BACTERIAL

PNEUMONIA
GROUP 4B
O BJ ECTI VE S
S T U D E N T-
GENERAL
NURSE
OBJECTIVES
CENTERED
To be able to improve the
teamwork and To be able to acquire
multidisciplinary knowledge and work
management of Bacterial efficiently and effectively in
Pneumonia, giving the future actual settings
opportunity to handle from the initial admission
substantial amount of through the recovery phase
accurate and broad of the patient with bacterial
information generated during pneumonia by: assessing,
the time of admission and planning intervening and
providing a unified holistic teaching various methods to
view and the current needs of manage bacterial pneumonia.
the patient.
OBJECTIVES
O BJ EC TI V ES
PAT I E N T-
CENTERED

To be able to have an
effective information
gathering and pain
management regarding to
physical and psychological
state as affected by
bacterial pneumonia.
B ACK G RO U ND O F T HE S T UDY

Pneumoniaisisan
Pneumonia aninflammation
inflammationofofthe
thelung
lungtissues.
tissues.

Bacterialpneumonia
Bacterial pneumoniais anis aninfection
infectionofofyour
yourlungs
lungs
causedby
caused bycertain
certainbacteria.
bacteria.

FourCategories
Four CategoriesOfOfPneumonia:
Pneumonia:
• • Community
Community––Acquired
AcquiredPneumonia
Pneumonia(CAP),
(CAP),
• • Hospital
Hospital––Acquired
AcquiredPneumonia
Pneumonia(HAP),
(HAP),
• • Healthcare
Healthcare––Associated
AssociatedPneumonia
Pneumonia(HCAP),
(HCAP),
and
and
• • Ventilator
Ventilator––Associated
AssociatedPneumonia
Pneumonia(VAP).
(VAP).
B ACK G RO U ND O F T HE S T UDY

GGLLOOBBAALL
• • Pneumonia
Pneumoniakilled
killed740,180
740,180children
childrenunder
underthetheage
ageofof55inin
2019,
2019,accounting
accountingforfor14%
14%ofofall
alldeaths
deathsofofchildren
childrenunder
under
five
fiveyears
yearsold
oldbut
but22%
22%ofofall
alldeaths
deathsininchildren
childrenaged
aged11toto
5.5.
• • Highest
HighestininSouth
SouthAsia
Asiaand
andsub-Saharan
sub-SaharanAfrica
Africa
• • InIn2015,
2015,India,
India,Nigeria,
Nigeria,Indonesia,
Indonesia,Pakistan,
Pakistan,andandChina
China
contributed
contributedtotomore
morethan
than54%
54%ofofallallglobal
globalpneumonia
pneumonia
cases,
cases,with
with32%
32%ofofthe
theglobal
globalburden
burdenfrom
fromIndia
Indiaalone.
alone.
• • All
Allkey
keyrisk
riskfactors
factorsfor
forchild
childpneumonia
pneumonia(non-exclusive
(non-exclusive
breastfeeding,
breastfeeding, crowding,
crowding, malnutrition,
malnutrition, indoor
indoor air air
pollution, incomplete immunisation, and paediatric
pollution, incomplete immunisation, and paediatric HIV) HIV)
B ACK G RO U ND O F T HE S T UDY

NNAT
ATIIOONNAALL
• • Pneumonia
Pneumoniaididthe thethird
thirdleading
leadingcause
causeofofdeath
deathininthe
the
Philippines
Philippines
• • ItItisisthe most common cause of death of children,
the most common cause of death of children, 5 5
years
yearsofofage
ageaccounting
accountingfor
forabout
about14%
14%ofofall
allcauses
causesofof
mortality.
mortality.
PAT I EN T’ S PRO FI L E

Name: B.I.
Age: 84-year-old
Sex: Female
Marital Status: Widowed
Education: College Graduate
Occupation: Retired Bank Manager
Chief Complaint
“Mrs. B.I. is confused and very sick. She
was up most of last night coughing.” as
verbalized by the patient’s caregiver.
H I S TO RY O F PA S T & P R E S E N T I L L N E S S
• 6 years ago the patient had • The patient had constipation 6 months ago.
• 13 years ago the patient
hypertension, with an • One week ago the patient presents upper
was diagnosed with respiratory symptoms.
average BP of 140/80 mm
Chronic bronchitis • Developed a cough that has gradually
Hg with medication. become worse and has difficulty catching
• She also experienced • She also has a history of her breath 3 days ago.
Urinary overflow
mild left hemiparesis caused • With increasing weakness and body
incontinence 10 years ago. malaise 2 days ago.
by CVA 4 years ago.

