Pneumonia

Question 1

What is Pneumonia?

Answer 1

• A lower respiratory tract infection that causes inflammation of the alveoli sacs
• Can be caused by bacteria, virus, fungi or inhalation of irritants

Question 2

What is nosocomial pneumonia?

Answer 2

Pneumonia acquired at the hospital

Question 3

How does Pneumonia develop?

Answer 3

• Normally, the respiratory system can “fight off” these type of germs by filtering the air taken in through the nose and airway BUT certain conditions can damage the body’s ability to do this and make the body more susceptible to developing PNA.
• germs get into the lungs by inhalation, aspiration, or from the blood and attack the alveoli sacs.
• These sacs become very inflamed and fill with fluid, body’s immune defense cell RBCs and WBCs, and bacteria.
• This causes the sac to lose the ability to inflate and deflate which allows proper gas exchange.

Question 4

What does the poor gas exchange due to PNA cause?

Answer 4

• HYPOXEMIA (low oxygen in the blood) because oxygen cannot transfer across capillary wall to attach to RBCs to supply the body with oxygen and
• the body keeps the CO2 (carbon dioxide) which leads to RESPIRATORY ACIDOSIS!

Question 5

What are some risk factors for developing PNA?

Give examples of each.

Answer 5

• Prior infection:
  
  • flu or cold
• Weak immune system:
  
  • Elderly, infants, HIV, autoimmune medications
• Immobile:
  
  • strokes or any other condition that causes decrease mental awareness or restrict ability to move
• Lung problems:
  
  • COPD, asthma, smokers
• Post-opt patient:
  
  • not coughing deep breathing
  • ET tubes (can develop Ventilator Associated Pneumonia (VAP)

Question 6

True or False

PNA is only caused by bateria

Answer 6

• False,
• it is caused by bacteria most commonly
• Viral (influenza, RSV) is most common cause of PNA in children
• Fungal cause is least common and usually only to those who are immune suppressed

Question 7

How is PNA diagnosed?

Answer 7

• Abnormal lung sounds (course crackles, rhonchi/wheezing)
• Chest x-ray
• Sputum culture & sensitivity

Question 8

Why is it important to send off sputum culture & sensitivity prior to providing any treatment for PNA?

Answer 8

The treatment can alter the results of the lab and negatively effect appropriate long term treatment

Question 9

PNA s/s?

Answer 9

• General cold symptoms
• Productive cough, fatigue, fever, n/v
• Increased HR/RR
• General body aches/activity intolerance
• n/v, loss of appetite
• Neuro changes (especially with elderly)

Question 10

Nursing interventions for PNA?

Answer 10

• Monitor respiratory system
  
  • RR, Vital signs
  • O2sat
  • ABGs, sputum culture
  • Suction as needed
• Encourage incentive spirometer use
• Fluids
• HOB > 30°
• Chest physiotherapy
• Admin of Meds

Question 11

What meds are typically used for treatment of PNA?

Answer 11

• Antipyretics
• Antiemetics
• Antivirals (if cause)
• Abx (if cause)
• Bronchodilators

Question 12

What is our PT teaching for PNA?

Answer 12

• Prevention
  
  • Pneumonia vax every 5yrs for 65+ (younger if risk factors are present)
• Smoking cessation
• Hygiene
• Breathing techniques
• Exercise
  
  • Can do, but take it easy and don’t overexert