pneumonia management and brief summary.pptx

Details regarding management

1. Pneumonia and its management by D. Vanitha NURSING SUPERINTENDENT SDH/CRS/TPTY

2. The story is set in  Greenwich Village  during a pneumonia epidemic. It tells the story of an old artist who saves the life of a young neighbouring artist, dying of pneumonia, by giving her the will to live. Through her window she can see an old ivy creeper (growing on a nearby wall), gradually shedding its leaves as autumn turns into winter, and she has taken the thought into her head that she will die when the last leaf falls. The leaves fall day by day, but the last lone leaf stays on for several days. The ill woman's health quickly recovers. At the story's end, we learn that the old artist, who always wanted to produce a masterpiece painting but had never had any success, spent considerable time painting with great realism a leaf on the wall for the whole night. Furthermore, the old artist himself dies of pneumonia contracted while being out in the wet and cold. The Last Leaf

3. Definition Inflammation in the lung characterized by accumulation of secretions and inflammatory cells in alveoli.

4. CLINICAL Classification Community-acquired pneumonia: (Typical/Atypical) Hospital-acquired Pneumonia(HAP/nosocomial) Suppurative & Aspiration pneumonia Pneumonia in immunocompromised patient 5

5. ANATOMIC Classification Lobar pneumonia   Broncho-pneumonia (Lobular)

6. Community-acquired pneumonia (CAP) Acc. to BTS Guidelines CAP is defined as, Acute lower respiratory tract infection accompanied by new infiltrates on chest radiograph or auscultatory findings consistent with pneumonia in a patient not hospitalized or residing in a long-term care facility for more than 2 weeks before onset of symptoms 7

7. Community-acquired pneumonia (CAP) - Predisposing factors Cigarette smoking     Upper respiratory tract infections Alcohol Corticosteroid therapy Old age Recent influenza infection Pre-existing lung disease HIV Indoor air pollution 8

8. Pathology Congestion – Vasodilatation Red Hepatization – Exudation + RBC Gray Hepatization - Neutro & Macrophages. Resolution – few macrophages, normal. 9

9. symptoms High grade fever Cough-productive Pleuritic chest pain Breathlessness Excessive sweating and clammy skin Loss of appetite and fatigue Confusion, especially in older people

10. signs Febrile Tachypnoea Tachycardia Cyanosis-central Hypotension Altered sensorium Use of accessory muscles of respiration Confusion- advanced cases 11

11. SIGNS of consolidation Percussion-dull Bronchial Breath sounds Crackles Pleural friction Rub 12

12. diagnosis CLINICAL DIAGNOSIS History Signs & symptoms Chest x-ray CT Etiological diagnosis Gram's Stain and Culture of Sputum Blood Cultures Antigen Tests Polymerase Chain Reaction Serology Bronchoalveolar lavage 13

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15. 16 Lobar pneumonia

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17. investigations CBC  Urea and electrolytes Liver function tests Serology Cold agglutinins Arterial blood gases Urine Pleural fluid 18

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20. management Adequate oxygenation Appropriate fluid balance Antibiotics Nutritional support may be required in severe or prolonged illness 21

21. Nursing management and supportive measures Analgesia and anti pyrectics Chest physiotherapy Intravenous fluids if indicated monitoring pulse oximetry Oxygen supplementation Patient positioning Respiratory therapy Suctioning and bronchial hygiene Hydration and nutrition 22

22. complications Lung abscess pleuritis Plural effusion E mpyema S epticemia 23

23. Preventive measures Smoking cessation Pneumococcal vaccination Influenza vaccination Adequate nutrition 24

24. Thank you Sdh / crs / tpty