UNIVERSITY COLLEGE OF NURSING,FARIDKOT
SEmINAR
ON
PNEUmONIA
SUbjECT:- ChILD hEALTh NURSING 2
SUbmITTED TO:-
RESP. mS.VANDNA
PROFESSOR
UCON
SUbmITTED bY:-
NAVPREET KAUR
m.SC 2 YEAR(NSG)
ND
UCON
PNEUMONIA
INTRODUCTION
Pneumonia is a form of acute respiratory infection that affects the lungs. The lungs are made
up of small sacs called alveoli, which fill with air when a healthy person breathes. When an
individual has pneumonia, the alveoli are filled with pus and fluid, which makes breathing
painful and limits oxygen intake.
Definition
Pneumonia is defined as acute inflammation and consolidation of lung parenchyma.
Incidence
The annual incidence rate of pneumonia is between 5 and 11 cases per 1000 under five
children. Pneumonia in children is a major concern in developing countries, because one—
third of all hospitals outpatients compromise of acute respiratory infections of which nearly
30% have Pneumonia.
Anatomy and physiology of lungs:-
The purpose of lungs is provide oxygen to the blood the respiratory system divides into
airways and lung parenchyma.
Function:- It get oxygen from the air to the blood performed by the alveoli. The alveoli are a
single cell membrane that allows for gas exchange to pulmonary vascular. A couple of
muscles help with inspiration and expiration such as diaphragm and intercostal muscles.
Classification
Pneumonia can be classified on anatomic and etiologic basis.
❖ Classification on anatomic basis
1 Lobar or lobular One or more lobes of lungs are involved.
Pneumonia
2 Interstitial pneumonia Interstitial tissues of lungs are affected.
3 Bronchopneumonia Patchy consolidation of lungs is known as
bronchopneumonia.
❖ Classification on etiologic basis
1 Bacterial Pneumonia It may be caused by pneumococcus, Streptococcus,
Staphylococcus, H.influenzae, and Haemophilus
pertussis.
2 Viral pneumonia It is caused by viruses like influenza, measles,
adenovirus and respiratory syncytial virus.
3 Fungal pneumonia It may be caused by histoplasmosis and
coccidoidomycosis.
4 Protozoal pneumonia It is caused by pneumocystis carinii, Toxoplasma
gondii, and Entamoeba histolytica.
❖ Miscellaneous types
1 Aspiration pneumonia It is caused by aspiration of food, nasal drops, amniotic
fluid by newborn, water(drowning) and chemicals like
kerosene oil etc.
2 Loffler’s pneumonia It is a disease in which Eosinophils accumulate in lungs,
in response to parasitic infection. It may be caused by
parasites like Ascaris lumbricoides.
3 Hypersensitivity It is an inflammation of alveoli within the lungs caused
pneumonitis by hypersensitivity to inhaled dust.
4 Hypostatic pneumonia It results from collection of fluid in dorsal region of
lungs and occurs especially in those confined to bed for
long time (like bedridden or elderly persons).
Risk Factors:-
▪ Low birth weight. ▪ Poor socioeconomic status
▪ Passive smoking ▪ Overcrowding
▪ Family history of bronchitis ▪ Pollution
▪ Large family size ▪ Lack of breastfeeding
Stages of pneumonia :- Bacteria or viruses reach the lungs through respiratory passage and
multiply in the alveoli. They disturb the defense mechanism of the lungs. There will be gross
alteration in properties of normal lung secretions.
S.no. STAGES OF PNEUMONIA
1 Congestion The first stage, which occur within 24 hours of
infection, is characterized by coughing,
fatigue and swelling of lungs.
2 Red Hepatization The second stage, which occur day 3-4, it
characterized worsening of symptoms and red
appearance of lung due to increase RBCs.
3 Gray Hepatization The third stage, which occur on day 5-7
characterized by grayish color due to damage
of RBCs.
4 Resolution The final stage, which occur day 8 – week 4,is
characterized by improved symptoms and
return to normal lung function.
Pathophysiology:-
Clinical Features
Clinical Features Of pneumonia include:
✓ Sudden onset
✓ High fever with chills.
✓ Cough with thick sputum
✓ Increased respiratory rate.
✓ Grunting respiration.
✓ Running nose.
