassess for marked dyspnea.
 Psychological support and quiet
environment.
 Pursed lip breathing.
 Chest physiotherapy.

22. THANK YOU