Case study BronchoPneumonia

BronchoPneumonia

1. BronchoPneumoniaBronchoPneumonia
Des 2015
By:By:
Omran Mohammed Alkhaybri.Omran Mohammed Alkhaybri.

2. Out LineOut Line
What is PneumOnia PneumOnia?
PathOPhysiOLOgy
etiOLOgy & CLiniCaL PiCture
symPtOms
hOW tO diagnOsis
treatment
Case study
referenCes

3. Case study presentaionCase study presentaion
Bronchopneumonia is a severe type of
pneumonia that is characterized by multiple
areas of acute and isolated consolidation that
affect one or more pulmonary lobes. It is one
of the most serious infection in childrens.The
disease assumes alarming proportion if both
the lungs are affected. Great care has to be
taken if the patient suffers from
bronchopneumonia. If it is left untreated, the
outcome may be fatal .

4. CrOss seCtiOn Of BrOnChOPneumOnia CrOss seCtiOn Of BrOnChOPneumOnia
affeCted Lungs affeCted Lungs

5. PATHOPHYSIOLOGYPATHOPHYSIOLOGY
VIRUS ENTER THE RESPIRATORY TRACT
INFLAMMATIONINFLAMMATION
ACCUMULATION OF BRONCHIAL SECRETION

ALVEOLI COLLAPSE

NARROWING OF AIRWAYS
SOB & DOB


BRONCHOPNEUMONIA

6. etiOLOgyetiOLOgy
Bronchopneumonia is caused by viruses, bacteria , fungi protozoa
and myco plasma
Bacteria
Streptococcus
Staphylococcus
Hemophilus influenza
Klebsella
Virus
legionella pneumonia
Fungi
candida albicans

Other predisposing factors include :
common in hospitalized patients
its occur as a complication of some other diseases , eg: in children –
diphtheria, measles, and whooping cough
In adults- influenza, typhoid and paratyphoid fever
its caused by organism aspirated from mouth

7. SIGNS & SYMPTOMSSIGNS & SYMPTOMS
BOOK BASE PATIENT MANIFESTATION
HIGH GRADE FEVER FEVER 38.8° C
COUGH W/ MUCUS PRESENT
CHEST PAIN MILD CHEST PAIN PRESENT
FATIGUE PRESENT
IRRITABILITY NOT PRESENT
DECREASED APETITE PRESENT
DECREASED BREATH SOUND PRESENT
HEADACHE ABSENT

8. DIAGNOSISDIAGNOSIS
Auscultation of breathing pattern
Chest xray
CBC, Sputum culture , c- reactive
protein

9. BRONCHOPNEUMONIA IMAGESBRONCHOPNEUMONIA IMAGES

10. TREATMENTTREATMENT
Advise to drink plenty of fluid
Enough rest
Elevate the head of the bed to
minimize respiratory effort
Administer oxygen, if needed
Use antibiotics as prescribe
Antipyretics as ordered

11. NURSING CASE STUDY OF A PATIENT WITH NURSING CASE STUDY OF A PATIENT WITH
BRONCHOPNEUMONIABRONCHOPNEUMONIA
NAME : X
AGE : 70YEARS
SEX : fEMAlE
NATIONAlITY : SAUDI
DATE Of ADMISSION :12/10/2015
CHIEf COMPlAINTS : fEvER,COUGH ,
SOB.
DIAGNOSIS : BRONCHOPNEUMONIA

12. Current illness Current illness
Dyspnea and orthopnea 3 day`s
Increase when she is move
Decreases when lyning on her back
Decreases when setting
GCS 10/15

13. INVESTIGATION INVESTIGATION
BIOCHEMESTRY CBC
GUL= 148.9 mg/dl WBC=15.62ul
LDH= 561 IU/L
Sodium=135mmol/l
Potassium=3.5mmol/l
CHEST X-RAY:
Showed focal consolidation in the right lower lobe.
ABG:
PH=7.28
PCo2=55

14. MEDICAL INTERVENTION MEDICAL INTERVENTION
Foley catheter.
ETT on M.V.
NGT

15. MedicationMedication
Meropenem Antibiotic Action with
gram +and-
bacteria
1g IV BID
Clarithromycin
Antibiotic
Wide
spectrum
gram +and-
bacteriaof
500mg IV BID
Lasix Diuretic Congestive
H.F and
edema
40mg IV BID
Clexane
Anticoagulant Prevent and
treat deep
vein
thrombosis
40mg S/C OD
Omeprazole Proton pump
inhibitor
Interaction
is high
40mg IV OD

16. SUBJECTIVE DATASUBJECTIVE DATA
RESPIRATORY
Dyspnea,Cough
CARDIOVASCULAR
Heart rate
RENAL
Polyuria

17. OBJECTIVE DATAOBJECTIVE DATA
RESPIRATORY
RR= 20/MIN
BREATH SOUND: Crackles
CARDIOVASCULAR
V/S = BP= 114/70, HR= 119/min TEMP=
38.8C
EDEMA
HEART SOUND = S1 + S2 +murmur
GASTRO
Mouth lesions.

18. FAMILY HISTORYFAMILY HISTORY
Her father died and has D.M and
H.T.N
Lifestyle
Houswife, Secondhand smoking.

19. CARE PLANCARE PLAN
NURSING DIAGNOSISNURSING DIAGNOSIS
1.INEFFECTIVE AIRWAY CLEARANCE
Related to increased sputum production .
Goal to improve airway clearance.
Objective breathing normally without effort
within 3 hours.
NURSING INTERVENTION
Assess rate and depth of breathing and chest
movement.
Frequent suction.
EVALUATION
No sing of diffcaluty breathing.
No abnormal lung sound.

20. CARE PLANCARE PLAN
NURSING DIAGNOSISNURSING DIAGNOSIS
2- RISK FOR INFECTION
Related to chest infection.
Goal to reduces risk of infection.
Objective no sing of infection during
hospitalization.
 NURSING INTERVENTIONNURSING INTERVENTION
Monitor V/S .
Limit visitor.
Isolation precautions as needed.
EVALUATIONEVALUATION
Achieve timely resolution of current infection
without compliction.

21. ReferencesReferences
Midical surgical nursing texbook
American Lung Association
www.lungusa.org
 NANDA International
http://www.nanda.org/