This document provides an overview of pneumonia including its definition, classification, risk factors, signs and symptoms, diagnostic tests, management, nursing care, prevention, and complications. Pneumonia is an infection and inflammation of the lung tissues that impairs gas exchange and is a common cause of mortality in young children and the elderly. It can be caused by viruses, bacteria, fungi or other pathogens. Diagnosis involves physical exam, chest imaging, and laboratory tests. Treatment consists of antibiotics, oxygen therapy, respiratory support and addressing complications. Nursing care focuses on respiratory assessment, airway clearance techniques, rest, pain management, and patient education.

1. Prepared by:
RN Arpana bhusal
BNS
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4. Definition
Pneumonia classification
pathophysiology of pneumonia
Risk factors
Sign and symptoms
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5.  Diagnostic tests
 medical management
 Nursing management
 Prevention
 Complication of pneumonia
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6. Fig:-Pneumonia
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7.  Pneumonia is the infection and inflammation
of the lung parenchyma tissues that impairs gas
exchanges..
 It is the commonest cause of mortality and
morbidity of children below 5 years of age.
 The elderly are also at high risk.
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9.  Etiological types
Infective
 viral (influenza)
 Bacterial
(streptococcus
pneumoniae)
 fungal
 mycobacterial
Non-infective
 toxins
 chemicals
 aspiration
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Morphological types
 Lobar pneumonia
 Bronchopneumonia
 Interstitial
Duration
 Acute
 Chronic
Clinical
 Primary/Secondary
 Typical/Atypical
 Community acquired/
Hospital acquired

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13.  Age- very young age children (up to 5 yrs)
 Poor socio-economic condition
 Malnutrition
 Vitamin A deficiency
 Low birth weight
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14.  Lack of breastfeeding
 Previous history of respiratory tract infection
 Passive smoking, immobility
 Indoor and outdoor environmental pollution
 Family history of bronchitis
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15.  Sudden onset of fever (102F-104F)
 Chills
 Cough (unproductive to productive with whitish sputum)
 Tachypnoea
 Dyspnoea
 Chest pain
 Chest indrawing
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16.  Nasal flaring
 Pallor/Cyanosis
 Behaviour : Irritable, restless, and lethargic
 GI: Anorexia, vomiting, diarrhea, abdominal pain
 Dull on percussion
On auscultation:-
 Diminished breath sounds on affected areas
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18.  History taking
 Physical examination
 Chest radiography: patchy infiltration,
consolidation, disseminated infiltration, patchy
clouding
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19.  Complete blood cell count (CBC): reveal
leucocytosis
 Blood Cultures, gram stain, sputum culture: reveal
the causative organism
 Positive Anti streptolysin -o (ASO) titre :
diagnostic of streptococcal pneumonia.
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20.  Antibiotics are prescribed on the basis of Gram stain
results and antibiotic guidelines (resistance patterns,
risk factors, etiology must be considered).
Combination therapy may also be used.
 Supportive treatment includes hydration, antipyretics
for fever , antitussive medications for treat cough,
antihistamines, or nasal decongestants.
 Bed rest is recommended until infection shows signs
of clearing.
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21.  Oxygen therapy is given for hypoxemia.
 Respiratory support includes high inspiratory
oxygen concentrations, endotracheal intubation,
and mechanical ventilation.
 Treatment of atelectasis, pleural effusion, shock,
respiratory failure, or super infection.
 For groups at high risk for CAP, pneumococcal
vaccination is advised
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22. Asessment:
 Assess respiratory symptoms: sypmtoms of fever,
chills or night sweats (signs of bacterial
pneumonia)
 Assess clinical manifestations: (bradycardia,
trachypnea, pain)
 Physical assessment :for body temperature, pulse
,amount odor and color of secretions shortness of
breath
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23.  Actual diagnosis:
 Impaired gas exchange related to cough
production,
 Ineffective airway clearance related to presence of
inflammation in bronchial walls ,
 Ineffective breathing pattern,
 Knowledge deficit/Deficient knowledge about the
treatment regimen and preventive health measure
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24.  Potential diagnosis:
 Risk for infection,
 Risk for nutritional imbalance: less than body
requirements
 Risk for deficient fluid volume related to fever and
dyspnea
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25.  Correcting breathing pattern
 Assess for hypoxia, signs of respiratory
distress, shock such as labored breathing, cold
clammy skin, cyanosis, headache, restlessness
and change in mental status
 Monitor vital signs, oximetery, and ABG
analysis for oxygenation.
 Monitor oxygen therapy used to relieve
hypoxemia
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26.  Collect sputum specimen for c/s tests in a
sterile container; notify the physician if
organism is resistant to the antibiotics being
given
 Encourage deep breathing and coughing
exercises after chest physiotherapy.
 Instruct patient to cover nose and mouth while
coughing
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27.  Rest and sleep
 Patient should be kept in bed rest to reduce oxygen
demand.
 Encourage use of relaxation techniques and
diversional activities.
 Position with head of bed should be slightly
elevated.
 Maintain semi-fowler’s position
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28.  Relieving pain
 Watch patient for signs of discomfort and
pain.
 Maintain semi-fowler’s position.
 Ascertain if pain worsens with deep breathing
and coughing: auscultate for friction rub.
 Give prescribed medicine, and monitor for
pain relief and signs of respiratory depression.
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29.  Reducing anxiety
 Correct dyspnea and relief physical
discomfort.
 Explain diagnostic procedures and the patients
role : correct misconception.
 Listen to patient concerns; attentive listening
relieves anxiety and reduces emotional
distress.
 Speak calmly and slowly.
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30.  Get the flu vaccine each year. People can develop
bacterial pneumonia after a case of the flu
 Get the pneumococcal vaccine
 Practice good hygiene
 Increase fluid intake upto 3liters/ day.
 Plan rest period, balance between rest and activity.
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31.  Teach preventive measures:role of nutrition and
fluids, vaccination against streptococcus
pneumonia and influenza.
 Wash your hands regularly, especially after you go
to the bathroom and before you eat.
 Eat right, with plenty of fruits and vegetables.
 Encourage for exercise.
 Get enough sleep.
 Quit smoking.
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32.  Pulmonary: Collapse, Delayed Resolution, Lung
Abscess,
 Pleural: Empyema, Pneumothorax, Effusion,
 Airway: Bronchiectasis, Sinusitis
 Cardiovascular: CCF, Shock, Endocarditis
 Extra- Thoracic: Septicemia, Meningitis,
Osteomyelitis, Febrile Convulsion, Acute
Haemolytic Anemia
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33.  Mandal G.N, Textbook of medical surgical nursing
(adult nursing) published by Makalu publication
house, 3rd edition, page no. 66-67
 Brunner and siddarth, Textbook of Medical-
Surgical Nursing, 13th edition, page no. 573-582,
605
 https://www.google.com/search?client=firefox-b-
d&q=pneumonia 2078/03/09@8pm
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