Problem based learning pneumonia

College of Health Sciences
MARIANO MARCOS STATE UNIVERSITY
PNEUMONIA
Problem-Based Learning
CARE OF THE MOTHER AND CHILD AT RISK OR WITH PROBLEMS
NCM_109B
Submitted by:
Abadilla, Michaela Therese D.
Acosta, Jemy Armyn B.
Agcaoili Annah Mikaela L. (Sub-secretary)
Agnir, John Harvey A.
Alquiza, Yves Anne Joie F.
Ansagay,Mc Lein A.
Antolin, Chloe Rosette B. (Secretary)
Asuncion, Keziah Claire D.
Asuncion, Mary Joyce R.
Aurelio, Lyca Mae M. (Chairman)
Group 1 RLE
BSN II-D
Submitted to:
MYRA M. FABIAN, R.N.
Clinical Instructor
FEBRUARY 28, 2021

CASE SCENARIO:
Baby Arym, a 6-month old boy was brought to the hospital cuddled by his mother. His
parents said the baby have productive cough, dyspnea, remittent fever for 3 day PTC. He
has been vomiting and refused to breast fed few hours PTC.
Physical exam revealed temp 103 F. RR 28 bpm, crackles on both lungs upon auscultation.
RR of 45 breaths/min and SPO2 of 90%. Present weight is 5kg.
Baby Arym was then admitted with the ff orders:
Lab & Diagnostics:
CBC

Electrolyte count
Chest X-Ray results showed white patch seen on left upper lobe of lung
Results were referred back to the doctor.
Medication:
Cefotaxime 125 mg IV every 6 hours
Ampicillin 125 mg IV after 6 hours
Ventolin nebulization every 4 hours
Oxygen inhalation @2L/min
Panadol drops, 10 drops. Now
Bacillus Clausi 1 amp PO OD
Multivitamin with zinc 0.75ml OD

TECHNICAL TERMS
Dyspnea – shortness of breath. The patient might feel out of breath, tightness of chest and
might not breathe deeply. ALQUIZA.
Remittent fever – type or pattern of fever in which temperature does not touch the
baseline and remains above normal throughout the day. Daily variation in temperature is
more than 1°C in 24 hours, which is also the main difference as compared to continuous
fever. Fever due to most infectious diseases is remittent. ACOSTA.
Crackles – Crackles are the clicking, rattling, or crackling noises that may be made by one or
both lungs of a human with a respiratory disease during inhalation. ANSAGAY.
Auscultation – is the medical term for using a stethoscope to listen to the sounds inside of
your body. ALQUIZA.
CBC – complete blood count. A complete blood count (CBC) is a blood test used to evaluate
your overall health and detect a wide range of disorders, including anemia, infection and
leukemia. ASUNCION, K.
 Red blood cells, which carry oxygen white blood cells, which fight infection
 Hemoglobin, the oxygen-carrying protein in red blood cells
 Hematocrit, the proportion of red blood cells to the fluid component, or
plasma, in the blood
 Platelets, which help with blood clotting
SpO2 – also known as oxygen saturation, is a measure of the amount of oxygen-carrying
hemoglobin in the blood relative to the amount of hemoglobin not carrying oxygen. AGNIR.
MCV – Mean corpuscular volume (MCV) is the average volume of red cells in a specimen.
MCV is elevated or decreased in accordance with average red cell size; ie, low MCV indicates
microcytic (small average RBC size), normal MCV indicates normocytic (normal average RBC
size), and high MCV indicates macrocytic (large average RBC size). ABADILLA.
WBC – White blood cells (WBCs), also called leukocytes or leucocytes, are the cells of the
immune system that are involved in protecting the body against both infectious disease and
foreign invaders. ACOSTA.
Platelet – A platelet blood count is a blood test that measures the average number of
platelets in the blood. Platelets help the blood heal wounds and prevent excessive bleeding.
ALQUIZA.
Ampicillin – is used to treat a wide variety of bacterial infections. It is a penicillin-type
antibiotic. It works by stopping the growth of bacteria. This antibiotic treats only bacterial
infections. ANSAGAY.
Multivitamins – It is needed for the body's defensive (immune) system to properly work. It
plays a role in cell division, cell growth, wound healing, and the breakdown of

