LEGEND

PNEUMONIA
DIAGNOSTIC TOOLS ETIOLOGY
●History and Physical PREDISPOSING FACTORS PRECIPITATING FACTORS DISEASE PROCESS
● Age > 65 years old (80 y.o) ● Air pollution
Examination ● Gender (Male) ● Exposure to toxic chemicals, SIGNS AND SYMPTOMS
● Diabetes fumes, or smoke DIAGNOSTIC TOOLS
● Pulse Oximetry ● Weakened immune system ● Smoking
MANAGEMENT
● Sputum Culture
● BAD PROGNOSIS
● Chest X-ray DISEASE PROCESS
GOOD PROGNOSIS
● Complete Blood Count Exposure to pathogen or source of infection
NURSING MANAGEMENT
(CBC) • Assess respiratory
Pathogen enters the respiratory tract
through inhalation or aspiration symptoms
●Arterial Blood Gas (ABG) • Physical assessment
• Assessment in elderly
Pathogen lodges on the bronchioles
patients
If not treated, • Monitor pulse oximetry.
Colonization of pathogen
complications may occur • Administer antibiotics as
prescribed.
Proliferation of pathogen in lower airways and alveoli
● Lung abscess • Administer oxygen as
● Pleural Effusion prescribed.
● Respiratory Failure Accumulation of pus (Blood elements, Neutrophils,
• Respiratory support includes
and Plasma protein) with the pathogen
● Bacteremia and Sepsis endotracheal intubation,
high inspiratory oxygen
Inflammation of the lungs
concentrations, and
BAD PROGNOSIS
mechanical ventilation.
Systemic inflammation Alveolar sac blocked by fluid Increased number of goblet cells • Best rest is recommended
response releases Cytokine accumulation until infection shows signs of
If treated towards invading pathogen
Increased production of mucus clearing.

●Improved Gas exchange Decrease oxygen in the

It then leads to a disruption in blood Sputum builds up
● Effective Breathing Pattern hypothalamic thermoregulation
Failure of ciliary clearance to
GOOD PROGNOSIS keep up

SIGNS AND SYMPTOMS

●Fever ●Hypoxemia ●Tachypnea ● Cough ●Crackles
●Chills ●Dyspnea ●Malaise ●Sputum ● Chest Pain
 DISEASE PROCESS
The disease starts with the exposure of the patient to the pathogen or source of infection. Pathogen includes bacteria and viruses but the most commonly detected pathogen in adulthood
to the elderly is bacteria. Streptococcus Pneumoniae (pneumococcus) is the most common type of bacteria and cause among the elderly, this can be also found in the respiratory tract of an
individual who is healthy, especially children. Bacteria frequently spread within houses and in crowded areas. There are 2 different ways the pathogen can enter the respiratory tract; it is
through inhaling and aspirating. When an individual with pneumonia sneezes or coughs, pathogens are inhaled by another person. One method to acquire this infection is aspirating this is
when the individual breathes in saliva, food, stomach contents, or even foreign material into the lungs. After the pathogen enters the body, it settles on the bronchioles then it will eventually
colonize the alveolar spaces and also penetrates or invades the airway mucosa. The pathogens will then proliferate in lower airways and alveoli. In response to the infection, there would be an
accumulation of pus which consist of blood elements (red blood cells), white blood cell particularly the neutrophil, and lastly the plasma protein. Neutrophils and plasma proteins will travel to the
site where there is a pathogen and they destroy the microorganisms. This same pus, however, is harmful. Neutrophils produce toxic and degradative chemicals that aid in the destruction of
bacteria, but they can also harm the lungs. Furthermore, the increase of plasma proteins causes fluid buildup in the lungs and it makes it more difficult to breathe and for carbon dioxide and
oxygen to move between the lungs of an individual and breathe in the air, which these gases must do in order for the body to function properly. This will lead to inflammation of the lungs which
then first activates the systemic inflammation response of the lung and activates the cytokine release toward invading the pathogen. However, this cytokine interacts with the anterior
hypothalamus, which controls thermoregulation, and leads to a disruption in hypothalamic thermoregulation that causes the individual to have an elevated body temperature or fever and it will
also manifest one of the symptoms of pneumonia which is the chills. Inflammation of the lungs can lead to occlusion of the alveolar sac due to pus accumulation. Since the alveolar sac is
blocked, the oxygen cannot pass through and gets its way to the bloodstream to transport into the system and loses its ability to expel the carbon dioxide, resulting in its accumulation. This
leads to a decrease of oxygen in the blood or a low oxygen level or hypoxemia which then causes dyspnea, tachypnea, and malaise. Lastly, in response to the inflammation of the lungs, an
increased number of goblet cells will occur, which then leads to increased production of mucus since goblet cells secrete mucus. Since there is an increase in the production of mucus in the
lungs, there would be an accumulation of phlegm or sputum which results in failure of ciliary clearance to keep up leading to signs and symptoms of cough, crackles, and chest pain.