2008 - 2014 2015 - 2020 2021

FA M I LY H I S TO RY

The patient’s family was positive in

hypertension and cancer but no history of
CAD, asthma, and DM.

P E R S O N A L H I S TO RY

The patient has smoked approximately ½ pack per

day in 64 years of her age and experienced
depression 2 years ago. She is occasionally
drinking alcohol but stop it recently.
N U R S I N G H E A LT H H I S T O RY

P S Y C H O S O C I A L S TAT U S
Mrs. B.I. is an 84-year-old white female. She is
widowed and a retired bank manager. She owns a
house and has a 45-year-old female caregiver.
Mrs. B.I. is currently using a walker and takes
daily strolls to the park with her caregiver. She is
able to perform most activities of daily living. She
smokes, and she also socialized with some friends
recently ill with “colds”.
Mental & Emotional Status
The patient is oriented to self only and is
lethargic. Her caregiver reported that Mrs. B.I.
was confused last night and nearly fell while
going to the bathroom.
N U R S I N G H E A LT H H I S T O RY

E N V I R O N M E N TA L
She is accompanied by her caregiver who is living
with her. The caregiver is also the one who
prepares her meals because she is unable to.

SENSORY PERCEPTION
The patient’s extra-ocular motor is intact, and her
pupil is equal, round, and reactive to light and
accommodation. Her eyes are watery. The
patient’s nares are slightly flared; purulent
discharge is also visible. The patient’s ears are
with slight serous fluid behind the tympanic
membrane. Her pharynx is erythematous with
purulent post-nasal discharge, and her mucous
membranes are inflamed and moist.
N U R S I N G H E A LT H H I S T O RY

M O T O R S TA B I L I T Y
The patient is negative to clubbing, cyanosis, and
edema. Her extremities are warm. The patient’s
muscle strength is 4/5 on the right side, while 1/5
on the left side. Upon palpation of pulses, her
pulses are faint bilaterally.
N U T R I T I O N A L S TAT U S
Mrs. B.I. has a decrease in appetite, as reported.

E L I M I N AT I O N
Patient’s urine is light yellow and hazy.
N U R S I N G H E A LT H H I S T O RY

R E S P I R AT O RY
The patient smokes ½ PPD and is tobacco-dependent for 64
years. She also drinks alcohol occasionally, but none recently.
Her RR is 38 and labored.
The patient is coughing and using accessory muscles to
breathe. She is tachypneic and appears to be uncomfortable and
in moderate respiratory distress. Upon auscultation, her RUL and
LUL reveal regions of crackles and diminished breath sounds.
The patient has been coughing up a significant amount of
phlegm that is thick and green in color. Upon sputum analysis,
there are too many neutrophils, some epithelial cells, negative
for microbes.

B O D Y T E M P E R AT U R E
The patient’s body temperature is normal.
N U R S I N G H E A LT H H I S T O RY
S L E E P - R E S T PAT T E R N
The patient’s caregiver stated that Mrs. I. has had
difficulty sleeping due to a persistent cough.

F L U I D A N D E L E C T R O LY T E S
No signs of dehydration were noted as well as
edema formation.
C I R C U L AT O R Y
The patient’s blood pressure is 140/90, no
orthostatic changes were noted. Her heart rate and
rhythm are regular. Negative for S3 and S4.