carbohydrates. Zinc is also needed for the senses of smell and taste. During pregnancy,
infancy, and childhood the body needs zinc to grow and develop properly. AGNIR.
Ventolin nebulization – VENTOLIN Inhalation Solution is indicated for the relief of
bronchospasm in patients 2 years of age and older with reversible obstructive airway
disease and acute attacks of bronchospasm. ALQUIZA.
Panadol Baby Drops – is used for a fast relief from pain and fever in babies from 2 months,
while being gentle to little stomachs. It also provides fast and effective relief of: ABADILLA.
 Fever
 Headache
 Pain and fever associated to earache
 Pain and fever associated to Immunization
 Pain and fever associated to Teething
 Cold & Flu related symptoms
Eosinophils – Prominent at the sites of allergic reactions and parasitic infections (rare in
blood but common at mucous membranes). Do not phagocytose pathogens but instead
release chemical products which perforate cell membranes. Consequently, they function as
the primary response to large multicellular parasites. ACOSTA.
Monocyte – Monocytes are the largest type of leukocyte and share phagocytosis duties with
neutrophils. They are slower to respond than neutrophils but are longer lasting, as they can
renew their lysosomes for continued digestion. Monocytes will differentiate into two types
of cells in response to pathogenic infection – macrophages and dendritic cells. They will
remain in the tissue and phagocytose, whereas dendritic cells present antigen fragments to
lymphocytes. ACOSTA.
Neutrophils – are a type of white Blood Cell, which primarily protect us from infections or
bacteria. They help heal damaged tissues, an increase in Neutrophils indicates a stress or
infection. ASUNCION, M.
Bacillus clausii – type of a Probiotics that is primarily and commonly used as a treatment for
acute diarrhea in adults and pediatric's, they are also been used as a therapy or treatment
to an helicobacter pylori infection. ASUNCION, M. Additionally, Probiotics may help improve
the balance of bacteria found in the gut, counteracting potential alterations brought on by
antibiotic treatment. AGNIR.
MEDICAL DIAGNOSIS- PNEUMONIA
Justification
 Raise of WBC and platelets that could indicate infection. AGNIR.
 Medication cefotaxime which is indicated to treat bacterial infections such as
pneumonia etc. ANSAGAY.

 Pneumonia is an infection in the lungs. It may be in one or both lungs. The infection
causes air sacs in your lungs to become pus-filled and inflamed. This causes a cough,
difficulty breathing, and crackles sound. Crackling or bubbling noises (rales) made by
movement of fluid in the tiny air sacs of the lung. ACOSTA.
 One of the signs and symptoms of pneumonia is having dyspnea and the patient in
the case suffers from dyspnea. ALQUIZA.
DEFINITION
Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs
may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills,
and difficulty breathing. A variety of organisms, including bacteria, viruses and fungi, can
cause pneumonia. ASUNCION, K.
INCIDENCE
In 2017, the Philippines' number of pneumonia cases amounted to approximately
495.2 thousand in the Philippines. The result was a significant decrease compared to the
previous year, which had 786.1 thousand cases. ABADILLA.
In 2017, pneumonia have caused approximately 57.2 thousand deaths in the
Philippines. An infection in the lungs, pneumonia was the 3rd leading cause of death among
Filipino women in the same year. ACOSTA.
In the Philippines, 57,809 pneumonia deaths were reported in 2016, nearly 10
percent of 582,183 registered deaths in 2016. This made pneumonia the 3rd top killer
behind ischemic heart disease and cancer. ABADILLA.
TYPES
 Hospital-acquired pneumonia (HAP)
This type of bacterial pneumonia is acquired during a hospital stay. It can be
more serious than other types, as the bacteria involved may be more resistant to
antibiotics. ANTOLIN.
 Viral pneumonia
This is generally caused by viral infections of the upper respiratory tract.
Symptoms begin as an upper respiratory tract infection and may progress to
diminished breath sounds and fine rales on auscultation. Viruses that cause
pneumonia travel through the air in droplets of fluid after someone sneezes or
coughs. These fluids can get into your body through your nose or mouth. ACOSTA.
 Bacterial pneumonia
This type is caused by various bacteria. The most common is Streptococcus
pneumoniae. It usually occurs when the body is weakened in some way, such as by
illness, poor nutrition, old age, or impaired immunity, and the bacteria are able to
work their way into the lungs. Bacterial pneumonia can affect all ages, but someone
is at greater risk if he/she abuse alcohol, smoke cigarettes, are debilitated, have

