PNEUMONIA

PRECIPITATING FACTORS
MODIFIABLE FACTORS
 Weak immune system
NON MODIFIABLE FACTORS
 Lifestyle  Malnutrition
 History of smoking  Environmental exposure
 Age: 65 years old and older, 2 years
 Immuno compromised  DM
old children
 Malnutrition  TB
 History of respiratory tract infection
 Prolong immobility  AIDS
 Gender: most common in males
 Alcoholism  Drug Abuse
 Drug abuse  Alcoholism

Inhaling respiratory pathogens

Coughing reflex and mucus

secretion activates

Pathogens colonized the alveoli

in one lobe of the lungs

Foreign body will excrete

endotoxins destroying tissue

Incubation of pathogen 48hrs Acquiring pathogens from a

Aspiration of ingested food Inflammatory response activates
upon hospitalization (S. Areus) hospital
 Acts on brain that regulates
metabolism and appetite
(Hypothalamus)
Decreased appeite
Anorexia
NSG. DIAGNOSIS
Imbalanced nutrition: Less than
body requirements r/t decreased
appetite
DIAGNOSTIC EXAM
 Hemaglucotest
NSG. MANAGEMENT
 Monitor VS
 Establish rapport
 Monitor blood glucose levels
regularly
 Assess the patient's level of
consciousness
 Educate the patient and family
members about the signs and
symptoms of hypoglycemia
 Encourage patients to maintain
a healthy diet
 Monitor for complications such
as seizures, loss of
consciousness, and cognitive
impairment.
PHARMACOLOGIC
MANAGEMENT
 D5050 IV
 Heraclene Forte (Vitamin
b12)
Macrophages will try to engulf PHARMACOLOGIC
pathogens by secreting Stimulates pyretic effect MANAGEMENT
Interleukin 1 and TNF alpha  Antipyretic
(Paracetamol)
 NSAIDS
NSG. DIAGNOSIS (Acetaminophen)
Hyperthermia r/t
inflammatory response NSG.
CONSIDERATIONS
Antipyretic
Hypoglycemia DIAGNOSTIC EXAM  Follow 14 rights
 Thermometer  Monitor VS
 Check for allergic
reaction
NSG. MANAGEMENT NSAIDS
 Monitor VS  Follow 14 rights
 Establish rapport  Monitor VS
 Assess patient’s  Advise to take the
anxieety level and level medication with
of consciousness milk or food
 Place the client on  Check for allergic
comfortable position reaction
that facilitates
breathing such as
sitting up, leaning
forward or using
pillows to prop up the
NSG. head and chest
CONSIDERATIONS  Teach the client
breathing techniques
Vitamin
 Follow 14 rights such as pursed- lip or
 Monitor VS diapgragmatic
 Advise the patient breathing
to avoid caffeine  Provide emotional
 Promote safety support and
reasssurance
 Some Interleukins binds to
PHARMACOLOGIC
smooth muscle of the bronchioles DOB
MANAGEMENT
causing bronchospasm
 Bronchodilators
(Salbutamol)
NSG. DIAGNOSIS  Corticosteroids
Ineffective breathing pattern r/t (Hydrocortisone)
bronchospasm  O2 therapy

DIAGNOSTIC EXAM
NSG.
 Chest Xray
CONSIDERATIONS
 ABG Test
Bronchodilators
 Physical Assessment
 Follow 14 rights
 Blood Test
 Monitor VS
 Monitor for
paradoxical
NSG. MANAGEMENT bronchospasm
 Monitor VS  Monitor for signs of
 Establish rapport muscle weakness
 Assess patient’s anxieety  Promote safety
level and level of Corticosteroids
consciousness  Follow 14 rights
 Place the client on  Monitor VS
comfortable position that  Educate the client
facilitates breathing such as about infection control
sitting up, leaning forward  The medication should
or using pillows to prop up be tapered gradually
the head and chest  Promote safety
 Teach the client breathing
techniques such as pursed-
lip or diapgragmatic
breathing

Increases permeability of
capillaries surrounding alveoli
 Congestion takes place due to
Stage 1: Congestion vasodilation and circulatory
permeability

Destructions of walls of the Microorganism enters in the blood

Exudation of RBC, fluids WBC
Stage 2: Red Hepatization alveoli circulation
and Fiber

