Pneumonia (superlative disease) Flashcards
What is pneumonia?
An inflammatory condition of the lung leading to abnormal alveolar filling with consolidation and exudation (blood and fibrin) causing a diffusion disorder.
What is the epidemiology for pneumonia?
Largest infectious cause of death in children.
More females get pneumonia then males (as women ignore symptoms).
Affects mostly children and elderly.
What causes it?
Bacteria, fungi virus,parasites,chemical aspiration, inhaltion(smoke)
How many stages are there of pneumonia and what are the names of each stage?
4 stages
- Congestion
- Red hepatization
- Gray hepatization
- Resolution
Describe the stages and give time frames for each?
Congestion-
first 24hours where vascular engorgement, intra alveolar fluid and numerous bacteria occur. Lung becomes heavy,boggy and red.
Red hepatization-
2-3days, massive exudation develops, neutrophils ,RBC’s leukocytes and fibrin fill alveolar space, the affected area appears red,firm and airless
Gray hepatization-
4-6days, progressive disintegration of red blood cells and persistence of fibrin exudate.
Resolution-
6+ days, consolidation exudate within alveolar spaces undergoes progressive digestion by the release of anti microbial enzymes and inhibitors to produce debris that is later reabsorbed, ingested by macrophages or coughed up.
What are the classifications of pneumonia?
Community acquired pneumonia (CAP)- pneumonia as a result from something within their community
Health care associated pneumonia (HCAP)- caught within a health care setting but not a hospital
Hospital acquired pneumonia (HAP)- acquired within 48hours of admission to hospital
Ventilator associated pneumonia (VAP)- occurs 72hours from ventilation.
What are the sign and symptoms?
Common symptoms include:
Fever, malaise,muscle ache, coughing, tactile fremitus, dyspnoea (SOB), chest pain, loss of appetite, rapid heart beat.
Less common symptoms:
Coughing up of blood, fatigue, nausea, diarrhoea, wheezing, confusion
What are the complications of pneumonia?
Lung abscess, pleural effusions, emphysema, septic shock.
What 5 clinical predictions rules we look for which we can use to diagnose pneumonia?
Temperature exceeding 37.8C HR exceeding 100bpm Crackles Decreased breath sounds and bronchial breath sounds Absence of asthma?
What diagnostic tests would be used?
CXR, CT Scans, Blood tests, sputum cultures, Pleural fluid culture, Bronchoscopy.
What are the general management techniques for pneumonia ?
Antibiotics to treat the source.
Giving the individual extra oxygen/ventilation.
Hydration (IV fluids) due to dehydration as a result of lost appetite and high temperature.
Rest.
Analgesics for specific chest pain.
Fever reducing medication eg.paracetamol.
Vaccinations against pneumonia for future.
What is our role of physiotherapy in treating individuals with pneumonia ?
- Carefully consider there oxygen consumption.
- Treating signs and symptoms during non-productive phase.
eg. Maximising there breathing patten, helping them to use relaxed breathing. - We use positioning, breathing exercises, suctioning and other methods during productive phase to help clear sputum.
