1.

Any infectious organisms that reach the alveoli are likely to be highly virulent, as they have
already evaded the host’s physical defense mechanism. Consequently, they may overwhelm the
macrophages, resulting in production of a fibrin-rich exudate that fills the infected and
neighboring alveolar spaces, causing them to stick together, rendering them airless. The
response also resulting in a proliferation of neutrophils. This can damage the lung tissue, leading
to fibrosis and pulmonary edema, which also impairs lung expansion. Pneumonia affects both
ventilations and diffusion. An inflammatory reaction can occur in the alveoli, producing an
exudate that interferes with the diffusion of oxygen and carbon dioxide. White blood cells,
mostly neutrophils, also migrate into the alveoli and fill the normally air-filled spaces. Areas of
the lung are not adequately ventilated because of secretions and mucosal edema that cause
partial occlusion of the bronchi or alveoli, with a resultant decrease in alveolar oxygen tension.
Bronchospasm may also occur in patients with reactive airway disease. Because of
hypoventilation, a ventilation perfusion mismatch occurs in the affected area of the lung.
Venous blood entering the pulmonary circulation passes through the under ventilated area and
travels to the left side of the heart poorly oxygenated. The mixing of oxygenated and
unoxygenated or poorly oxygenated blood eventually results in arterial hypoxemia.
2. There are varieties of risk factors related to pneumonia. This includes age which is high risk in
young and old people. Young children have immature immune systems, lack of previous
antibody building exposures to pathogens and narrow airways. Old people are has weaker
immune system and more problem developed upon coughing and gag reflexes. Pneumonia
occurs in patients with certain underlying disorders such as heart failure, diabetes, alcoholism,
COPD, and AIDS. Additional risk factors are travel or exposure to certain environments and
residence in a long term care facility. People at high risk for pneumonia should get vaccine, also,
by washing hands regularly, eating proper foods such as fruits and vegetables to enhance
immunity. Also, the needs for regularly exercising, enough of sleep, smoking and alcohol will
help with overcoming pneumonia.
3. Some etiologies of ARDS includes aspiration of gastric contents or other substances which
inhibits injury to the lungs, viral/bacterial pneumonia, damages the internal part of the lung
causing further damages. In addition, chest trauma, inhalation of toxic substances, infection of
the blood, prolonged heart problem and other injury to the system that is associated with the
lungs could lead to ARDS. Nursing assessment includes: assessing respiratory rate of the client
for sign of tachypnea, short of breath or dyspnea, decrease breath sounds, deteriorating gas
levels, hypoxemia despite high concentration of delivered oxygen, decreased pulmonary
compliance and pulmonary infiltrates.
4. Sarcoidosis is an inflammatory disorder resulting in non-caseation granulomas in one or more
organs and tissues; and found no known etiology. Pneumoconiosis is a chronic inflammation of
the lung and resulting fibrosis. Manifested by exposure to specific substance: coal, appear
relatively inert and may accumulate in considerable amount with minimal tissue response, while
silica and asbestos have potent biologic effects. Particles of appropriate size to be retained in
lungs. Silicosis is known as pulmonary disease caused by inhalation of tiny particles of silicon
dioxide in the form of unbound crystalline silica. Silicosis is a primary pneumoconiosis involving
fibro nodular lung disease caused by inhalation of silica dust. Asbestosis is the scarring of lung
tissue beginning around terminal bronchioles and alveolar ducts and extending into the alveolar
walls resulting from the inhalation of asbestos fibers. Sarcoidosis, silicosis, and asbestosis are
lung problem or infections that starts by inhaling foreign objects into the lungs which leads to
pneumoconiosis, creating fibrosis in the lungs and damages further.