recently had surgery, have a respiratory disease or viral infection, or have a
weakened immune system. AGCAOILI.
 Mycoplasma pneumonia
This type has somewhat different symptoms and physical signs and is
referred to as atypical pneumonia. It is caused by the bacterium Mycoplasma
pneumoniae. It generally causes a mild, widespread pneumonia that affects all age
groups. ABADILLA.
Commonly referred to as “Walking Pneumonia” this is a less severe type of
pneumonia which is often confused with a cold or flu. This type of pneumonia has
symptoms such as sore throat, headaches, and tiredness. Antibiotics can be used for
treatment. ALQUIZA.
 Fungal Pneumonia ANSAGAY.
Fungi are a less common cause of pneumonia. A person is not likely to get
fungal pneumonia if you're healthy. But a person has a higher chance of catching it if
the immune system is weakened from:
 An organ transplant
 Chemotherapy for cancer
 Medicines to treat an autoimmune disease like rheumatoid arthritis
 HIV
People get fungal pneumonia by breathing in tiny particles called fungal
spores. People in certain jobs are more likely to come into contact with them, such
as:
 Farmers who work around bird, bat, or rodent droppings
 Landscapers and gardeners who work with the soil
 Members of the military or construction workers who are around a lot
of dust
Symptoms of fungal pneumonia are similar to other types, including:
 Fever
 Cough
 Chlamydia trachomatis pneumonia
Typically seen in newborns up to 12 weeks of age, is often contracted from
contact with the mother’s vagina during birth. Symptoms begin gradually with nasal
congestion, a sharp cough, and poor weight gain. These progress to tachypnea and
wheezing and rales on auscultation. Antibiotics are often used for pharmacologic
treatment. ACOSTA.
CAUSES
1. Caused by common viruses that cause cold, flu and other respiratory infections such
as adenovirus, rhinovirus, influenza (flu), respiratory syncytial virus (RSV) and
parainfluenza virus. The viruses and bacteria that cause pneumonia are contagious
and are spread by sneezing, coughing or contact with contaminated surfaces like

shared drinking glasses or utensils, used tissues or even doorknobs and faucets.
ANSAGAY.
2. Pneumonia can be caused by bacteria or viruses, most commonly they are caused by
Streptococcus pneumoniae in children. ASUNCION, M.
3. Almost always caused by bacteria or a virus. In children below school age, viral
infection is the most common cause. School-aged children and young adolescents
are more likely to develop a bacterial infection. ABADILLA.
4. When diagnosing community-acquired pneumonia, physicians should rely mainly on
the patient’s history and physical examination, supplemented by judicious use of
chest radiographs and laboratory tests as needed. The child’s age is important in
making the diagnosis. Pneumonia in neonates younger than three weeks of age most
often is caused by an infection obtained from the mother at birth. Streptococcus
pneumoniae and viruses are the most common causes in infants three weeks to
three months of age. ASUNCION, K.
EFFECTS TO THE BODY
1. The infection causes the lungs' air sacs (alveoli) to become inflamed and fill up with
fluid or pus. That can make it hard for the oxygen you breathe in to get into your
bloodstream. The symptoms of pneumonia can range from mild to severe, and
include cough, fever, chills, and trouble breathing. ACOSTA.
2. The long-term effects associated with early childhood pneumonia include restrictive
or obstructive lung function deficits and an increased risk of adult asthma, non-
smoking related COPD, and bronchiectasis. AGNIR.
RISK FACTORS
1. Chronic disease. You're more likely to get pneumonia if you have asthma, chronic
obstructive pulmonary disease (COPD) or heart disease and weakened or suppressed
immune system. ALQUIZA.
2. Anyone can get pneumonia, but many factors can increase your chances of getting
sick and having a more severe illness. One of the most important factors is your age.
People age 65 and over are at increased risk because their immune system is
becoming less able to fight off infection as years go by. Infants and children two
years of age or younger are also at increased risk because their immune systems are
not yet fully developed. ASUNCION, K.
3. Other risk factors can be grouped into three main categories: medical conditions,
health behaviors, and environment. ASUNCION, K.
Medical conditions
 Chronic lung diseases such as COPD, bronchiectasis, or cystic fibrosis that
make the lungs more vulnerable.
 Other serious chronic illnesses, such as heart disease, diabetes and sickle cell
disease.

