Pneumonia

Pneumonia

1. PneumoniaPneumonia
Dr. Walaa NasrDr. Walaa Nasr
Lecturer of Adult Nursing Lecturer of Adult Nursing
Second year Second year
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2. PneumoniaPneumonia
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Out linesOut lines
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DefinitionDefinition
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Classification of pneumonia Classification of pneumonia
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According to causesAccording to causes
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According to area involved According to area involved
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Mode of transmission Mode of transmission
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Predisposing factorsPredisposing factors
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PathophysiologyPathophysiology
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Clinical manifestationsClinical manifestations
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Diagnostic testsDiagnostic tests
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Medical managementMedical management
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Nursing interventionNursing intervention
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Preventive measuresPreventive measures
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Prognosis Prognosis
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ComplicationsComplications
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3. 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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4. Classification of
pneumonia
According to causesAccording to causes
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BacterialBacterial (the most common cause of (the most common cause of
pneumonia)pneumonia)
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ViralViral pneumonia pneumonia
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FungalFungal pneumonia pneumonia
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ChemicalChemical pneumonia (ingestion of pneumonia (ingestion of
kerosene or inhalation of irritating kerosene or inhalation of irritating
substance)substance)
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InhalationInhalation pneumonia (aspiration pneumonia (aspiration
pneumonia)pneumonia)
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5. 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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6. PneumoniaPneumonia
Mode of transmission
Ways you can get pneumonia include:Ways you can get pneumonia include:
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Bacteria and viruses living in your nose, Bacteria and viruses living in your nose,
sinuses, or mouth may spread to your lungs.sinuses, or mouth may spread to your lungs.
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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).
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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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7. 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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8. 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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9. 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.
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10. 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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11. PneumoniaPneumonia
Clinical manifestations
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SShaking chillshaking chills
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RRapidly rising fever ( 39.5 to 40.5 degree)apidly rising fever ( 39.5 to 40.5 degree)
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SStabbing chest pain aggravated by respiration and coughingtabbing chest pain aggravated by respiration and coughing
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TTachypnea, nasal flaringachypnea, nasal flaring
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PPatient is very ill and lies on the affected side to decrease painatient is very ill and lies on the affected side to decrease pain
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UUse of accessory muscles of respiration e.g. abdomen and se of accessory muscles of respiration e.g. abdomen and
intercostals musclesintercostals muscles
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CCough with purulent, blood tinged, rusty sputumough with purulent, blood tinged, rusty sputum
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SShortness of breathhortness of breath
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FFlushed cheekslushed cheeks
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LLoss of appetite, low energy, and fatigueoss of appetite, low energy, and fatigue
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CCyanosed lips and nail beds yanosed lips and nail beds
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12. 
History takingHistory taking
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Physical examinationPhysical examination
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Chest x-rayChest x-ray
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Blood testBlood test
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Sputum cultureSputum culture
Pneumonia
Diagnostic tests
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13. Antibiotic, depending on sputum
and blood culture
Oxygen therapy
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Chest physiotherapy
Pneumonia
Medical management
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14. Pneumonia
Nursing interventionNursing intervention
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Maintain a patent airway and Maintain a patent airway and
adequate oxygenation.adequate oxygenation.
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Obtain sputum specimens as Obtain sputum specimens as
needed.needed.
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Use suction if the patient canUse suction if the patient can’’t t
produce a specimen.produce a specimen.
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perform chest physiotherapy.perform chest physiotherapy.
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15. Pneumonia
Nursing intervention (contNursing intervention (cont……((
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Provide a high calorie, high protein diet Provide a high calorie, high protein diet
of soft foods.of soft foods.
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To prevent aspiration during nasogastric To prevent aspiration during nasogastric
tube feedings, check the position of tube, tube feedings, check the position of tube,
and administer feedings slowly.and administer feedings slowly.
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To control the spread of infection, To control the spread of infection,
dispose secretions properly.dispose secretions properly.
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16. Pneumonia
Nursing 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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17. Pneumonia
Preventive 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.Brought to you
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18. Pneumonia
Prognosis
With treatment, most
patients will improve
within 2 weeks. Elderly
or very sick patients
may need longer
treatment.
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19. Pneumonia
Complications
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Acute respiratory distress syndrome (ARDS)Acute respiratory distress syndrome (ARDS)
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Pleural effusionPleural effusion
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Lung abscessesLung abscesses
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Respiratory failure (which requires mechanical Respiratory failure (which requires mechanical
ventilator)ventilator)
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Sepsis, which may lead to organ failureSepsis, which may lead to organ failure
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v=nhUT5BfAFicv=nhUT5BfAFic
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