ACUTE PULMONARY FAILURE

(Community acquired pneumonia)

ACUTE PULMONARY FAILURE
 Acute respiratory failure occurs when fluid builds up in the air sacs in your lungs.
 When that happens, your lungs can't release oxygen into your blood. In turn,
your organs can't get enough oxygen-rich blood to function.

Community acquired pneumonia

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 In community-acquired pneumonia (CAP), you get infected in a community
setting. It doesn’t happen in a hospital, nursing home, or other healthcare center.
 Community-acquired pneumonia (CAP) is one of the most common infectious
diseases and is an important cause of mortality and morbidity worldwide.
 Typical bacterial pathogens that cause CAP include:
o Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella
catarrhalis.
 Pneumonias caused by chlamydia and mycoplasma are often clinically
indistinguishable from other pneumonias.

 Symptoms and signs are :

o fever, cough, sputum production, pleuritic chest pain, dyspnea,
tachypnea, and tachycardia.

 Diagnosis is based on clinical presentation

o Chest x-ray
o Consideration of alternative diagnoses (eg, heart failure, pulmonary
embolism)
o Sometimes identification of pathogen

 Treatment
o Risk stratification for determination of site of care
o Antibiotics
o Antibiotic therapy is the mainstay of treatment for community-acquired
pneumonia. Appropriate treatment involves starting empiric antibiotics
as soon as possible, preferably ≤8 hours after presentation. 
o Antivirals for influenza or varicella
o Supportive measures

 Prognosis is excellent for relatively young or healthy patients, but many

pneumonias, especially when caused by S. pneumoniae, Legionella,
 Staphylococcus aureus, or influenza virus, are serious or even fatal in older,
sicker patients.
 Nursing Interventions:
o Assess respiratory symptoms.
Symptoms of fever, chills, or night sweats in a patient should be reported
immediately to the nurse as these can be signs of bacterial pneumonia.
o Assess clinical manifestations.
Respiratory assessment should further identify clinical manifestations
such as pleuritic pain, bradycardia, tachypnea, and fatigue, use of
accessory muscles for breathing, coughing, and purulent sputum.
o Physical assessment.
Assess the changes in temperature and pulse; amount, odor, and color of
secretions; frequency and severity of cough; degree of tachypnea or
shortness of breath; and changes in the chest x-ray findings.
o Assessment in elderly patients.
Assess elderly patients for altered mental status, dehydration, unusual
behavior, excessive fatigue, and concomitant heart failure.
o Instruct patient and family about the cause of pneumonia, management of
symptoms, signs, and symptoms, and the need for follow-up.
o Instruct patient about the factors that may have contributed to the
development of the disease.

o Nursing Priorities
o Maintain/improve respiratory function.
o Prevent complications.
o Support recuperative process.
o Provide information about disease process, prognosis, and treatment.