 A weakened immune system due to HIV/AIDs, an organ transplant,
chemotherapy or long-term steroid use.
 Difficulty swallowing, due to stroke, dementia, Parkinson's disease, or other
neurological conditions, which can result in aspiration of food, vomit or saliva
into the lungs that then becomes infected.
 Recent viral respiratory infection—a cold, laryngitis, influenza, etc.
 Hospitalization, especially when in intensive care and using a ventilator to
breathe.
Health behaviors
 Cigarette smoking, which damages the lungs.
 Drug and alcohol abuse, which increase the risk of aspiration pneumonia.
Environment
 Exposure to certain chemicals, pollutants or toxic fumes, including
secondhand smoke.
DIAGNOSTIC TEST
1. Chest X ray. Identifies structural distribution (e.g., lobar, bronchial); may also reveal
multiple abscesses/infiltrates, empyema (staphylococcus); scattered or localized
infiltration (bacterial); or diffuse/extensive nodular infiltrates (more often viral).
In the case, Baby Arym's chest xray results showed white patch seen on left upper
lobe of lung The white patch is called infiltrates that identify an infection. A
pulmonary infiltrate is a substance denser than air, such as pus, blood, or protein,
which lingers within the parenchyma of the lungs. Pulmonary infiltrates are
associated with pneumonia. ACOSTA.
2. Blood tests. A blood count looks for signs of an infection. An arterial blood gas test
looks at the amount of carbon dioxide and oxygen in the blood. AGNIR
3. Pulse oximetry. To measure how much oxygen is in your blood. Pneumonia can keep
your lungs from moving enough oxygen into your blood. To measure the levels, a
small sensor called a pulse oximeter is attached to your finger or ear. Performed
early in the evaluation when respiratory symptoms are present. Observe for cyanosis
also. ASUNCION, K. & AURELIO.
4. Physical Assessment. ALQUIZA.
 The child's nostrils open wider when he or she breathes in.
 The child's skin between his or her ribs and around his or her neck pulls in
with each breath.
 The child is wheezing, which means you hear a high-pitched noise when he or
she breathes out.
 The child is breathing fast:
 More than 60 breaths in 1 minute for newborn babies up to 2 months old
 More than 50 breaths in 1 minute for a baby 2 months to 12 months old

Other diagnostic tests:
1. A sputum test, which is when a sample of spit or phlegm is laboratory-tested.
This might confirm if a certain type of bacterium is causing the pneumonia.
ABADILLA.
2. The chest radiograph confirms the diagnosis of pneumonia and may indicate
a complication such as pleural effusion or empyema. ALQUIZA.
3. A bronchoscopy, which is when a tube with a camera and light attached to
the end is guided into the lungs so a doctor can look inside. This is rare and
generally only used in complicated pneumonia cases. ABADILLA.
4. Polymerase chain reaction (PCR) test. This test quickly checks your blood or
sputum sample to find the DNA of germs that cause pneumonia. ASUNCION,
K.
5. Pleural fluid culture is made by taking a fluid sample by taking or putting a
needle between the ribs from the pleural area and is sent to be analyzed to
help determine what type of infection the children or adults had acquired.
ASUNCION, J.
6. Chest computed tomography (CT) scan. This test can show how much of
your lungs are affected by pneumonia. It can also show whether you have
complications such as lung abscesses or pleural disorders. A CT scan shows
more detail than a chest X-ray because computers can combine these
pictures to create three-dimensional (3D) models to help show the size,
shape, and position of your lungs and structures in your chest. This imaging
test is often done to follow up on abnormal findings from earlier chest x rays.
ASUNCION, K.
SIGNS AND SYMTPOMS ABADILLA.
Symptoms of pediatric pneumonia depend on a number of factors, particularly the
age of the affected child, and whether the cause of the infection is bacterial or viral.
Symptoms in newborns
Newborns and babies under a month old are the only age group that rarely
cough as a direct consequence of pneumonia. The most common symptoms are
irritability and not feeding properly. A child of this age may also display:
 Abnormally fast breathing
 Shortness of breath
 Grunting sounds
Symptoms in babies over a month old
Once a baby is over a month old, then the most noticeable symptom of
pneumonia is likely to be coughing. All of the symptoms that affect newborns will

