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Predisposing factors: Precipitating factors:

- 68 y/o - sustained cold climate


- Male Streptococcus pneumoniae; - crowded place
- Smoked two packs of Haemophilus influenza; - long-term hospitalization
cigarettes per day for 50 years Candida- related pneumoniae; - use of ventilator
Viral- related pneumoniae - Bacteria, virus, fungi

CONDUCTION ZONE Organisms enter the respiratory


- - Bacteria, virus,
of the respiratory tract tract via pulmonary ventilation;
fungi
Inspiration/ aspiration
-

Activation of defense mechanism


(impairment expected) RESPIRATION ZONE

INEFFECTIVE Lose effectiveness of defense OVERALL EXPECTED S/S


IMMUNO-DEFENSE mechanism *cough (productive)/ *Sat O2 >90%
MECHANISM * decreased/increased breath sounds
*chills/ shaking; *fever/malise
Patency and Sterility of Lower *increased CPM
Respiratory Tract disrupted and SIGNS/ SYMPTOMS
penetrated by microbes Increased RR; * cough induced

Microbes multiply in the alveoli Irritation of airway

Indigenous microbiota including WBCs Increased goblet cell


altered by opportunistic pathogen activity and production
proliferation and colonization

Release Damaging Toxins C


(Endo/ Exotoxin)
B
INCREASED Increased
OCCLUDED MUCUS fluid
A AIRWAY PRODUCTION production
made alveoli
INFECTION and/ or
Risk for S/S
Exudates hypoxemia lungs
Altered
Surfactant coming from inflammation Depth
loss microbes Ineffective
Impaired O2 and (shallow) cough
vasodilation CO2 exchange ↑ RR Airway
Distensibility Increased Clearance
loss and friction body Increased blood flow N. Dx: crackles
increased temp. Ineffective
airway
Plasma and protein-rich Hyperven Airway
N. Dx: clearance
Fluid leakage -tilation constriction
Hyperthermia
s/s
Accumulation of O2 saturation Increased Ineffective
Shivering on edematous fluid <95% respiratory tissue
onset
rate perfusion
Inflamed and fluid-filled N Dx:
ATELECTASIS alveolar sacs Impaired gas
exchange, deficit
Alveolar air sacs
Dead space
become inefficient
(inside alveolar sacs)
Ventilatory
Imbalanced H+; Decrease of carbon dioxide Demands
HPO4 decreased
Lung consolidation
N Dx:
Respiratory Risk for
Inefficient breathing pattern; Risk for respiratory
Alkalosis Induced Resp.
alkalosis Risk for hypoxia alkalosis or acidosis

hypoxia

ACTIVITY INTOLERANCE