INTEGUMENTARY STATUS
The patient’s skin is warm and clammy. There is
no presence of rashes. Patient is also negative for
clubbing, cyanosis, and edema.
ANATOM Y & PH Y SI O LO G Y
LUNGS RIGHT LUNG LEFT LUNG

THREE LOBES TWO LOBES

ANATOM Y & PH Y SI O LO G Y

PLEURA
A protective DIAPHRAGM
membrane • Inhalation (diaphragm
covering of the contracts)
• Exhalation (diaphragm
lungs. relaxes)
ANATOM Y & PH Y SI O LO G Y

AIR

Trachea
Bronchi

Alveoli
ANATOM Y & PH Y SI O LO G Y
INFLAMED LUNGS

Signs
Signs of of respiratory
respiratory
failure:
failure:
• • Fast
Fastbreathing
breathing
• • Feeling
Feelinglikelikeyou
youcan’t
can’tbreathe
breatheinin
enough
enoughair air
• • Confusion
Confusion
• • Feeling sleepy
Feeling sleepy
• • Lips
Lips oror fingernails
fingernails becoming
becoming aa
bluish
bluishcolor
color
ETIOLOGY
BACTERIAL PNEUMONIA

TYPICAL PNEUMONIA AT Y P I C A L
refers to pneumonia PNEUMONIA
caused by: is mostly caused by:
• Streptococcus • Legionella pneumophila
pneumoniae • Mycoplasma
• Haemophilus influenzae pneumoniae
• Staphylococcus aureus • Chlamydia pneumoniae
ETIOLOGY
BACTERIAL PNEUMONIA

C A U S E D B Y: R I S K FA C T O R S
• Alcohol
• Smoke cigarettes,
• Illness • Are debilitated,
• Poor nutrition • Have recently had surgery,
• Old age, • Have a respiratory disease or
• Impaired immunity viral infection,
• Have a weakened immune
system.
PAT H OP HY SI O LO G Y
The organism gains access to the lungs through aspiration of oropharyngeal
contents, by inhalation of respiratory secretions from infected individuals, via the
bloodstream, or from direct spread to the lungs from surgery or trauma  

The infecting organisms trigger inflammation of the airways

Vasodilation and increase capillary permeability

Plasma leaks out and WBC migrate in the alveoli & fill the normally air-containing
spaces  

Inflammatory exudates fill the alveolar air spaces that interfere with the diffusion of
O2 & CO2, producing lung consolidation

Impaired gas exchange in the alveoli leads to varying degrees of hypoxia, depending
on the amount of lung tissue affected
S I G N S & S Y M P TO M S

• Productive cough • Crackles

• Dyspnea • Increase tactile fremitus,
• Tachypnea accompanied percussion dullness, and
by nasal flaring and use of diminished breath sounds
accessory muscle on auscultation.
• Upper respiratory • Anorexia (loss of appetite)
symptoms (pharyngitis or • Fatigue
sore throat and nasal • Confusion
congestion)
L AB O RATO RY & A NALYS I S
L A B O R AT O R Y B L O O D T E S T R E S U LT
Na 141 meq/L Glu, 138 mg/dL * Lymphs 10%
  fasting
K 4.5 meq/L Hb 13.7 g/dL * Monos 3%

 
CI 105 meq/L Hct 39.4% * Eos 1%

 
HCO3 29 meq/L WBC 15,200/mm3 Ca 8.7 mg/dL
 
BUN 16 mg/dL * Neutros 82% Mg 1.7 mg/dL
 
Cr 0.9 mg/dL * Bands 4% PO4 2.9 mg/dL
 
L AB O RATO RY & A NALYS I S
ART ERI AL BL O O D G ASES
pH 7.50 Pa02 59 mm Hg on room air PaC02 25 mm Hg

 
U R I N A LY S I S
Appearance: Light yellow Protein (-) Nitrite (-)
and hazy  
SG 1.020 Ketones (-) Leukocyte esterase (-)
 
pH 6.0 Blood (-) 2 WBC/RBC per
  HPF
Glucose (-) Bilirubin (-) Bacteria (-)
 
