PneumoniPneumoniaa
Dr. Walaa NasrDr. Walaa Nasr
Lecturer of Adult Nursing Lecturer of Adult Nursing Second year Second year
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PneumoniaPneumonia Out linesOut lines
DefinitionDefinition Classification of pneumonia Classification of pneumonia According to causesAccording to causes According to area involved According to area involved Mode of transmission Mode of transmission Predisposing factorsPredisposing factors PathophysiologyPathophysiology Clinical manifestationsClinical manifestations Diagnostic testsDiagnostic tests Medical managementMedical management Nursing interventionNursing intervention Preventive measuresPreventive measures Prognosis Prognosis ComplicationsComplications Brought to you
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PneumoniaPneumonia DefinitionDefinition
Is an inflammatory Is an inflammatory process of the lung process of the lung parenchymaparenchyma that is that is commonly caused by commonly caused by infectious agents.infectious agents.
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Classification of pneumonia
According to causesAccording to causes BacterialBacterial (the most common cause (the most common cause
of pneumonia)of pneumonia) ViralViral pneumonia pneumonia FungalFungal pneumonia pneumonia ChemicalChemical pneumonia (ingestion of pneumonia (ingestion of
kerosene or inhalation of irritating kerosene or inhalation of irritating substance)substance)
InhalationInhalation pneumonia (aspiration pneumonia (aspiration pneumonia)pneumonia)
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Classification of pneumonia (cont…)
According to areas involvedAccording to areas involved
Lobar pneumonia; if one or more lobe is involved
Broncho-pneumonia; the pneumonic process has originated in one or more bronchi and extends to the surrounding lung tissue.
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PneumoniaPneumonia Mode of transmission
Ways you can get pneumonia include:Ways you can get pneumonia include:
Bacteria and viruses living in your nose, Bacteria and viruses living in your nose, sinuses, or mouth may spread to your sinuses, or mouth may spread to your lungs.lungs.
You may breathe some of these germs You may breathe some of these germs directly into your lungs (droplets infection).directly into your lungs (droplets infection).
You breathe in (inhale) food, liquids, vomit, You breathe in (inhale) food, liquids, vomit, or fluids from the mouth into your lungs or fluids from the mouth into your lungs ((aspiration pneumonia).
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PneumoniaPneumonia Predisposing factors
Immuno-suppresed patients Cigarette smoking Difficult swallowing (due to stroke,
dementia,parkinsons disease, or other neurological conditions)
Impaired consciousness ( loss of brain function due to dementia, stroke, or other neurological conditions)
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PneumoniaPneumonia Predisposing factors
Chronic lung disease (COPD, bronchostasis)
Frequent suction Other serious illness such as
heart disease, liver cirrhosis, and DM
Recent cold, laryngitis or flu
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PneumoniaPneumonia Pathophysiology
The streptococci reach the alveoli and lead to inflammation and pouring of an exudates into the air spaces.
WBCs migrates to alveoli, the alveoli become more thick due to its filling consolidation, involved areas by inflammation are not adequately ventilated, due to secretion and edema. This will lead to partial occlusion of alveoli and bronchi causing a decrease in alveolar oxygen content. Brought to you
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PneumoniaPneumonia Pathophysiology (cont…)
Venous blood that goes to affected areas without being oxygenated and returns to the heart. This will lead to arterial hypoxemia and even death due to interference with ventilation.
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PneumoniaPneumonia Clinical manifestations
SShaking chillshaking chills RRapidly rising fever ( 39.5 to 40.5 degree)apidly rising fever ( 39.5 to 40.5 degree) SStabbing chest pain aggravated by respiration and tabbing chest pain aggravated by respiration and
coughingcoughing TTachypnea, nasal flaringachypnea, nasal flaring PPatient is very ill and lies on the affected side to atient is very ill and lies on the affected side to
decrease paindecrease pain UUse of accessory muscles of respiration e.g. abdomen se of accessory muscles of respiration e.g. abdomen
and intercostals musclesand intercostals muscles CCough with purulent, blood tinged, rusty sputumough with purulent, blood tinged, rusty sputum SShortness of breathhortness of breath FFlushed cheekslushed cheeks LLoss of appetite, low energy, and fatigueoss of appetite, low energy, and fatigue CCyanosed lips and nail beds yanosed lips and nail beds Brought to you
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History takingHistory taking Physical examinationPhysical examination Chest x-rayChest x-ray Blood testBlood test Sputum cultureSputum culture
PneumoniaDiagnostic tests
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Antibiotic, depending on sputum and blood culture
Oxygen therapy
Chest physiotherapy
PneumoniaMedical management
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PneumoniaNursing interventionNursing intervention
Maintain a patent airway Maintain a patent airway and adequate oxygenation.and adequate oxygenation.
Obtain sputum specimens Obtain sputum specimens as needed.as needed.
Use suction if the patient Use suction if the patient cancan’’t produce a specimen.t produce a specimen.
perform chest perform chest physiotherapy.physiotherapy.
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PneumoniaNursing intervention (contNursing intervention (cont……))
Provide a high calorie, high protein Provide a high calorie, high protein diet of soft foods.diet of soft foods.
To prevent aspiration during To prevent aspiration during nasogastric tube feedings, check the nasogastric tube feedings, check the position of tube, and administer position of tube, and administer feedings slowly.feedings slowly.
To control the spread of infection, To control the spread of infection, dispose secretions properly.dispose secretions properly.
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PneumoniaNursing intervention (contNursing intervention (cont……))
Provide a quiet, calm environment, with frequent rest periods.
Monitor the patient’s ABG levels, especially if he’s hypoxic.
Assess the patient’s respiratory status. Auscultate breath sounds at least every 4 hours.
Monitor fluid intake and output.
Evaluate the effectiveness of administered medications.
Explain all procedures to the patient and family.
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PneumoniaPreventive measures
Frequent turning of bed ridden patients and early ambulation as much as possible.
Coughing and breathing techniques.
Sterilization of respiratory therapy equipment
Suctioning of secretion in the unconscious who have poor cough and swallowing reflexes, to prevent aspiration of secretions and its accumulation.
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PneumoniaPrognosis
With treatment, most patients will improve within 2 weeks. Elderly or very sick patients may need longer treatment.
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PneumoniaComplications
Acute respiratory distress syndrome (ARDS)Acute respiratory distress syndrome (ARDS) Pleural effusionPleural effusion Lung abscessesLung abscesses Respiratory failure (which requires Respiratory failure (which requires
mechanical ventilator)mechanical ventilator) Sepsis, which may lead to organ failureSepsis, which may lead to organ failure http://www.youtube.com/watch?http://www.youtube.com/watch?
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