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14 Cards in this Set
- Front
- Back
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Pnuemonia (Cuases)
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-Acute inflammation of the lung parenchyma (bronchioles and alveoli)
-Normal defense mechanisms are impaired -Acquisition of organisms Aspiration Inhalation Hematogenous spread |
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Pneumonia Risk Factors
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-Aging process
-altered LOC -altered oropharyngeal flora -Chronic diseases -Compromised immune system -Drugs (sedatives, opoids, anti-depressants, anesthesia) -Immobility -Gastric feedings -Malnutrition -Tracheal intubation (develops w/in 48-72 hrs) -URIs -Smoking/air pollution -Alcohol/drug abuse -Inhalation of noxious substances -Prolonged hospitalization - pediatric differences (smaller airways, fewer alveoli) |
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Types of Pneumonia
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-Community-Acquired Pneumonia CAP
-Hospital-Acquired Pneumonia HAP -Aspiration Pneumonia -Fungal Pneumonia -Opportunistic Pneumonia |
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Community Acquired Pneumonia
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-Lower respiratory infection
-Onset in the community or during the first 2 days of hospitalization -Highest incidence in winter months -Common organisms are Streptococcus pneumoniae and H. influenzae |
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Hospital Acquired Pneumonia
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-Occurs 48 hours or longer after hospital admission and not incubating at time of hospitalization
-Second most common nosocomial infection -Highest in mechanically ventilated patients -Common organisms are Pseudomonas aeruginosa, E.coli, Staph aureus, and Enterobacter |
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Opportunistic Pneumonia
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-Bacterial and viral causative organisms
-Pneumocytitis pneumonia (PCP) -Cytomegalovirus (CMV) |
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Pathophysiology
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S. pneumonia aspiration >
Inflammatory response > Alveolar edema / exudate formation > alveoli and brochiloles fill with serous fluid, blood cells, fibrin, and bacterium > CONSOLIDATION of lung tissue > impaired gas exchange |
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Clinical Manifestations
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Gradual or sudden onset of symptoms
-fever -chills -productive cough -pleuritic chest pain -dyspnea -confusion, stupor in older, debilitated patients -headache -Fatigue |
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Physical Exam
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-Dullness to percussion
-Crackles -Bronchial breath sounds -Increase tactile fremitus |
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Diagnostic Studies
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-Chest XR
-Sputum for C&S -Sputum for gram stain -CBC -Pulse oximetry -ABGs -CT of lung |
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Acute Collaborative Care
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Pharmacologic therapy:
-Antibiotics -Analgesics -Antipyretics -Bronchodilators -Oxygen therapy -Nutritional Support -Hydration Chest Physiotherapy -Vaccinations |
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Nursing Diagnosis and PCs
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x
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Nursing Interventions
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Identify clients at risk
Minimize risk of aspiration Rest during acute phase then ambulate HOB to semi/high fowlers Cough/deep breath Splint chest Suctioning Push fluids Positional changes Smoking cessation Assist with ADLs Administer meds and oxygen Nutrition Hand washing, proper use of respiratory equipment Prompt treatment of URIs |
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Discharge Teaching
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-Completed prescribed medication regimen
-Avoid smoking or second hand smoke -Limit activities and increase rest periods -Cough and deep breath for 6-8 weeks -Adequate fluid intake and nutrition -Report any change in symptoms |
