The document discusses pneumonia, defining it as an inflammation of the lung tissue caused by various microorganisms. It classifies pneumonia into types such as community-acquired, hospital-acquired, ventilator-associated, and pneumonia in immunocompromised patients. Risk factors, pathophysiology, clinical manifestations, diagnostic assessments, and management approaches are explained. The document also outlines a nursing care plan for patients with pneumonia focusing on ineffective airway clearance, fluid deficits, nutritional imbalances, and patient education needs.

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2. OUTLINE
 Define Pneumonia
 Classify Pneumonia
 Explain Risk Factors
 Explain Pathophysiology
 Illustrate Clinical Manifestation
 Explain assessment and diagnostic finding
 Explain Management
 Explain Prevention
 Summary
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3. INTRODUCTION
 Pneumonia is an inflammation of the lung
parenchyma caused by various microorganism,
including bacteria, mycobacteria, fungi, and
viruses. Pneumonitis is a more general term
that describes an inflammatory process in the
lung tissue that may predispose or place the
patient at risk for microbial invasion.
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4. DEFINITION
 Infection that inflames air sacs in one or both
lungs, which may fill with fluid.
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6. CLASSIFICATION
 Pneumonias are classified as –
 Community acquired pneumonia {CAP},
 Hospital acquired {nosocomial} pneumonia
{HAP},
 Pneumonia in the immunocompromised host
 Ventilator associated pneumonia
 Aspirational pneumonia
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7. COMMUNITY ACQUIRED
PNEUMONIA
 CAP occurs either in community setting or with
in the first 48 hours after hospitalization or
institutionalization. The need for hospitalization
for CAP depends on severity of the pneumonia.
The causative agents for CAP that requires
hospitalization are most frequently S.
pneumoniae, H.influenza, legionella,
pseudomonas aeruginosa and other gram
negative rods.
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8.  S.PNEUMONIAE - {pneumococcus} It is a gram
positive organism that resides naturally in the upper
respiratory tract colonize the upper respiratory tract
that cause disseminated invasive infection. and other
lower respiratory tract infection such as
Rhinosinusitis.
 H. INFLUENZA- causes a type of CAP that
frequently affects elderly people and those with
comorbid illness{ chronic obstructive pulmonary
disease.
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9.  M. PNEUMONIAE – mycoplasma pneumonia
is spread by infected respiratory droplets
through person to person contact. It spreads
throughout the entire respiratory tract, including
the bronchioles, and has the characteristics of a
bronchopneumonia.
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10. HOSPITALACQUIRED PNEUMONIA
 It is also known as nosocomial pneumonia. It is
defines as the onset of pneumonia symptoms
more than 48 hours after admission in patients
with no evidence of infection at the time of
admission.
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11. VENTILATOR ASSOCIATED
PNEUMONIA
It is consider as a type of nosocomial pneumonia
 That is associated with endotracheal intubation
and mechanical ventilation This type of
pneumonia is defined as bacterial pneumonia
that develops in patient with acute respiratory
failure who have been receiving mechanical
ventilation for atleast 48 hours.
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12. PNEUMONIA IN THE
IMMUNOCOMPROMISED HOST
 Pneumonia in immunocompromised host
includes Pneumocystis pneumonia{PCP}, fungal
pneumonias, and mycobacterium tuberculosis.
Pneumonia in the immunocompromised host
occurs with use of corticosteroids or other
immunosuppressive agents, chemotherapy,
nutritional depletion, use of broad spectrum
antimicrobial agents, acquired
immunodeficiency syndrome{AIDS}.
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13. ASPIRATION PNEUMONIA
 It refers to the pulmonary consequence resulting
from entry of endogenous or exogenous
substance into the lower airway.
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14. RISK FACTORS
 Heart failure
 Diabetes mellitus
 Chronic obstructive pulmonary disease
 AIDS.
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15. PATHOPHYSIOLOGY
Due to any etiological factors {bacteria, fungi,
virus, heart failure}
Inflammation in alveoli
Mast cells activate and release histamines,
prostaglandins, cytokinines, leukotrienes.
Due to cytokinines release, fluid shift to
extracellular space {capillary permeability}
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16. Alveoli filled with fluid
Consolidation
Decrease O2 saturation in body
Hypoxemia/ hypoxia
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17. CLINICAL MANIFESTATION
 Sudden onset with chills
 Rapidly rising fever{ 38.50 to 40.50 C} {1010 to
105 0 F}
 Pleuritic chest pain that is aggrevated by deep
breathing and coughing.
 Tachypnea {25 – 45breath/min}
 Respiratory distress {shortness of breath, use of
accessory muscles in respiration}
 Headache
 Myalgia
 Pleuritic pain
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18.  A relative bradycardia { a pulse temperature
deficit in which the pulse is slower than that
expected for a given temperature}.
 Upper respiratory tract infection {nasal
congestion, sore throat}
 Pharyngitis
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19. ASSESSMENT AND DIAGNOSTIC
FINDING
 History taking { particularly of a recent respiratory tract
infection}
 Physical examination
 Chest X ray
 Blood culture{ blood stream invasion {bacteremia}
occurs frequently}.
 Sputum examination – the sputum sample is obtained by
having patient do the following.
 Rinse the mouth with water to minimize contamination
by normal oral flora.
 Breath deeply several times
 Cough deeply
 Expectorate the raised sputum into a sterile container
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20. MEDICAL MANAGEMENT
 PHARMACOLOGICAL MANAGEMENT
 ANTIBIOTIC – Penicillin , amoxicillin,
fluoroquinolone, ceftiaxone.
 ANTI VIRAL – Oseltamivir, zanamivir.
 ANTIFUNGAL – Variconazole or
anidulafungin.
 ANTI TUBERCULAR DRUG – Izoniazid +
Rimapcin + Etambutol+ Pyrazinamide.
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21. NURSING MANAGEMENT
 DIAGNOSIS :
 Ineffective airway clearance related to
copious tracheobronchial secrections.
 Risk for deficient fluid volume related to fever
and rapid respiratory rate.
 Imbalanced nutrition : less than body
requirements.
 Activity intolerance related to impaired
respiratory function.
 Deficient knowledge about the treatment
regimen and preventive health measures.
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22. INEFFECTIVE AIRWAY CLEARANCE RELATED TO
COPIOUS TRACHEOBRONCHIAL SECRECTIONS.
 INTERVENTIONS -
 Identify patients at risk for ineffective airway clearance.
 Assess lung sounds
 Assess respirations
 Evaluate the ability to swallow or cough
 Note changes in mental status or restlessness
 Assess sputum color and consistency
 Assess ABGs and oxygen saturation
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