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Pneumonia - Coggle Diagram
Pneumonia
Pathophysiology
Alveoli of the one or both lungs get inflamed as a result of an infection
Pathogen reaches the alveoli and the host defenses are “overwhelmed by microorganism virulence”
Makes it difficult for individuals to get the oxygen they breathe into their bloodstream
Endogenous sources of microorganisms include: nasal carriers, sinusitis, oropharynx, gastric or tracheal colonization, and hematogenous spread
Inflamed alveoli (s) may accumulate fluid or pus
Cough with phlegm or pus
Caused by: bacteria, viruses, and fungi
WBCs also migrate into the alveoli and fill up the “normally air-filled spaces”.
Lungs are not adequately ventilated which results in partial occlusion of the alveoli or bronchi
Arterial hypoxemia
Spreads by: person to person, via coughing, sneezing, touching, and/or breathing
Hospital-acquired pneumonia
Enterobacter species, Escherichia coli, influenza, Klebsiella species, Proteus, Serratia marcescens, S. aureus, and S. pneumonia
Most likely: in intensive care units on orders for ventilators
Community-acquired pneumonia
streptococcus pneumoniae, H. influenza, Legionella, and Pseudomonas aeruginosa
Viruses are the most common cause of pneumonia for infants and children
Health care-acquired pneumonia
similar to organisms that cause hospital-acquired pneumonia
esiding at long-term care facilities or receive treatment/ care in outpatient clinics (ex. nursing and rehabilitation centers, kidney dialysis centers, senior-living care homes)
Aspiration pneumonia
inhalation of food, drinking, vomiting, or salvia into the lungs
disturbs the normal gag reflex
may be caused by: brain injury, excessive consumption of alcohol or drugs, or difficulties with swallowing
S. pneumonia, H. influenza, and S. aureus
Pneumonia in the immunocompromised host
Pneumocystis pneumonia, fungal pneumonias, and Mycobacterium tuberculosis
develop from organisms of low virulence
4 stages
Consolidation
Red hepatization
Grey hepatization
Resolution
Medications
antibiotics
Cipro (ciprofloxacin)
Levaquin (levofloxacin)
Oracea (doxycycline)
Relenza (zanamivir)
antipyretics
pain relievers
acetaminophen (tynenol)
asprin
motrin
antitussives
Pneumococcal vaccination
Interventions
removal of secretions
promoting and encouraging increased fluid intake
Fluid intake: 2 to 3 L per day
humidifiers is/if prescribed by the doctor
administering supplemental oxygen
deep breathing, coughing, turning exercises
chest physiotherapy
comfortable positioning of the patient: Semi-Fowlers
encouraging bed rest
administering antibiotics, antipyretics, pain relievers, and antitussives as prescribed by the doctor
improving airway patency
encouraging patient to conserve energy
maintenance of proper fluid volume (may involve supplement fluids/electrolytes via IV)
maintenance of adequate nutrition
patient education to promote understanding of treatment protocol and preventive measures
Pertinent Assessment Findings
fever, chills, shortness of breath, chest pain described as sharp or stabbing occurring from breathing, rapid heart rate, rapid breathing rate, nausea, vomiting, diarrhea, and a cough that produces sputum that is green or yellow in color
sweating, rapid and shallow breathing, loss of appetite (anorexia), and confusion
low blood pressure, pleuritic chest pain, hemoptysis, muscle fatigue and aches, and pain in the joints
early symptoms
fever, dry cough, headache, pain in the muscles, and weakness
lips and nailbeds that appear a bluish color due to lack of oxygen in the blood
Assessments types
patient health history
physical examination
chest x-ray
fiberoptic bronchoscopy
ABGs
pulse oximetry
gram stain/cultures
CBC
Serologic studies (viral or Legionella titers, cold agglutinins)
pulmonary function studies
electrolytes
bilirubin
percutaneous aspiration/open biopsy of lung tissues
Patient Education
Prevention of developing pneumonia
infection control
proper hand hygiene/washing
avoiding contact with those who have pneumonia
signs and symptoms of pneumonia
how to perform deep breathing and coughing exercises
how to use an incentive spirometer
how to manage symptoms
importance of seeing a doctor for a follow-up appointment
avoiding coming into contact with healthy individuals, and individuals who are immunocompromised or at-risk
coughing/sneezing into tissue and disposal, or into elbow
to follow medication/treatment regimen as ordered/prescribed