Microorganisms binds to RBC units

Stage 3: Gray Hepatization RBC breakdown causing infection
Imbalance between protease and
antiprotease in the alveoli
NSG. MANAGEMENT
 Monitor VS
 Establish rapport
Immune cells and enzymes fight
Macrophages clear pus from the  Monitor I/O Triggers dilation of blood vessels as
the infection, allowing the alveoli
infected area  Monitor fluids and immune response
to function effectively Ekectolytes
 Elevate the head of bed to
prevent aspiration
 Promote safety
Activates productive cough Inability of alveoli to facilitate
Stage 4: Resolution gas exchange Septic Shock

NSG. CONSIDERATIONS
PPI, H2 Blocker, Antacids
Hematemesis
 Follow 14 rights
 Monitor VS
 Take the medication 30 to
1min before meal
NSG. DIAGNOSIS  Assess for nutrional
Risk for aspiration r/t vomiting deficiencies for long term
use Further hardening of alveolar
wall

PHARMACOLOGIC DIAGNOSTIC EXAM

MANAGEMENT  Blood test
 PPI (Omeprazole)  Emdoscopy
 H2 blocker  Imaging test
 Antacids
 Pulmonary Consolidation/
Bibasilar rales
NSG. DIAGNOSIS
Impaired gas exchange r/t fluid
filled alveoli
DIAGNOSTIC EXAM
 Blood test
 Physical Assessment
 Chest Xray
NSG. MANAGEMENT
 Monitor VS
 Establish rapport
 Assess the patient's
respiratory status and
response to treatment.
 Position the patient in an
upright position or elevate
the head of the bed to
reduce the pressure on the
lungs and facilitate
breathing.
 Encourage coughing and
deep breathing exercises to
help clear secretions from
the lungs.
 Provide adequate hydration
to thin the mucus and
promote its clearance.
 Encourage the patient to
rest and conserve energy to
reduce oxygen demand.
PHARMACOLOGIC
MANAGEMENT
Bronchodilators

 Corticosteroids
 Diuretics
 O2 therapy
NSG. CONSIDERATIONS
Bronchodilators
 Follow 14 rights
 Monitor VS
 Monitor for paradoxical
bronchospasm
 Monitor for signs of
muscle weakness
 Promote safety
Corticosteroids
 Follow 14 rights
 Monitor VS
 Educate the client about
infection control
 The medication should be
tapered gradually
 Promote safety Proliferative stage where there will be
Diuretics
 Follow 14 rights
 Monitor VS
 Monitor I/O
 Monitor serum K
 Monitor weight
Decreasing brain
Difficulty Breathing oxygenation
Confused mental state
Increase respiratory effort or delirium
NSG. DIAGNOSIS
Further hardening of alveolar Risk for Injury r/t altered
mental status
DIAGNOSTIC EXAM
Inability to recoil (ARDS)  Clinical Hx
 Behavioral observation
 Cognitive assessment
Refractory hypoxemia NSG. MANAGEMENT
 Monitor VS
 Establish rapport
 Implement fall
precaution
Respiratory alkalosis
 Provide assistance with
activities of daily living
 Provide assistive devices
 Maintain calm and quiet
Shifts to Respiratory acidosis due to environment
hypercarbia as O2 are low  Reorient the patient
PHARMACOLOGIC
MANAGEMENT
decrease in compliance and worse Antipsychotics

Hypoxemia  02
NSG.
CONSIDERATIONS
Fibrotic stage
 Follow 14 rights
dead space, poor prognosis causing
lung collapse  Monitor VS
 Provide comfort
measures
 Monitor LOC
Respiratory Failure
Tachycardia
NSG. DIAGNOSIS
Decreased cardiac output r/t
increaed heart rate
DIAGNOSTIC EXAM
 Pulse oximeter
 ECG
 EKG
NSG. MANAGEMENT
 Monitor VS
 Establish rapport
 Provide emotional support
 Assess for chest pain,
shortness of breath and
palpitations
 Avoid caffeine or alcohol
PHARMACOLOGIC
MANAGEMENT
 ACE Inhibitors
 Beta- blockers
 Calcium channel blocker
 Antiarrhytmic
NSG. CONSIDERATIONS
ACE Inhibitors
 Follow 14 rights
 Monitor VS
 Monitor serum K
 Provide safety
 Administer drug on empty
stomach
B-Blockers/ CCB
 Follow 14 rights
 Monitor VS
 Monitor renal and hepatic
function
 Advice patient to take
drugs before meals
 Tell patient to rise slowly
from sitting or lying