PHARMACOLOGIC INTEVENTIONS
COMBIVENT
Generic
GenericName:
Name:Ipratropium
Ipratropiumbromide
bromide
Brand Name: Combivent
Brand Name: Combivent
Dosage:
Dosage: 500
500mcg/2
mcg/2sprays
sprays0.06%
0.06%per
per
nostril
nostril
Route:
Route: Inhalation/Spray
Inhalation/Spray • • B ro n c h o d i l a t o r
Frequency: TID-QID B ro n c h o d i l a t o r
Frequency: TID-QID • • S i d e e f f e c t s : Dizziness, headache, blurred vision, nausea,
S i d e e f f e c t s : Dizziness, headache, blurred vision, nausea,
vomiting,
vomiting,GI GIupset,
upset,cough.
cough.
•• Nursing Consideration:
Nursing Consideration:
Protect solution for inhalation from light. Store unused
Protect solution for inhalation from light. Store unused
vials
vialsininfoil
foilpouch.
pouch.
Use nebulizer mouthpiece instead of face mask to avoid
Use nebulizer mouthpiece instead of face mask to avoid
blurred
blurredvision
visionororaggravation
aggravationofofnarrow-angle
narrow-angleglaucoma.
glaucoma.
Ensure adequate hydration, control environmental
Ensure adequate hydration, control environmental
temperature
temperaturetotoprevent
preventhyperpyrexia.
hyperpyrexia.
Have patient void before taking medication to avoid urinary
Have patient void before taking medication to avoid urinary
retention
retention
PHARMACOLOGIC INTEVENTIONS
AZITHROMYCIN
GenericName:
Generic Name:Azithromycin
Azithromycin
BrandName:
Brand Name: Zithromax,
Zithromax,Zmax
Zmax
Dosage:
Dosage: 500mg
500 mg
Route:
Route: POPO
Frequency: QD
Frequency: QD
• •ANTIBIOTIC
ANTIBIOTIC
• •Side
Side effects
effects: : Stomach
Stomachcramping,
cramping,discomfort,
discomfort,diarrhea;
diarrhea;
fatigue,headache
fatigue, headache(medication
(medicationmay
mayhelp);
help);additional
additionalinfections
infections
ininthe
themouth
mouthororvagina.
vagina.
• •Nursing
NursingConsideration:
Consideration:
Take
Takethethefull
fullcourse
courseprescribed.
prescribed.
DoDonot
nottake
takewith
withantacids.
antacids.Tablets
Tabletsand
andoral
oralsuspension
suspensioncan
canbebe
takenwith
taken withororwithout
withoutfood.
food.
Report
Reportsevere
severeororwatery
waterydiarrhea,
diarrhea,severe
severenausea
nauseaororvomiting,
vomiting,
rashororitching,
rash itching,mouth
mouthsores,
sores,vaginal
vaginalsores
sores
PHARMACOLOGIC INTEVENTIONS
Generic
GenericName:Albuterol
Name:Albuterol ALBUTEROL
Brand
BrandName:
Name:Proventil
ProventilHFA,
HFA,Ventolin
VentolinHFA,
HFA,Proair
Proair
HFA,
HFA, ProAir
ProAirRespiClick,
RespiClick,Proventil,
Proventil,AccuNeb,
AccuNeb,
Ventolin
VentolinInjection
Injection
Dosage:
Dosage: Adult
Adultdosage
dosage(ages
(ages18–64
18–64years):
years):22
inhalations
inhalations
Child dosage (ages 4–17 years): 2 • • B e t a - 2 A g o n i s t s , B ro n c h o d i l a t o r s
Child dosage (ages 4–17 years): 2 B e t a - 2 A g o n i s t s , B ro n c h o d i l a t o r s
inhalations • • S i d e e f f e c t s : nervousness or shakiness, headache,
inhalations S i d e e f f e c t s : nervousness or shakiness, headache,
 Route: Oral throat or nasal irritation, rapid heart rate
throat or nasal irritation, rapid heart rate (tachycardia) (tachycardia)
 Route: Oral
Frequency: Every 4–6 hours. feelings
feelings ofoffluttering
fluttering ororaapounding
pounding heart
heart (palpitations).
(palpitations).
Frequency: Every 4–6 hours. •• Nursing Consideration:
Nursing Consideration:
Monitor respiratory rate, oxygen saturation, and lungs
Monitor respiratory rate, oxygen saturation, and lungs
sounds
soundsbefore
beforeand andafter
afteradministration.
administration.
If more than one inhalation is ordered, wait at least 2
If more than one inhalation is ordered, wait at least 2
minutes
minutesbetween
betweeninhalations.
inhalations.
Use a spacer device to improve drug delivery, if
Use a spacer device to improve drug delivery, if
appropriate.
appropriate.
PHARMACOLOGIC INTEVENTIONS
ASPIRIN
GenericName:
Generic Name:Aspirin
Aspirin
Brand Name:
Brand Name: Bayer Bayer
Dosage:
Dosage:
 Tablet:8181mg,
 Tablet: mg,25mg,
25mg,500mg
500mg
 Tablet,delayed–release:
 Tablet, delayed–release:162mg,
162mg,325mg,
325mg,500mg
500mg T h e r a p e u t i c : NSAIDs
 Tablet, Chewable: 75 mg, 81mg T h e r a p e u t i c : NSAIDs
 Tablet, Chewable: 75 mg, 81mg P h a r m a c o l o g i c :
P h a r m a c o l o g i c : SalicylatesSalicylates
 Tablet, enteric-coated: 81mg
 Tablet, enteric-coated: 81mg
SSi di de e EEf ffef ce tcst :s : Gastrointestinal
Gastrointestinal issues, issues, Kidney
Kidney Failure,
Failure,
Liverinjury,
Liver injury,Hearing
Hearingloss lossororringing
ringingininthetheears
ears
NNuur rs isni ng gCCo onns isdi de er ra at itoi onns :s :
AssessAssessfor forpain:pain:Type,Type,location
locationand andpattern
pattern
Monitor
MonitorBlood Bloodpressure pressure

