Week 6: Pneumonia Flashcards
Pathophysiology of Pneumonia
inflammation of the lung parenchyma (functional lung tissue) resulting from a bacterial, viral, or fungal infection
- inflammatory response and build up of fluid and exudate in alveoli
- may be local or diffuse
Epidemiology of Pneumonia
- occur at anytime at any age
- > 65 age are at higher risk of death
- hospital acquired pneumonia develops 48 hours after hospital admission
Risk Factors
- altered mental status
- advanced age (>65)
- long-term care residence
- smoking
- chronic respiratory disease (asthma, emphysema)
- immune system dysfunction
- prolonged immobility
- aspiration of stomach contents or foreign material
- prolonged NPO
- diminished cough, gag, or swallowing reflexes, exposure to gases, air pollutants, or noxious inhalants
- hospitalization for more than 48 hours
Expected Findings
-localized or diffused
-wheezing, rhonchi, or rales
-fever
-tachypnea/ dyspnea
-tachycardia
-chills
-cough, productive or nonproductive
-pleuritic chest pain
-fatigue
>If Severe: purulent or blood-tinged sputum, low BP, dysrhythmias
-anxiety
-weakness
-chest discomfort due to coughing
-confusion from hypoxia is the most common manifestation of pneumonia in older adults clients
Laboratory Tests
- sputum cultures
- blood cultures: (rule out organisms in the blood)
- CBC: elevated WBC
- ABG: hypoxemia (decreased Pa02 less than 80mmhg)
- Elevated C-reactive protein
- Electrolytes: manifestations of dehydration
Diagnostic Procedures
- chest x-ray
- computed tomography (consodilation)
- pulse oximetry
Therapeutic Procedures
- O2 for hypoxia
- adequate hydration
- proper nutrition
- antibiotic
Medications
- bronchodilators with Albuterol or Combivent
- antibiotic
Client Education
- hand hygiene
- adequate rest
- antibiotics
- understand signs + symptoms
- continue medications for treatment of pneumonia
- avoid crowded areas
- obtain immunizations for influenza and pneumonia
- discontinue tobacco use if needed
Complications
- MRSA CAP can lead to necrotizing bacteria
- acute meningitis
- impaired lung function
- empyema
- bacteremia
- atelectasis
- septic shock
- organ impairment
Empyema
collection of purulent material in the pleural space
Bacteremia
bacteria in the bloodstream
Atelectasis
complete or partial collapse of lung (alveoli)
Safety Considerations
bacteria causing pneumococcal pneumonia can gain access to the blood stream leading to septicemia and septic shock
Most common causative organism
Streptococcus