✓ Irritability
✓ Sore throat.
✓ Anorexia
Late symptoms include:-
✓ Convulsions
✓ Drowsiness
✓ Inability to drink from mouth
✓ Wheezing.
✓ Hoarseness of voice.
✓ Cyanosis.
✓ Pleural pain which may be increased by deep breathing and is referred to shoulder or
abdomen.
Diagnostic Evaluation
Diagnostic of pneumonia can be made on the following basis:
❖ History of the child reveals presence of cough with increased respiration.
❖ Chest X-ray:- To finding bronchopneumonia include diffuse Patchy consolidation in
lungs.
❖ Sputum culture:-Isolation of organism from nasopharynx or throat by culture or
polymerase chain reaction (PCR) in viral pneumonia.
❖ Blood test:- reveals increased blood count with polymorphonuclear leukocytosis
seen in bacterial pneumonia.
❖ Lung Biopsy
Complications
• Pleural effusion.
• Emphysema.
• Bronchiectasis.
• Retention of sputum causing lobar collapse.
Management
Management of pneumonia depends on the causative agent detected. Antimicrobial therapy is
started on the basis of sensitivity test.
❖ Oxygen administration while hypoxemia or Acidosis.
❖ Antibiotics:- Treatment of bacterial pneumonia include Pencillin, amoxicillin and
Azithromycin.
❖ Fungal infections:- Drug treatment for Fungal infections is amphotericin B,
Fluconazole, Pencillin and sulfonamides.
Surgical management
❖ Chest tubes:- Drain air, blood or fluid from pleural space, the area around the lungs.
❖ Lobectomy:- Removes the affected lobe of the lung.
❖ Thoracotomy:- Incision in the chest to remove damaged lung tissues.
NURSING MANAGEMENT :-
1 Make continuing assessment ➢ Monitor the child’s respiratory rate and
pattern.
➢ Monitor breath sounds- wheezing.
➢ Observe signs of respiratory distress.
2 Impaired gas exchange ➢ Maintain Patent airway.
related to alveolar capillary ➢ Administer oxygen to maintain
membrane changes as saturation.
evidenced by tachycardia. ➢ Change the position frequently to
prevent pooling of secretions in lungs.
➢ Keep child warm.
➢ Provide steam Inhalation.
➢ Teach about deep breathing exercise.
3 Hyperthermia related to ➢ Provide bed rest.
inflammatory process as ➢ Prescribed antibiotics.
evidenced by increased body ➢ Increased fluid intake to prevent
temperature. dehydration.
4 Imbalanced nutrition less ➢ Provide adequate fluids.
than body requirement ➢ Do not give orally if child having
related to disease condition breathing because there is greater risk of
as evidenced by refusal of aspiration.
food by child.
5 Inadequate sleep pattern ➢ Provide diversion therapy to child to
related to respiratory avoid boredom.
distress. ➢ Administer mild sedatives when child is
restless.
Conclusion
Pneumonia is an acute infection in the lungs that can lead to more serious complications if
not treated. In most cases of viral pneumonia resolve without treatment;common bacterial
pathogens. Pneumonia is a form of acute respiratory infection that affects the lungs. The
lungs are made up of small sacs called alveoli, which fill with air when a healthy person
breathes. When an individual has pneumonia, the alveoli are filled with pus and fluid, which
makes breathing painful and limits oxygen intake.
BIBLIOGRAPHY
➢ Rimple Sharma;Text Book of essential Pediatrics nursing;3rd edition, Publisher:
Jaypee Brothers Medical publishers (P) Ltd, Year 2021, page no.184-186.
➢ OP Ghai,Vinod K Paul,Arvind Bagga.Essential Pediatrics.CBS Publishers and
Distributors.New Delhi.Seventh edition.page no;172-175.
➢ A. Parthasarathy,PSN Menon,Piyush Gupta,MKC Nair.IAP Textbook of
Pediatrics.Fifth Edition.Jaypee Brothers Medical Publishers;New Delhi.Page No;60-
62.
➢ Kleigman,St Geme,Blum,Shah.Nelso Textbook of Pediatrics.21st Edition.Elsevier
publications;page no;930-935.
➢ https://www.cedars-sinai.org/health-library/diseases-and-conditions---
pediatrics/p/pneumonia-in-children.html