 AssessAssessfor forsymptoms
symptomsfor forstroke.
stroke.MIMIduring
duringtreatment
treatment
Monitor
Monitorliver liverfunction
functionstudiesstudies
Monitor
Monitor blood blood studies:studies: CBC, CBC, Hgb,Hgb, Hct,
Hct, protime,
protime,
cholesterolififthe
cholesterol thepatient
patientisisononlong longterm
termtherapy
therapy
MEDICAL MANAGEMENT

 Antimicrobial Therapy
 Analgesia and antipyretics (ibuprofen,
acetaminophen)
 Chest physiotherapy
 Intravenous fluids (and, conversely, diuretics)
if indicated.
 Monitoring
 Oxygen supplementation
 Positioning of the patient
 Respiratory therapy, including treatment with
bronchodilators.
 Suctioning and bronchial hygiene
DI AG NO S TI C E VAL UAT I O N

Physical Examination Chest Radiography

Pulse oximetry test Chest CT Scanning
Arterial blood gas (ABG) Chest Ultrasonography
Blood cultures BAL with and Without Bronchoscopy
Sputum test Thoracentesis
Transtracheal Aspiration
SU RG I CAL MA NAG E ME NT
THORACOTOMY
• The physician gains access to the
chest cavity by cutting through the
chest wall.
• Thoracotomy allows for study of
the condition of the lungs;
removal of a lung or part of a
lung; removal of a rib; and
examination, treatment, or
removal of any organs in the chest
cavity.
SU RG I CAL MA NAG E ME NT
Before the procedure
• The attending physician will explain the
procedure prior to the surgery
• Provide inform consent and let the patient ask
questions
• Assist the patient for blood test and other
diagnostic test.
• Inform the physician for any allergic reaction
to any medication such as latex, iodine, tape,
contrast dyes, and anesthetic agents (local or
general).
• Notify the physician to all of medications
(prescribed and over-the-counter) and herbal
supplements that the patient had been taken
• Check for the present medications or
maintenance that the patient using.
• Educate the patient to stop smoking to
improve chances of successful recovery
NPO before surgery and advice not to eat
and drink after midnight
• Teach the patient to use incentive
spirometer three times a day as prescribe
by the physician to exercise the lungs
SU RG I CAL MA NAG E ME NT
After the procedure
• Increase gradually the activities
from sitting to standing and
walking to prevent thrombo
embolism.
• Advance the patient diet from soft
to solid as tolerated
• Advice the patient for follow up
check up before discharge
At Home
• Take warm showers to help ease pain
• Sleep in a recliner or on the sofa.
• Eat a well-balanced diet with plenty
of protein.
• Ease back into physical activity by going
for walks, but pace yourself as your
strength comes back.
• Drink plenty of liquids, and eat a lot of
fiber your pain medicine might make it
hard for you to have bowel movements.
• Wash the area around the cuts gently with
soap and water every day, but don’t bathe
in the tub.
NU TR I T I O NAL MAN AG EM E NT
Eat Protein rich foods
• Nuts
• Seeds
• Beans
• White meat
• Salmon and sardines Drink plenty of fluids. 
• Turmeric
• Ginger
• Honey

