Pneumonia

Front 1

What is pneumonia?

Back 1

1/ Def:inflammatory process in the lung structure a/s with increasing in interstitial & alveolar fluid, Decrese Gas Exchange

Front 2

What is etiology of pneumonia?(Risk factors)

Back 2

2/Etiology Risk factors:
_Virulence or quantity of infective agent
_Viral or bacteria
_Microplasm & fungi
*Protective mechanism: impaired by air polution, smoking, URI, aging, decrease filtration, decrease warming(cold), decrease humidication

Front 3

Pathophysiology?

Back 3

3/Patho:
With Pneumonia, inflamatory and pulmonary response to offending agent (body react to offending agent). It is happened in 3 ways:
+Aspiration of organism what in nasopharynx, oralpharynx into lung.
+Inhalation:of microbe in the air (mycoplasma pneumonia, fungi pneumonia, smoke, dust, gases, chemical)
+Hematogenous:spread fr. primary infection (staph.)=>staph. pneumonia)

Front 4

Classification of pneumonia?

Back 4

4/Classification:
_Community accquire:pt come to the hospital with it=> incubation. S/S in 2 days
_Hospital accquire:after 48h of admission.Pneumonia has highest motality and mobility of NOsocomial Infection. N.need to becareful with the Asepsic technique.
5/Clinical manifestation:
_Fever, chill, sweat.
_Cough, N/V
_Dyspnea, pleuritic chest pain
_Sputum production (green, bloody, rusty)
_Headache, sorethroat
_Crackling sound fr. fluid in interstitial area (tactile Femitus), INCR vibrating.
_Chest sound like bronchial breath sound over area of consolidation(tubular_loud sound)
_Unequal chest wall expansion(if large enough area)
_In elderly: can see mental confusion

6/Difinitive Diagnostic test:
_Blood test(WBC)
_Skin test
_ABG (arterial blood gas_O2)
_Chest X-Ray
_Sputum culture, graim stain, fungi, blood and urine culture
**Over the are of pneumonia, will see wjite opacification in the area consolidation(in one area instead all over the lung)

7/ Other types of Pneu.in Immunocompromised patient:
_PCP=pneumocystic carinii pneumonia=HIV/autoimmune Sx dod/on steroid/chemo, transplant taking the drug to block the reaction to the transplant depending on the drugs, sometimes we don't have drug to treat.
_CMV=cytomegalovirus=cause by viral pneumonia in immuno-compromised pt=>bacterial pneumonia
_Fungi:fungi pneumonia
8/Complication :
_Pleural effusion, Atelectasis, COnsolidation(localied infection), empyema, pericarditis, endocarditis, arthritis, pleurisy, lung abcesses, meningitis

9/Tx (asap)
_Antibiotic, Antiviral drugs(not work w/ bird flu)
_Specimen for sensitivity
_Fluid( 3L/day, check H. fnx)
_Oxygen therapy, med for fever/pain
_At least 1500 Kcal/day
10/Prevention(HMO):
_Flu, pneumonia vax (not cover 100%)
_Exercise habit=>keep natural resistance=>prevent aspiration
_Side lie, 30 degree, fowler position.
_Turn w/in 2h, mobility, oral care, coughing, deep breathing.
_Not over meds(pain), maintain sterial tech.
***HMO:
H=hob 30 degree
M=mobility
O=oral care(2X/day, swab in between, infuse fluid w/ syringe, brush & use suction PRN)
**Diffcult swallowing=>speech therapy=>liquid diet, start w/ thick one

Front 5

Clinical manifestation of Pneumonia

Back 5

5/Clinical manifestation:
_Fever, chill, sweat.
_Cough, N/V
_Dyspnea, pleuritic chest pain
_Sputum production (green, bloody, rusty)
_Headache, sorethroat
_Crackling sound fr. fluid in interstitial area (tactile Femitus), INCR vibrating.
_Chest sound like bronchial breath sound over area of consolidation(tubular_loud sound)
_Unequal chest wall expansion(if large enough area)
_In elderly: can see mental confusion

Front 6

Difinitive Diagnostic test for Pneumonia

Back 6

6/Difinitive Diagnostic test:
_Blood test(WBC)
_Skin test
_ABG (arterial blood gas_O2)
_Chest X-Ray
_Sputum culture, graim stain, fungi, blood and urine culture
**Over the are of pneumonia, will see wjite opacification in the area consolidation(in one area instead all over the lung)

Front 7

Other types of pneumonia in immunocompromised patient?
1/PCP
2/CMV
3/Fungi

Back 7

7/ Other types of Pneu.in Immunocompromised patient:
_PCP=pneumocystic carinii pneumonia=HIV/autoimmune Sx dod/on steroid/chemo, transplant taking the drug to block the reaction to the transplant depending on the drugs, sometimes we don't have drug to treat.
_CMV=cytomegalovirus=cause by viral pneumonia in immuno-compromised pt=>bacterial pneumonia
_Fungi:fungi pneumonia
8/Complication :
_Pleural effusion, Atelectasis, COnsolidation(localied infection), empyema, pericarditis, endocarditis, arthritis, pleurisy, lung abcesses, meningitis

9/Tx (asap)
_Antibiotic, Antiviral drugs(not work w/ bird flu)
_Specimen for sensitivity
_Fluid( 3L/day, check H. fnx)
_Oxygen therapy, med for fever/pain
_At least 1500 Kcal/day
10/Prevention(HMO):
_Flu, pneumonia vax (not cover 100%)
_Exercise habit=>keep natural resistance=>prevent aspiration
_Side lie, 30 degree, fowler position.
_Turn w/in 2h, mobility, oral care, coughing, deep breathing.
_Not over meds(pain), maintain sterial tech.
***HMO:
H=hob 30 degree
M=mobility
O=oral care(2X/day, swab in between, infuse fluid w/ syringe, brush & use suction PRN)
**Diffcult swallowing=>speech therapy=>liquid diet, start w/ thick one

Front 8

Complication of pneumonia?

Back 8

a

Front 9

Treatment of pneumonia

Back 9

a

Front 10

Prevention of Pneumonia

Back 10

a