possibly be present too, although grunting becomes less common as the baby grows
older. Other pneumonia symptoms observed in babies of this age include:
 Congestion, the feeling that the chest is full or clogged
 Wheezing or heavy breathing
 Fever, particularly during pneumonia caused by bacterial infection
COMPLICATION
1. Kidney, liver, and heart damage. This happens when these organs don’t get enough
oxygen to work properly or when your immune system responds negatively to the
infection. If baby arym's SPO2 continue to drop, it could lead to organ failure due to
inadequate oxygen. ACOSTA.
2. Fluid accumulation. Fluid accumulation around the lungs (pleural effusion).
Pneumonia may cause fluid to build up in the thin space between layers of tissue
that line the lungs and chest cavity (pleura). If the fluid becomes infected, you may
need to have it drained through a chest tube or removed with surgery. ALQUIZA.
3. Lung abscess. An abscess occurs if pus forms in a cavity in the lung. An abscess is
usually treated with antibiotics. Sometimes, surgery or drainage with a long needle
or tube placed into the abscess is needed to remove the pus. ASUNCION, K.
4. Necrotizing pneumonia, a condition that develops when your infection causes your
lung tissue to die and form lung abscesses (pockets of tissue filled with pus). It also
makes your pneumonia harder to treat. You may need surgery or drainage with a
needle to remove the pus. ACOSTA.
MANAGEMENT
1. Antibiotics – by IV (intravenous) or by mouth (oral) to treat bacterial infection.
ANSAGAY.
Nursing Responsibilities
i. Observing the rights of medication administration such as the right patient,
the right drug, the right dose, the right route, and the right time to ensure
safety of patient. ACOSTA.
ii. Observe and monitor for side effects as well as adverse effects and
immediately notify the physician if so. ALQUIZA.
iii. Watch out for drug toxicity. AGNIR.
2. Oxygen Therapy
Oxygen therapy is a treatment that delivers oxygen gas for Baby Arym to
breathe. He can receive oxygen therapy from tubes resting in your nose, a face mask,
or a tube placed in your trachea, or windpipe. This treatment increases the amount
of oxygen the lungs receive and deliver to your blood. With this oxygen therapy, the
SPO2 of Baby Arym will increase. ACOSTA.

i. Check often the oxygen tank as well as the oxygen humidifier that provides
long-lasting moisture. This to provide utmost newborn comfort during
oxygen therapy, especially in drier conditions. ACOSTA.
ii. Pneumonia can be prevented in babies by breastfeeding during the first six
months of life. Breast milk has antibodies that protect newborns, which are
transmitted to the baby through breastfeeding. AURELIO.
3. Medications ASUNCION, K.
Infants three weeks to three months of age who are suspected of having
bacterial pneumonia require immediate attention, particularly if they are febrile,
tachypneic, or appear toxic.7 These patients are best treated in a hospital. Initial
therapy consists of cefuroxime (Ceftin) or cefotaxime. Once stabilized, infants may
be changed to an oral antibiotic for 10 days.
Cefotaxime
Special Considerations
i. Monitor renal and hepatic function.
i. Observe site closely for extravasation during administration.
ii. Observe for signs of adverse effects, especially those suggesting a
superinfection.
iii. Observe for signs of renal, hepatic, or hematological dysfunction during
prolonged therapy.
4. Nebulizer – indicated for the relief of bronchospasm in patients. A nebulizer
treatment is to help loosen the mucus in your lungs and help you breathe better.
ALQUIZA &ABADILLA.
Nursing Responsibility
i. Being given to infants take extra care and hold the baby and the breathing
mask firmly in place. AURELIO
5. Giving Paracetamol. In the case scenario, baby Aryn was prescribed for paracetamol,
paracetamol for children are commonly Pamol or panadol, paracetamol is safe to
administer for children or infants 3 months and older, in the case, baby Arym has
103 degrees Fahrenheit or 39.4 degrees’ Celsius temperature which suggests fever
that is why antipyretic was ordered. ASUNCION, M.
i. Before administering the medication ensure that the baby is not allergic to
any ingredients of the medication, give correct dosage and frequency to the baby
to prevent over dosage, keep records of what time you have administered the
drug and to monitor the temperature of the infant. Administer only as needed or
as ordered by the physician. ASUNCION, M.

