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Pneumonia, Cites: Ignatavicius, D., Workman, L., Rebar, C., &…
Pneumonia
Interventions
Oxygen therapy
incentive spirometry
encouraging patients to cough and deep breath every 2 hours
Drink at least 2 L of water per day
bronchodilators are prescribed when bronchospasm
Antibiotics to treat bacterial pneumonia
Cough medicine
fever reducers/pain relievers
Patient Education
Educate patients on getting the pneumococcal vaccine after age 65
Educate patient to get plenty of rest and get at least 3 L of fluids everyday
Encourage good hand hygiene
Teach patient good techniques to alleviate any anxiety, and refer to a counselor if needed
Instruct patient to notify primary health care provider if chills, fever, persistent cough, dyspnea, wheezing, hemoptysis, increased sputum production, chest discomfort, and increased fatigue returns fails to go away or returns
Avoid large crowds
rest until you feel better, take adequate rest breaks
Assessment
Ask about respiratory illness and whether patient has been exposed to the flu, pneumonia or had had a recent viral infection
manifestations:
flushed cheeks, chest pain or discomfort, myalgia, headache, chills, fever, cough, tachycardia, dyspnea, tachypnea, hemoptysis and sputum production
Confusion is possible (in patients that are 65+)
Observe:
patients breathing pattern, position, and use of accessory muscles
crackles will be heard on auscultation, wheezing will also be heard if inflammation or exudate narrows the airways
Labs:
sputum (examined by gram stain, culture and sensitivity testing)
CBC (to assess for elevated WBC)
In severely ill patients ABGs are assessed
Serum electrolyte, BUN and creatinine levels are assessed
Imaging/other diagnostic assessments
Chest x - ray
pulse oximetry
Pathophysiology
All pneumonias have excess fluid in lungs from inflammatory process, pneumonia from respiratory infection is associated with the formation of thick exudate containing proteins and other particles that reduce gas exchange
pathogens penetrate the airway mucosa and multiply in alveolar space, wbcs then move to infection causing formation of exudates
once the exudates collect the alveolar walls thicken, which decreases gas exchange
2-5 million cases occur annually in the US
Types of pneumonia
community acquired
health care associated (< 48 hrs after admission)
hospital acquired (> 48 hrs after admission)
ventilator associated
aspiration pneumonia
Risk factors:
being in the hospital
chronic diseases
smoking
weekend/suppressed immune system (HIV, chemotherapy patients)
Cites:
Ignatavicius, D., Workman, L., Rebar, C., & Heimgartner, N. (2021). Medical-surgical nursing:
Patient-centered collaborative care.
Evolve
, (10th ed.). ISBN: 978-0-323-61242-5
Pneumonia. (2023).
Mayo Clinic.
https://www.mayoclinic.org/diseases-conditions/pneumonia/symptoms-causes/syc-20354204