Pneumonia Flashcards
definition of pneumonia
ANY type or infection of the LOWER respiratory system
pneumonia disease process
inflammation of lung tissues = alveolar air spaces become filled with purulent, inflammatory cells and fibrin
how does transmission occur with pneumonia?
inhalation of infectious droplets
risk factors for PNA
–age extremes
–compromised immunity
–underlying lung disease
–alcoholism
–altered LOC
–impaired swallowing
–nursing home resident
–hospitalization
–influenza
what puts people at risk for aspiration PNA?
–alcoholism
–altered LOC
–impaired swallowing
HAP
hospital acquired pneumonia
–develops within 48 hours of admission
–worse outcomes than CAP
–ICU care
VAP
–endotracheal intubation
most common route of getting PNA
aspiration of oropharyngeal secretions
patho of PNA
inflammatory rxn in lungs –> vasodilation –> infection spreads to resp. tract and alveoli –> goblet cells stimulated and mucus excreted –> mucus accumulates between alveoli and capillaries –> alveoli cannot open and close effectively d/t purulent exudate –> gas exchange suffers
what fails in PNA?
failure of mucociliary defense mechanism allows exudative fluid and inflammatory cells to invade alveoli
who has an ineffective mucociliary clearance mechanism?
smokers
symptoms of PNA
–usually preceded by URI
–fever
–chills
–productive OR dry cough
–malaise
–pleural pain
–dyspnea
–hemoptysis
cough differences in PNA
bacterial = productive/purulent (gram negative in HAP)
viral = nonproductive/scanty (cause of CAP)
sputum in bacterial PNA
green, rusty colored, look like red currant jelly
symptoms of severe PNA
–tachypnea
–signs of respiratory distress/failure
signs of respiratory distress
–tachypnea
–nasal flaring/pursed lips
–stridor/wheezing
–AMS/agitation
–tachycardia
–delayed cap refill
–pale
signs of respiratory failure
–RR > 60
–retractions
–grunting
–mottling
–head bobbing
–severe air hunger
–bradycardia
–hypotension
diagnosis of PNA
–pulmonary consolidations
–infiltrates on CXR
–CBC
–+ sputum for C&S
components of pulmonary consolidations
–dullness to percussion
–inspiratory crackles
–increased tactile fremitus (vibration with speech)
–egophony (prolonged “ahh” in lungs when people say “ee”)
bacterial PNA
gram +
–staph aureus (through bloodstream via IV to lungs)
–strep pneumoniae (usually with CAP, sputum brown or rusty)
gram -
–sicker and more difficult to treat
–central line infection
aspiration PNA
aspirated material from GI tract stimulates inflammatory response within alveoli
viral PNA
–flu = major risk factor
–virus alters pulmonary immune defense and makes lungs vulnerable to additional bacteria infection
s/s of viral PNA
–fever
–chills
–DOE
–cough
treatment of viral PNA
supportive care
pneumocystis carini pneumonia
–related to immune suppression
–yeast-like fungus
mycoplasma
–“walking pneumonia”
–mild PNA, persistent cough, HA, earache
–bacterial “like” organism, properties of bacteria and virus
Legionella
–gram negative
–spread via water system –> A/C, mists sprayed on produce, hot tubs
–must report to health dept
aspergillus
–fungal PNA
–released from walls of old buildings, reconstruction, stored grain, dead leaves, compost
–affects lung tissue
PNA treatment
–bacterial = antibiotics
–viral = supportive
–ensure oxygenation
–adequate hydration
–good pulm. hygiene
–neb treatments
PCV13 vaccine
prevents pneumococcal pneumonia caused by 13 strains of strep PNA
–recommended for children
PPSV23 vaccine
prevents against additional 23 types of PNA bacteria
–secondary dose for adults if received PCV15 for first dose
