TUTORIAL 8 PNEUMONIA.pptx is discuss in detail about the pneumonia disease

this slide is discuss in detail about pneumonia disease

1. Pneumonia MADAM ROZILA BINTI IBRAHIM MAY 2024

2. LEARNING OUTCOME At the end of the session, learner’s should be able to; Discuss the types of pneumonia. Describe the risk factors, transmission, and prevention of relapse. Discuss symptoms management and integrative nursing. Apply the holistic care for patient with pneumonia based on the nursing process. 2

3. DEFINITION PNEUMONIA An infection that inflames the air sacs one or both lungs. 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. it is the most common infectious cause of death. it is usually characterized by consolidation. consolidation is a pathological process in which the alveoli are filled with a mixture of inflammatory exudate, bacteria & wbc

4. EPIDEMIOLOGY Occurs throughout the year Results from different etiological agents varying with the seasons Occurs in persons of all ages Clinical manifestations severe in very young, elderly & in chronically ill patients 4

5. ETIOLOGY Bacteria : Streptococcus pneumoniae , legionella pneumophila, Chlamydophila pneumoniae, staphylococcus aureus , Moraxella catarrhalis, streptococcus pyogenes , Neisseria meningitidis, klebsiella pneumoniae , and haemophilus influenzae , pneumocystis jiroveci . Viruses : influenza virus, adenoviruses, rhinovirus other infectious agents, such as fungi : pneumocystis carini 5

6. RISK FACTORS 6

7. CLASSIFICATION Classified based on two types : Type 1 Lobar pneumonia Bronchopneumonia 2. Type 2 Community- acquired pneumonia (CAP) Hospital-acquired pneumonia (HAP) 7

8. INDICATIONS Infants and young children Elderly age>65 People with health problems or weakened immune systems. 8

9. TYPE 1 PNEUMONIA: Lobar pneumonia Lobar pneumonia is an acute bacterial infection of a part of lobe/two or the entire lobe, of one or both the lungs. 9

10. TYPE 1 PNEUMONIA: Bronchopneumonia B ronchopneumonia is an infection of the terminal bronchioles that extends into the surrounding alveoli resulting in patchy consolidation of the lung. 10

11. LOBAR PNEUMONIA Lobar Pneumonia 11

12. BRONCHOPNEUMONIA (Bronchitis and Pneumonia occur together) 12

13. PATHOPHYSIOLOGY/ stages of pneumonia It includes 4 stages 1. Congestion 2. Red hepatization 3. Gray hepatization 4. Resolution 13

14. congestion Initial phase within 24 hour of infection . Alveoli congested with blood-  serousexudate . After the pneumococcus organism reaches the alveoli, there is an outpouring of fluids into alveoli. The organism multiplies in the serous fluid and infection spreads 14

15. red hepatization 2-3 days after initial stage . The massive dilation of the capillaries and alveoli that are filled with this organism, neutrophils, RBC, and fibrin . The lung appears red and granular, similar to that of liver which is why the process is called ‘hepatization’. 15

16. gray hepatization 4-6 days infection. Due to the disintegration of red blood cells and the persistence of fibrinopurulent exudate. RBC Blood flow decreases/breakdown, and leukocytes and fibrin consolidate in the affected part of lung. 16

17. resolution 8-10 days of infections. Complete resolution and healing occurs if there is no complications. The exudates become lysed and is processed by macrophages.(reabsorption of fluid and debris by macrophages) The normal lung tissue is restored and the persons gas exchange ability returns to normal. 17

18. SIGNS AND SYMPTOMS   High fever, shaking chills Shortness of breath (d yspnoea ) Increased breathing rate Chest pain when you breathe deeply or cough Dusky or purplish skin colour (cyanosis) from poorly oxygenated blood Fatigue and muscle aches Nausea, vomiting or diarrhoea Cough, particularly cough productive of sputum 18

19. Chest X-ray For Lobar Pneumonia 19 Lobar pneumonia Consolidation confined to one or more lobes (or segments of lobes) of lungs.

20. Chest X-ray For Bronchopneumonia 20 Bronchopneumonia Patchy consolidation usually in the bases of both lungs.

21. Community Acquired Pneumonia (CAP) pneumonia which develops in an otherwise healthy person outside of hospital or have been in hospital for less than 48hrs 21

22. HOSPITAL ACQUIRED pneumonia (HAP) P neumonia that was not incubating upon admission developing in a patient hospitalized for greater than 48 hrs. 22

23. COMPLICATIONS Bacteria in the bloodstream (bacteremia) Lung abscess.  Build up of fluid in the space between the lung and chest wall (pleural effusion). Difficulty breathing.  Shock and respiratory failure Septic arthritis Endocarditis 23

24. MANAGEMENT & TREATMENT OF PNEUMONIA drug therapy : administer antibiotic for bacteria pneumonia. eg ; amoxicillin, azithromycin and doxycycline. severe cases required iv antibiotic. anti viral : for viral pneumonia caused by influenza eg ; oseltamivir ( tamiflu ) pain relievers/ fever reducer: acetaminophen or ibuprofen 24

25. MANAGEMENT & TREATMENT OF PNEUMONIA Oxygen therapy - maintain adequate oxygen levels in the blood. Monitor vital sign Place patient in fowler’s position Give good ventilation systems- avoid crowded Teach deep breathing exercise. Mechanical ventilation- in critical cases when breathing severely impaired. Fluid management - prevent from dyhydration 25

26. MANAGEMENT & TREATMENT OF PNEUMONIA Advice stop smoking. Practice good hygiene. (preventing an infection) Stay rested and fit. Wearing surgical masks by the sick may also prevent illness. Appropriately treating underlying illnesses (such as HIV, diabetes mellitus, and malnutrition) can decrease the risk of pneumonia. Get a pneumonia vaccination. 26

27. PREVENTION Vaccination ; pneumococcal, influenza Healthy lifestyle ; regular exercise, balanced diet, good rest. Regular check up Repeat chest x-ray 27

28. VACCINATION Pneumococcal conjugate vaccine ( prevnar ) For children less than 2 years of age or between two and four years with certain medical conditions. Pneumococcal polysaccharide vaccine (pneumovax) Adults who are at increased risk of developing pneumococcal pneumonia, such as the elderly, diabetics, those with chronic heart, lung, or kidney disease, alcoholics, smokers, and those without a spleen. 28

29. Relevant Nursing Diagnosis Anemia R/t disease progression Ineffective airway clearance & chances of E.T Tube Blockage Self care deficit R/t Disease condition and Bed-ridden Status Impaired Nutritional status R/t disease condition Risk of infection R/t disease process, Invasive lines and Low TC, Hb level Anxiety R/t Disease condition Impaired gas exchange R/t Disease process 29

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31. THANKS A LOT! 31