Pneumonia

Pneumonia

Diagnostic Tests
1. Cultures and sensitivities
2. Chest x-ray essential for early diagnosis
3. Pulse Oximetry
  1. (Copstead & Banasik.2013)
4. CBC, electrolyte levels BUN and creatinine
Causative Factors
1. Hospital acquired
  1. Infectious organism
    1. Bacteria, viruses, mycoplasmas, fungi, rickettsiae, protozoa, and helminths
      1. People
      2. Equipment and supplies
        (Lopez, Struckey & Mallory, 2016)
      3. Invasive devices
      4. Environment
  2. Noninfectious agents
    1. Inflammation in the interstitial spaces, the alveoli and often the bronchioles
      1. By surviving lung defenses including inflammation, Organisms penetrate airway mucosa and multiply in alveolar spaces
        WBCs migrate to infection causing a capillary leak, edema and exudate
        Fluids collect in and around alveoli and the walls thicken reducing gas exchange
        The capillary leak spreads infection to other areas of the lung and if the organisms move into the bloodstream sepsis results
        (Lewis, Heitkemper, Dirksen,& Bücher.2012)
        Fibrin and edema of inflammation stiffen lung reducing vital capacity
        Alveolar collapse further reducing gas exchange to blood causing hypoxemia
        Park, & Kim 2015
    2. Aspiration of fluid, food, and vomitus
      1. GERD
    3. Inhalation of toxic gases, chemicals, smoke
2. Community acquired
Signs and Symptoms
1. Flushed cheeks, bright eyes, anxious expression
  1. (Merai, Siegel, Rakotz, Busch, Wright, Wong & Thorpe 2016)
2. Myalgia, headache, chills, fevers, cough, and sputum
3. Pain or discomfort in chest or pleura
4. Tachycardia, dyspnea, tachypnea
5. Crackles are heard when assessing breathing
6. Hypoxemia
  1. Arterial oxygen less than 80 mm Hg
Pathophysiology
1. Fluid in the lungs
Treatments
1. Fluid and oxygen management
  1. Pulm. Toilet
  2. Nasal & Oral Suctioning
    1. Doyle-Cox, Brousseau, Tullouch, Mielniczuk, Davies, Sherrard, & Clark, 2016
2. Pain control
3. Anti-infective drugs
4. Maintain patent airway
  2. Cough &deep breathe every 2hrs
  3. Bronchodilators help when bronchospasm or wheezing is present
    1. Albuterol
      1. (Copstead & Banasik.2013)
5. Health promotion education for caregivers
  1. Hand Washing
Risk Factors
1. Older adult
  1. (Lewis, Heitkemper, Dirksen,& Bücher.2012)
2. Exposure to viral or influenza infections
  1. Mechanical ventilation
  2. Adenovirus

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