Probiotics
• Yogurt  
NU TR I T I O NAL MAN AG EM E NT

Vitamin C
• Citrus fruits
• Leafy vegetables
Whole Grains
• Ragi • Quinoa
• Bajra • Oats
• Barley • Brown
• Buckwheat rice

Foods to avoid
• Cold beverages,
• Ice creams,
• Cold desserts.
• Avoid processed and
fried foods.
COMPLEMENTARY, ALTERNATIVE AND INTEGRATIVE MEDICINE

Fenugreek Holy Basil and Black

Lagundi Leaves Pepper
Garlic Astragalus Root
Sesame Seeds Eucalyptus and Tea
Steam Inhalation Tree Oil
Cayenne Pepper Ginger
Turmeric
NU RS I NG MA NAG E M EN T
• Elevate the head of the bed, change position frequently.
• Anticipate the need for supplemental oxygen or
intubation if the patient’s condition deteriorates.
• Monitor v/s closely, especially during initiation of
therapy.
• Assess depth/rate of respiration and chest movement.
• Instruct the S.O concerning about the disposition of
secretions and report changes in color, amount and odor
of secretions.
•  Encourage good hand washing techniques. 
• Encourage adequate rest.
• Administer antimicrobials as ordered.
NURSING CARE PLAN
ASSESSMENT
Subjective:
Subjective:
“Mrs. B.I. is confused and very sick. She was up
“Mrs. B.I. is confused and very sick. She was up most most
ofoflast
lastnight
nightcoughing.”
coughing.”asasverbalized
verbalizedby
bythe
thepatient’s
patient’s
caregiver.
caregiver.

Objective:
• Use of accessory muscles. • Vital signs:
• Weakness and malaise T: 37.3°C
• Cough with green thick PR: 80 bpm
sputum RR: 25 cpm
• Confusion BP: 140/80 mmHg
• Crackles and diminished
breath sound upon
auscultation at RUL and
LUL.
NUR SING C ARE PL AN
NURSING DIAGNOSIS

Ineffective airway clearance related to

inability to maintain airway as evidenced by
increased sputum production, (+) crackles
and use of accessory muscles.
NUR SING C ARE PL AN
PLANNING
ShortTerm
Short TermGoal:
Goal:
After 8 hours ofof nursing
After 8 hours nursing interventions,
interventions, the
the patient
patient will
will
demonstrateairway
demonstrate airwaypatency
patencywith
withadequate
adequateoxygenation,
oxygenation,will
will
maintain normal
maintain normal temperature,
temperature, normal
normal breath
breath sounds
sounds and
and
effective coughing.
effective coughing.

