PNEUMONIA

It often includes the inflammation of the alveoli (spherical outcroppings of the respiratory sites of gas exchange with the blood) and abnormal alveolar filling up with fluid. Pneumonitis is more general term that describes an inflammatory process in the lung tissue that may predispose or place the patient at risk for microbial invasion.WHAT IS PNEUMONIA? ‡ is an abnormal inflammation of a lung. ‡ .

This complicated the matters even more in viral pneumonia. The ciliated epithelial cells are damaged in case of viral pneumonia. Viral infection of the lungs damages the lungs and makes them even more susceptible to bacterial infections.PNEUMONIA ‡ The causative agent or organism gains entry into the body through the respiratory tract by way of inspiration or aspiration of oral secretions. With the body's response to the invasion. there is further damage to the lungs as the fluid is leaked into the alveoli. ‡ ‡ . This leads to cell death by direct action of the virus or through a cell controlled self destruction called apoptosis. The organisms that can reach the lungs through blood circulation are staphylococcus and gram negative bacilli. The invading organism starts to multiply and release damaging toxins that cause inflammation and edema of the lung parenchyma.

the 24-hour congestion stage. The pathophysiology of pneumonia in children is described in 4 stages. Microscopic examination shows presence of many bacteria and few neutrophils.PNEUMONIA FOR CHILDREN ‡ ‡ Pathophysiology of Pneumonia in Children Pneumonia in children is basically a self-limiting condition most of the times. Let us have a look at the pathophysiology of pneumonia in children in short. the red hepatization stage. . Recurrent cases of pneumonia are seen in chronic cases of asthma or cystic fibrosis. 24 Hour Congestion Stage ‡ This is the first stage of pneumonia that occurs within 24 hours of infection. The lung is characterized by vascular congestion and alveolar edema. the gray hepatization stage and the resolution stage.

The sputum contains a tinge of blood or purulent discharge. The lung tissue becomes red and firm that leads to difficulty in breathing or rapid breathing. that is. reduction of available area within the lung for gas exchange may also be seen.PNEUMONIA Red Hepatization ‡ The red hepatization stage is seen when the red blood cells and fibrin enters the alveoli. Gray Hepatization Stage ‡ The fibrin and dying red and white blood cells collects in the alveolar spaces in the gray hepatization stage. . atelectasis. In this stage.

The enzymes in the lungs are brake down the substances causing inflammation. . The white blood cells fight off the invading organism and the remains may be coughed up.PNEUMONIA Resolution Stage ‡ This is the last stage of pathophysiology of pneumonia in children.

.most common cause of CAP in people younger than 60 years of age. DM) ‡Pseudomonas aeruginosa ‡Other gram-negative rods .frequently affects elderly people and those with comorbid illnesses (e. Community-Acquired Pneumonia³occurs either in the community setting or within the first 48 hours after hospitalization or institutionalization. pneumoniae. ‡H. alcoholism.g.4 Classifications of Pneumonia: 1. The causative agents are: ‡S. COPD. influenzae.

The common organisms responsible for HAP: ‡Enterobacter species ‡Escherichia Coli ‡H. Hospital-Acquired Pneumonia³also known as nosocomial pneumonia. influenzae ‡Methicillin-sensitive or Methicillinresistant Staphylococcus aureus (MRSA) ‡S.4 Classifications of Pneumonia: 2. is defined as the onset of pneumonia symptoms more than 48 hours after admission in patients with no evidence of infection at the time of admission. pneumoniae .

4 Classifications of Pneumonia: 3. The organism that causes PCP is now known as Pneumocystis jiroveci instead of Pneumocystis carinii. influenzae ‡P. The organisms also observed in CAP or HAP: ‡S. tuberculosis . Pneumonia in the Immunocompromised Host³includes Pneumocystis pneumonia. pneumoniae ‡S. fungal pneumonias and Mycobacterium tuberculosis. aeruginosa ‡M. aureus ‡H. The acronym PCP still applies because it can be read ´Pneumocystis pneumoniaµ.

4 Classifications of Pneumonia: 4. The most common form of aspiration pneumonia is bacterial infection from aspiration of bacteria that normally reside in the upper airways. Aspiration Pneumonia³refers to the pulmonary consequences resulting from entry of endogenous or exogenous substances into the lower airway. The common pathogens are: ‡H. influenzae ‡S. aureus .

pulmonary ventilation/perfusion scan. pleural fluid culture. CBC. Causes: Aspiration Infection Depressed cough reflex Dehydration Increased secretions from anesthesia Immobilization . clammy skin. RELATED DIAGNOSTIC TESTS: Crackles are heard when listening to the chest with a stethoscope (auscultation). rales Additional symptoms that may be associated with this disease: shortness of breath. coughing up blood. apnea. or ill feeling (malaise). Tests include: chest X-ray. uneasiness. tacypnea. serious illness and affects about 1 out of 100 people each year. arterial blood gases. easy fatigue. fever. chest pain (sharp or stabbing increased by deep breathing or increased by coughing). or pus-like sputum chills with shaking ). nausea and vomiting. greenish. stress. loss of appetite. anxiety. abdominal pain . There are different categories of pneumonia. It is caused by many different organisms and can range in seriousness from mild to life-threatening illness. general discomfort. muscular stiffness (rare). sputum gram stain. and tension. joint stiffness (rare). lung needle biopsy .ETIOLOGY: Pneumonia is a very common. This disease may also alter the results of the following tests: thoracic CT. SIGNS & SYMPTOMS: Cough (with mucus-like. routine sputum culture. nasal flaring. headache.

Nursing management: WATCH OUT FOR! Fever Chills Cough. expectorants and analgesics Exercise deep breathing every 2 hours Maintain personal hygiene Ensure rest and comfort Provide emotional support to client and family Teach proper disposal of tissues and sputum . Increase OFI Administer antibiotic. Administer oxygen as indicated Ø O2 sats should be done regularly ( at least q4°during acute phase) to make sure that patient is getting adequate perfusion.productive of purulent or rusty sputum Crackles and wheezes Dypnea Chest pain Nursing intervention: Promote full aeration of lungs by positioning the client in Semi Fowlerposition-Pt will need to have breath sounds monitored q 4° to determine if pneumonia is progressing.

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