ROLES
1) Physician
As medical experts, physicians perform diagnostic/therapeutic activities
involving the management of situations where medical prioritization and decisions
are required. Their expertise lead to the diagnosis as well as the management of the
disease of the infant. ALQUIZA.
In addition, physicians are also communicators. They convey medical
problems and solutions through respectful rapport with the parties involved such as
patients/relatives, colleagues and other collaboration partners. This can be through
oral or written explanation. Since, the patient is an infant, the role of the physician
as a communicator shall be applied to the patient's mother or significant others.
ALQUIZA.
As collaborators, physicians work effectively with other health care
professionals to provide safe, high-quality patient-centered care. They need to
engage in respectful shared decision-making with other colleagues in the health care
professions by establishing positive relationship and negotiating shared
responsibilities. They must also implement strategies to promote understanding,
manage differences, and resolve conflicts in a manner that supports a collaborative
culture. Lastly, they need to determine when care should be transferred to another
physician or health care professional and demonstrate safe handover of care, using
both verbal and written communication, during a patient transition to a different
health care professional, setting, or stage of care. AURELIO.
Lastly, as health advocate, physician motivate and exert their influence on
the health behaviors of the individual and the system as a whole by offering
guidance and advice as well as initiating and implementing preventive measures as
required. So again, it'll be done with the mother as she is the primary care giver of
the infant. ALQUIZA.
2) Nurses
As a care provider, they need to observe and monitor the condition of the
patient. they need to record all the information with regards to the patient such as
the medications that were given, the procedures that were done and etc. Not only
they are responsible for the administration medication and other therapies but for
the holistic care of patient which encompasses the psychosocial, developmental,
cultural and spiritual needs of the patient. ASUNCION, K.
Another role is the nurse as educator. Since in our case scenario, the
patient is only 3-month-old, so health teachings should be given to the significant
other of the patient such as his or her parents, in order to still provide necessary
care for the client even after discharge. ASUNCION, K.
Another role of Nurses is being a collaborator. In the case, nurses should
directly involve in planning the care for the baby. Nurses should be able to
communicate information such as the laboratory results of Baby Arym like the chest

