PNEUMONIAS

An acute infectious disease of the lungs usually caused by the pneumoccocus

resulting in the consolidation of one or more lobes of either one or both lungs.

Etiology
• Majority of cases due to Diploccocus pneumonia
• Occasionally pneumoccocus of Friedlander
• Viruses

Predisposing causes
• Fatigue
• Overexposure to inclement weather (extreme heat or cold)
• Exposure to polluted air
• Malnutrition

Incubation period - 2 to 3 days

Signs and symptoms

Symptoms vary, depending on the type of pneumonia and the individual.

With bacterial pneumonia, the person may experience:
• shaking
• chills
• chattering teeth
• severe chest pain
• cough that produces rust-colored or greenish mucus
• very high fever
• sweating
• rapid breathing
• rapid pulse rate
With viral pneumonia, the person may experience:
• fever
• dry cough
• headache
• muscle pain and weakness
These flu-like symptoms may be followed within one or two days by:
• increasing breathlessness
• dry cough becomes worse and produces a small amount of mucus
 • higher fever
• bluish color to the lips
With mycoplasma pneumonia, the person may experience:
• violent coughing attacks
• chills
• fever
• nausea
• vomiting
• slow heartbeat
• breathlessness
• bluish color to lips and nailbeds
• diarrhea
• rash
• muscle aches
Regardless of the type of pneumonia, the person may also experience the following
symptoms:
• a loss in appetite
• feeling ill
• clammy skin
• nasal flaring
• fatigue
• mental confusion
• joint and muscle stiffness
• anxiety, stress and tension
• abdominal pain

Diagnosis
• Based on history and clinical sign and symptoms
• Dull percussion note on affected side (lung)
• X-ray
• Sputum samples can be collected and examined under the microscope. If the
pneumonia is caused by bacteria or fungi, the organisms can often be detected
by this examination. A sample of the sputum can be grown in special incubators,
and the offending organism can be subsequently identified. It is important to
understand that the sputum specimen must contain little saliva from the mouth
and be delivered to the laboratory fairly quickly. Otherwise, overgrowth of
noninfecting bacteria may predominate.
 • A blood test that measures white blood cell count (WBC) may be performed. An
individual's white blood cell count can often give a hint as to the severity of the
pneumonia and whether it is caused by bacteria or a virus. An increased number
of neutrophils, one type of WBC, is seen in bacterial infections, whereas an
increase in lymphocytes, another type of WBC, is seen in viral infections.
• Bronchoscopy is a procedure in which a thin, flexible, lighted viewing tube is
inserted into the nose or mouth after a local anesthetic is administered. The
breathing passages can then be directly examined by the doctor, and specimens
from the infected part of the lung can be obtained.
• Sometimes, fluid collects in the pleural space around the lung as a result of the
inflammation from pneumonia. This fluid is called a pleural effusion. If the amount
of this fluid that develops is large enough, it can be removed by inserting a
needle into the chest cavity and withdrawing the fluid with a syringe in a
procedure called a thoracentesis. In some cases, this fluid can become severely
inflamed (parapneumonic effusion) or infected (empyema) and may need to be
removed by more aggressive surgical procedures.

Complications
• Emphysema or pleural effusion
• Endocarditis or pericarditis with effusion
• Otitis media in children
• Hypostatic edema and hyperaemia of unaffected lung in the elderly
• Jaundice
• Abortion

Management
• Bedrest
• Adequate salt, fluid, calorie and vitamin intake. Water requirement increase
because of fever, sweating and increased respiratory rate; Plasma chlorides tend
to fall in pneumonia, hence sodium chloride should be given by mouth or by vein
if necessary. Adequate urine output is essential for excretions of toxins and for
avoidance of serious urinary complications due to medications. Adequate caloric
and vitamin (especially Vitamin C) intake are essential since the body reserves
are rapid depleted by the increased rate of metabolism due to thee abnormally
high body temperature.
• Tepid sponge for fever
• Frequent turning from side to side
• Antibiotics base on Care of Acute Respiratory Infection (CARI) of Department of
Health
Prevention of Pneumonia
• Practice good hygiene.
• Get an influenza shot each fall.
• Get a pneumonococcal vaccine. People who stand to benefit most from
vaccination are those over the age 65; anyone with chronic health problems
(such as diabetes, kidney disease, heart disease, etc.); anyone who has had
 their spleen removed; anyone living in a nursing home or chronic care facility;
caregivers of the chronically ill (healthcare workers or family caregivers); children
with chronic respiratory diseases (such as asthma), and anyone who has had
pneumonia in the past (due to increased risk of reinfection). The
pneumonococcal vaccine is 90 percent effective against the bacteria and
protects against infection for five to 10 years.
• Practice good preventive measures by eating a proper diet, getting regular
exercise and plenty of sleep.
• Do not smoke.

References:
Public Health Nursing in the Philippines’ Book, Edition 10th
http://www.healthscout.com
http://www.medicinenet.com

PNEUMONIA
 Isang abnormal na pamamagang kalagayan na kalagayan ng baga

Pinagmulan
• karamihan ng mga kaso dahil sa Diploccocus pulmonya
• Paminsan-minsan pneumoccocus ng Friedlander
• Mga virus

Kadahilanan
• Sobrang pagpapagod
• Masungit ng panahon (matinding init o malamig)
• Mapolusyon kapaligiran
• Kulang sa nutrisyon

Mga Karaniwang Sintomas

• karaniwang sipon
• Kulay kalawang na plema
• Produktibong ubo
• Mabilis na paghinga
• Mataas na lagnat
• Madalas na pagsusuka
• Kumbulsyon ay maaaring mangyari
• Matinding ginaw, sa mga maliliit na bata
• Nananakit na dibdib

Diyagnosis
• Batay sa kasaysayan at klinikal na senyales at sintomas
• SputumGrain Stain – eksaminasyon sa dura upang malaman ang anong klaseng
organismo ang nagdulot nito
• Blood test – eksaminasyon sa dugo na inaalam ang kalubhaan ng pulmonya at kung ito
ay sanhi ng bakterya o virus.
• Resulta ng X-ray

Tagapamahala
• Pagpapahinga
• Pagkain ng masusustansyang pagkain
• Sapat na pagkain ng maalat at bitamina
• Madalas na pag-inom ng tubig
• Himukin paihiin ng madalas
• Pagpunas ng maligamgam kung may lagnat
• Pagkonsulta at pag-inom ng gamot, ayon sa preskripsyon at direksyon ng doctor

Pag-iwas
• Madalas na paghuhugas ng kamay
• Pagkain ng masusustansyang pagkain
• Regular na pag-ehersisyo
• Sapat na tulog
• Hindi paninigarilyo.
• Magpabakuna laban sa pneumonia ( pneumonococcal vaccine)
–90 porsyento epektibo laban sa bakterya at pinoprotektahan laban sa
impeksyon para sa limang sa 10 taon.