LLo onng gTe

Ter rmmGGo oa al :l :
After3 3days
After daysofofnursing
nursinginterventions
interventionsthe
thepatient
patientwill:
will:
• • Determine
Determineactivities
activitiestotoconserve
conserveenergy.
energy.
• • Maintain
Maintainadequate
adequatehydration.
hydration.
• • Maintain
Maintainororincrease
increaseweight weightwithout
withoutfluid
fluidexcess
excess
• • Verbalize
Verbalize knowledge
knowledge and and complies
complies about
about management
management
strategies
strategies
• • Exhibits
Exhibitsnonocomplications
complications
• Remainsoriented
• Remains orientedand andware
waretotosurroundings.
surroundings.
NUR SING C ARE PL AN
N U R S I N G I N T E RV E N T I O N
Independent:
Independent:
Assessment
Assessment
• • Assess
Assess the
the rate,
rate, rhythm,
rhythm, and
and depth
depth ofof respiration,
respiration,
chest
chestmovement,
movement,and anduse
useofofaccessory
accessorymuscles.
muscles.
Therapeutic
Therapeutic
• • Elevate
Elevatethe
thehead
headofofthe
thebed
bedand
andchange
changethe
theposition
position
frequently.
frequently.
• • Provide
Provideoral
oralhygiene.
hygiene.
Educative
Educative
•• Encourage
Encouragehydration
hydrationbyby22toto3L3Laaday.
day.
•• Encourage
Encouragethe
thepatient
patienttotorest
restand
andavoid
avoidoverexertion.
overexertion.
NUR SING C ARE PL AN
N U R S I N G I N T E RV E N T I O N

Dependent:
Dependent:
Assessment:
Assessment:
• • Monitor
Monitorsputum,
sputum,chest
chestX-ray
X-rayand
andtemperature.
temperature.
Therapeutic
Therapeutic
• • Administer
Administeroxygen
oxygenasasprescribed.
prescribed.
• • Administer
Administerantibiotics
antibioticsasasordered.
ordered.
• • Administer
Administer medications
medications such such asas mucolytic
mucolytic and
and
bronchodilators
bronchodilators
• • Suction
Suctionasasindicated
indicated
NUR SING C ARE PL AN
N U R S I N G I N T E RV E N T I O N

Collaborative:
Collaborative:
Therapeutic
Therapeutic
• • Teach
Teach the
the patient
patient with
with lung
lung expansion
expansion maneuvers
maneuvers
such
such asas the
the use
use ofof incentive
incentive spirometry,
spirometry, and
and deep
deep
breathing
breathingexercises.
exercises.
• • Assist patient in chest physiotherapy
Assist patient in chest physiotherapy with the with the
respiratory
respiratorytherapist.
therapist.
NUR SING C ARE PL AN
E VA L U AT I O N
ShortTerm
Short TermGoal:
Goal:
After 8 8 hours
After hours ofof nursing
nursing interventions
interventions the
the patient
patient
demonstrates patent
demonstrates patent airway
airway asas evidence
evidence byby adequate
adequate
oxygenationbybypulse
oxygenation pulseoximetry
oximetrywith
withnormal
normalbreathing
breathingpattern
pattern
and chest movement.
and chest movement.

L o n g Te r m G o
L o n g Te r m G o a l : a l :
After3 3days
After daysofofnursing
nursinginterventions
interventionsthe
thepatient
patientrest
restand
and
conserveenergy
conserve energybybylimiting
limitingactivities
activitiesand
andremain
remainininbed
bedwhile
while
asymptomatic and
asymptomatic and slowlyslowly increase
increase activities,
activities, maintain
maintain
adequatehydration
adequate hydrationverbalizes
verbalizesknowledge
knowledgeabout
aboutmanagement
management
strategies and shows no signs of complications and
strategies and shows no signs of complications and identifies identifies
surroundingand
surrounding andisisaware
awareofofherhersurroundings
surroundings
 THANK YOU
Javier, Princess Joy R. Pascual, Janine Krista E. Salvador, Arshyl D.
Lagmay, Samantha S. Quilo, Mark Vincent S. Santos, Pamela Gied C.
Leal, Catherine A. Rancudo, Tim John Louie Tan, Claire Ann
Lomboy, Heavenly Kyle Relozor, Tricia May M. Tambogon, Jhayvan
Lopez, Laurence Lance E. Risma, Lorraine Nicole M. Tomagcao, Corinne
Marquez, Micah D. Rosete, Rio Friolo Valdez, Jasper N.

 Roniel Aquino
Clinical Instructor