Pneumonia

Question 1

Classification of Pneumonia

Answer 1

classified based on how it is acquired:

Community-Acquired Pneumonia (CAP)
Hospital-Acquired Pneumonia (HAP)
Health Care-Associated Pneumonia (HCAP)

Question 2

A person acquires the infecting organisms in 3 ways:

Answer 2

• Aspiration from the nasopharynx or oropharynx
• Inhalation of microbes floating in the air
• Spread through the blood from an infection somewhere else in the body

• Pneumonia is more likely to result when a patient’s immune defense mechanisms become compromised or the system is exposed to infectious agents.

Question 3

How Pneumonia works

Answer 3

• Fluid and exudate accumulate within the alveoli and surrounding tissue causing abnormal breath sounds.
• This leads to an inhibited exchange of oxygen and carbon dioxide resulting in hypoxemia.
• Inflammation and pain contribute to ineffective breathing patterns.
• Carbon dioxide and oxygen exchange improve when fluid and exudate leave the alveoli and surrounding tissue.

Question 4

Symptoms: Clinical Manifestations

Answer 4

• Main: cough, SOB, speutum, chest pain
• Sudden fever, chills, cough with purulent sputum, pink, rusty , green, yellow or white sputum.pleuritic chest pain, SOB, confusion, fatigue, aches and pains, tachypnea, tachycardia, hypoxemia, anorexia

Chest assessment
> Increased tactile fremitus, wheezing and crackles.
•Changes in mental status,

•Remember that tactile fremmitus (vibration) is increased with pneumonia and pulmonary edema and decreased with pleural effusion)

Atypical signs of viral pneumonia:
• Gradual onset, dry cough, headache, malaise, fatigue, sore throat, N&V, diarrhea, chills fever.

Question 5

Diagnostic studies

Answer 5

CXR, CT, MRI, ABG, WBC , HBG,HCT Pulse oximetry, HX, sputum C&S, blood cultures

Obtaining a sputum culture to determine the organism
Acquiring arterial blood gases (ABGs) to assess for hypoxemia, hypercapnia, and pH level
Measuring complete blood count (CBC) with differential. White blood cell (WBC) count often reveals leukocytosis.

Question 6

Treatment:

Caused by virus (viral pneumonia )

Answer 6

no treatment
just treating symptoms 
-increase fluids (thins out secretions)
-increase 02
-Acetaminophen

Question 7

Treatment:

Caused by bacteria

Answer 7

• antibiotics
• Intravenous (IV) antibiotic therapy should be switched to oral therapy as soon as the patient is hemodynamically stable
• Total treatment time for patients with community-acquired pneumonia should be a minimum of five days,

Question 8

Nursing Management: Pneumonia

Nursing assessment – what do you assess?

Answer 8

History – lung cancer, COPD, DM, debilitating disease, malnutrition AIDS
Use of antibiotics, corticosteroids, chemo, immunosuppraccets
Recent abdominal or thoracic surgery
Smoking
Alcohol use disorder
Respiratory infections
clinical manifestations
Nursing diagnoses

Question 9

Nursing Management: Pneumonia

Planning

Answer 9

Clear breath sounds 
Normal breathing patterns
No signs of hypoxia
Normal chest x-ray
No complications related to pneumonia

Question 10

Nursing Management: Pneumonia

Evaluation

Answer 10

Evaluate
Dyspnea not present
Sp02 greater then 95 unless other COPD
Free of adventitious breath sounds
Clear sputum from airway
Reports pain control
Verbalizes causal factors
Adequate fluid and caloric intake
Performs activities of daily living

Question 11

Reduction Risks for Hospital-Acquired Pneumonia

Answer 11

Positioning
-Place the patient with altered consciousness in positions (e.g., side-lying, upright) that will prevent or minimize aspiration

Aspiration Risk

• watch patients with feeding tube/difficulty swallowing
• bed 30º

VAP

• elevate bed
• oral care

Infection Control