x-ray, CBC results as well as the different leukocyte count and responses to
therapies regarding patient health effectively. Nurses are the most familiar with the
individual patient situation as they monitor their signs and symptoms on an ongoing
basis and should collaborate with other members of the medical team to promote
the best patient health outcomes. We, nurses are expected to perform both
collaborated dependent interventions and independent functions for the Baby
Arym to aid him towards his recovery from Pneumonia. ACOSTA.
3) Medical technologist
The one who test the blood or the blood culture to determine if there is an
infection to the blood of the infant. AGNIR.
Conductor and analyzer of laboratory tests and analysis. They are also
responsible for the accurate and precise data to be given. ANSAGAY.
Part of the infectious control team, they monitor and surveil infections
either hospital-acquired or not. They analyze Bacterial samples and notice if there
are indeed infections. Obtained surveillance or routine work, greatly contributes to
infection control. A 24hr system for the microbiological laboratory may prevent
occupational infection of health care workers. ASUNCION, M.
4) Radiologic Technologist
Plays an important role in patient care as they produce x-ray image in
detecting the problem of the infant which provide care that leads to diagnosis,
treatment and cure. So in the case, the radtech did the chest x-ray as ordered by
which it was found out that there is a white patch seen on the left upper lobe of the
lungs. So, this lead to the diagnosis of the pneumonia and getting a treatment as
well as preventive measures to be done. Since they already did the chest x-ray, they
have to collaborate to the physician in order to validate the results. ALQUIZA.
LONG TERM REHABILITATION
1. Encourage breastfeeding. ACOSTA.
 We already know that breastmilk is a superior nutrition. There is an increased
resistance to infections, and therefore fewer incidents of illness and
hospitalization.
2. Smoke Free Environment. ACOSTA.
 We should encourage the parents of Baby Arym to avoid exposing their infant
to areas with smokers or any presence of smoke. Smoking increases the risk
of acquiring again pneumonia. Smoking also makes it harder for Baby Arym to
get better after he had pneumonia.
3. Treatment of critically ill children (those requiring ventilation) should include
timely administration of appropriate antibiotics. Delays of only a few hours in
one retrospective study were associated with significantly longer durations of
ventilation, intensive care unit (ICU) stay, and total hospitalization. AURELIO.

4. Pneumococcal Vaccines. ACOSTA.
 Encourage the parents to have routine administration of pneumococcal
conjugate vaccine (PCV13) for all children younger than 2 years of age: Give
PCV13 to infants as a series of 4 doses, one dose at each of these ages: 2
months, 4 months, 6 months, and 12 through 15 months. PCV13 protects
against 13 types of pneumococcal bacteria, which cause the most common
pneumococcal (new-muh-KOK-uhl) infections in kids. PPSV23 protects against
23 types. These vaccines prevent infections in children who get them, and
help stop the infections from spreading to others.
PROGNOSIS
 Pneumonia claims the lives of over 800,000 children under five every year,
including over 153,000 newborns, who are particularly vulnerable to
infection. That means a child dies from pneumonia every 39 seconds and
almost all of these deaths are preventable. AURELIO.
 In general, the prognosis is good. Most cases of viral pneumonia resolve
without treatment; common bacterial pathogens and atypical organisms
respond to antimicrobial therapy. Long-term alteration of pulmonary
function is rare, even in children with pneumonia that has been complicated
by empyema or lung abscess. ALQUIZA.
RELATED CONCERNED ISSUES
Pneumonia requires different medical interventions such as oxygen therapy or
nebulization, diagnostic procedures, medications and others. One of the related issues
concerned is securing a consent form. Consent to treatment means the parents must give
permission before their child receive any type of medical treatment, test or examination.
This must be done on the basis of an explanation by the nurse and physician. ACOSTA.
It is vital that you give the patient all the information they need about the procedure
so that the parents could give informed consent about the pneumonia therapy of Baby
Arym. ACOSTA.
REFERRALS
If the newborn is benefited under PhilHealth but needs further papers to fully claim
the benefit, we, nurses should help them refer to the DSWD or other private sectors that
could provide help to them financially or in any ways. While, if the newborn is not a
beneficiary of PhilHealth, we must inform them and refer to them how would they avail this.
ALQUIZA.
LEARNING GOALS AURELIO
1. Learners will be ready to attend patient diagnosed with pneumonia when exposed to
hospital setting.

