Pneumonia: nursing management
Definition
Pneumonia is a pulmonary infection
with inflammation that develops after
someone inhales airborne pathogens or
aspirates pathogens in secretions from the
upper respiratory or gastrointestinal tract.
Classification
- bacterial
- viral
- fungal
Depending on the patient's clinical and X-ray
findings, pneumonia is further classified as lobar
pneumonia (affecting one or more lobes),
bronchopneumonia (affecting the terminal
bronchial tree, distal airways, and alveoli), or
inflammation of the interstitial space.
Community-acquired pneumonia is
pneumonia that someone contracts outside the
hospital setting. In many cases, a respiratory
virus, such as influenza or adenovirus, is the
infectious organism. The most common bacterial
cause is Gram-positive Streptococcus
pneumoniae.
Nosocomial (hospital-acquired) pneumonia
develops more than 7 days after hospital
admission. It's likely to be caused by different
pathogens, including Staphylococcus aureus
and Klebsiella.
Risk factors for CAP
a. Elderly
b. Very young
c. Cystic fibrosis
d. Respiratory conditions
e. Smoking
f. Immunocomprompromised
g. Heart disease
h. Diabetes
Signs and symptoms
a. Cough
b. Sputum
c. Dyspnea
d. Pleuritic chest pain
e. Crackles (auscultation)
f. Dullness (percussion)
g. Fever or hypothermia
h. Low or high WBC count
Less common signs and symptoms
a. Increased heart rate
b. Cyanosis
c. Retractions (infants and children)
d. Lung secretions
e. Dehydration
f. Anorexia
g. Behavior changes
X-ray findings
a. Viral
b. Bacterial
c. Uncommon organism
Treatment
1. Antibiotic therapy if applicable
2. Maintain oxygenation
3. Maintain airway clearance
4. Maintain adequate hydration
5. Monitor temperature
Patient education
1. Hand hygiene
2. Asthma control
3. Yearly flu immunization