2. The learners will be able to interpret significance of laboratory results to the signs
and symptoms manifested by the patient.
3. The learners will be able to integrate nursing independent interventions and core
competencies in caring for a pneumonia patient.
SUMMARY AGCAOILI, ANTOLIN & AURELIO
Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs
may fill with fluid causing cough with phlegm or pus, fever, chills, and difficulty breathing. A
variety of organisms, including bacteria, viruses and fungi, can cause pneumonia.
In 2017, the Philippines' number of pneumonia cases amounted to approximately
495.2 thousand and approximately 57.2 thousand deaths. This made pneumonia the 3rd top
killer behind ischemic heart disease and cancer. Additionally, pneumonia was the 3rd
leading cause of death among Filipino women in the same year.
The types of pneumonia mentioned are hospital-acquired pneumonia (HAP), viral
pneumonia, bacterial pneumonia, mycoplasma pneumonia, fungal pneumonia, and
chlamydia trachomatis pneumonia. Hospital-acquired pneumonia (HAP) type of bacterial
pneumonia is acquired during a hospital stay. Viral pneumonia is generally caused by viral
infections of the upper respiratory tract. Furthermore, bacterial pneumonia is caused by
various bacteria and the most common is the Streptococcus pneumoniae. Mycoplasma,
commonly referred to as “walking pneumonia”, is caused by bacterium Mycoplasma
pneumoniae. Moreover, fungal pneumonia is less common cause of pneumonia. Lastly, the
chlamydia trachomatis pneumonia is typically seen in newborns up to 12 weeks of age, and
is often contracted from contact with the mother’s vagina during birth.
The causes are common viruses that cause cold, flu and other respiratory infections,
and streptococcus pneumoniae is the most common causes in infants three weeks to three
months of age. Pneumonia in neonates younger than three weeks of age most often is
caused by an infection obtained from the mother at birth.
The effect of pneumonia to the body is an infection causes the lungs' air sacs
(alveoli) to become inflamed and fill up with fluid or pus, it can make it hard for the oxygen
you breathe in to get into your bloodstream. It also includes restrictive or obstructive lung
function deficits and an increased risk of adult asthma, non-smoking related COPD, and
bronchiectasis.
The risk factors of pneumonia are chronic diseases such as asthma, chronic
obstructive pulmonary disease (COPD) or heart disease. One of the most important factors
is also the age where infants and people age 65 and over are at greater risk. Other risk
factors can be grouped into three main categories: medical conditions, health behaviors,
and environment.
Pneumonia is diagnosed mainly through chest X ray, blood tests, pulse oximetry and
physical assessment. Other diagnostic tests include sputum test, chest radiograph,

bronchoscopy, polymerase chain reaction (PCR) test, pleural fluid culture and chest
computed tomography (CT) scan.
Symptoms of pediatric pneumonia depend on a number of factors, particularly the
age of the affected child. Symptoms in newborns are irritability, not feeding properly,
abnormal fast breathing, shortness of breath and grunting sounds. Symptoms in babies over
a month old are coughing, congestion, wheezing or heavy breathing and fever.
Further complications of pneumonia include kidney, liver, and heart damage, pleural
effusion, lung abscess and necrotizing pneumonia.
Management of pneumonia includes administration of antibiotics and other
medications like Cefotaxime and paracetamol, oxygen therapy, and nebulizer. Be sure to
perform appropriate nursing responsibilities.
For the different roles of the healthcare team, physician’s roles are medical experts,
communicators, collaborator and health advocate, nurse’s roles are care provider, educator
and collaborator. While medical technologist roles are conductor and analyzer of laboratory
tests and analysis, they are also part of the infectious control team. For radiology
technologist they produce x-ray image necessary for diagnosis.
Long term rehabilitation of pneumonia includes frequent breastfeeding, smoke-free
environment, timely administration of antibiotics, and pneumococcal vaccines.
In general, the prognosis is good. Most cases of viral pneumonia resolve without
treatment; common bacterial pathogens and atypical organisms respond to antimicrobial
therapy.
Pneumonia requires different medical interventions and one of the related issues
concerned is securing a consent form. This must be done on the basis of an explanation by
the nurse and physician.
This problem-based learning would be an avenue by which the learners will be able
to attend patient diagnosed with pneumonia properly, to interpret significance of laboratory
results to the signs and symptoms manifested by the patient and to integrate nursing
independent interventions and core competencies in caring for patients suffering from
pneumonia.

11 nursing diagnosis common to pneumonia nursing care plans (NCP), they are as follows:
1. Ineffective Airway Clearance
2. Impaired Gas Exchange
3. Ineffective Breathing Pattern
4. Risk for Infection
5. Acute Pain
6. Activity Intolerance
7. Hyperthermia
8. Risk for Deficient Fluid Volume
9. Risk for Imbalanced Nutrition: Less Than Body Requirements
10. Deficient Knowledge
11. Deficient Fluid Volume

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