PRESENTED BY
• RN,BScN
• ABDULLA KHAMIS NGWALI
• FROM
• PEOPLES REPUBLICS OF ZANZIBAR
Module: critical care
Topic: pneumonia
Objectives
At the end of the presentation, we expect the learners to
be knowledgeable about:
1. The definition of pneumonia.
2. List the classification of pneumonia.
3. According to causes.
4. According to area involved.
5. Understand the mode of transmission of pneumonia.
6. Illustrate the predisposing factors of pneumonia.
7. Describe the path physiology of pneumonia.
Conti…
8.List the clinical manifestations of pneumonia.
9.Discuss the diagnostic tests of the person with
pneumonia.
10.Explain the medical management for the patient with
pneumonia.
11.Describe the nursing intervention for the patient with
pneumonia.
12.Understand preventive measures of pneumonia.
13.Identify the prognosis of the patient with pneumonia.
14.Analyze the complications of pneumonia.
Introduction
• At the end of the breathing tubes in your
lungs are clusters of tiny air sacs. If you have
pneumonia, these tiny sacs become inflamed
and fill up with fluid. Terms such as
bronchopneumonia, lobar pneumonia and
double pneumonia are sometimes used, but
refer to the same condition with the same
causes and treatment.
Definition
• Is an inflammatory process of the lung
parenchyma that is commonly caused by
infectious agents.
OR
• Pneumonia is inflammation (swelling) of the
tissue in one or both of your lungs. It is usually
caused by an infection
Classification of pneumonia
According to causes
• Bacterial (the most common cause of
pneumonia)
• Viral pneumonia
• Fungal pneumonia
• Chemical pneumonia (ingestion of kerosene or
inhalation of irritating substance)
• Inhalation pneumonia (aspiration pneumonia).
•
According to areas involved
• Lobar pneumonia; if one or more lobe is
involved.
• Broncho-pneumonia; the pneumonic process
has originated in one or more bronchi and
extends to the surrounding lung tissue.
Conti…
• According to the manner in which the infection
was acquired: This type of infection is acquired in
the community and the causative organism is one
that is prevalent in the community at the time.
•
• Hospital acquired /nasocomian pneumonia:-this
type of infection is acquired in a health care
institution due to cross infection and the
causative organism is one that lead to infection.
•
Predisposing factors
• Immuno-suppresed patients.
• Cigarette smoking.
• Difficult swallowing (due to stroke,
dementia,parkinsons disease, or other
neurological conditions).
• Impaired consciousness ( loss of brain
function due to dementia, stroke, or other
neurological conditions).
Conti….
• Chronic lung disease (COPD, bronchostasis)
• Frequent suction
• Other serious illness such as heart disease,
liver cirrhosis, and DM, recent cold, laryngitis
or flu.
Pathophysiology
• The streptococci reach the alveoli and lead to
inflammation and pouring of exudates into the
air spaces. WBCs migrate to alveoli, the alveoli
become thicker due to its filling consolidation,
and involved areas by inflammation are not
adequately ventilated, due to secretion and
edema.
Conti….
• This will lead to partial occlusion of alveoli and
bronchi causing a decrease in alveolar oxygen
content. Venous blood that goes to affected
areas without being oxygenated and returns
to the heart. This will lead to arterial
hypoxemia and even death due to
interference with ventilation.
Sign and Symptoms
• Shaking chills
• Rapidly rising fever ( 39.5 to 40.5 degree)
• Stabbing chest pain aggravated by respiration and coughing
• Tachypnea, nasal flaring
• Patient is very ill and lies on the affected side to decrease pain
• Use of accessory muscles of respiration e.g. abdomen and
intercostals muscles
• Cough with purulent, blood tinged, rusty sputum.
• Shortness of breath.
• Flushed cheeks.
• Loss of appetite, low energy, and fatigue.
• Cyanosed lips and nail beds.
Physical Examination
•
• Chest x-ray
• Blood test
• History taking
• Sputum culture
•
Nursing management
• Maintain a patent airway and adequate oxygenation.
• Obtain sputum specimens as needed.
• Use suction if the patient can’t produce a specimen.
• Perform chest physiotherapy.
• Provide a high calorie, high protein diet of soft foods.
• To prevent aspiration during nasogastric tube feedings, check
the position of tube, and administer feedings slowly.
• Provide a quiet, calm environment, with frequent rest
periods.
• Monitor the patient’s ABG levels, especially if he’s hypoxic.
• Assess the patient’s respiratory status, auscultate breath
sounds at least every 4 hours
Preventive measures
• You can help stop germs spreading to others by practising good
hygiene, For example: When you cough or sneeze, cover your
mouth and nose with a tissue to catch the germs Throw used
tissues away immediately, in a bin or toilet – germs can live for
several hours after they leave your nose or mouth. Wash your
hands regularly, to avoid transferring germs to anyone else or other
objects.
• Frequent turning of bed ridden patients and early ambulation as
much as possible.
• Coughing and breathing techniques.
• Sterilization of respiratory therapy equipment
• Suctioning of secretion in the unconscious who have poor cough
and swallowing reflexes, to prevent aspiration of secretions and its
accumulation.
Conti….
Vaccinations
To help protect against pneumonia, people in
higher risk groups should be vaccinated. The
recommended vaccinations are: The pneumonia
jab (pneumococcal vaccination), which protects
against pneumococcal infection
Life style
Smoking, alcohol misuse and intravenous drug
abuse can increase your risk of developing
pneumonia.
Conti…
Smoking
• Smoking damages your lungs, which means
they become infected more easily.
• If you smoke, the best thing you can do to
prevent pneumonia is quit smoking.
Conti….
• Alcohol misuse
Excessive and prolonged alcohol misuse is known to weaken
your lungs' natural defenses against infections, making you
more vulnerable to pneumonia. One study found 45% of
people admitted to hospital with pneumonia had an alcohol
misuse problem. Alcohol misuse is defined as regularly
drinking over the recommended weekly limits (21 units of
alcohol for men and 14 units of alcohol for women).
• Not only does alcohol misuse increase your risk of developing
pneumonia, it also increases your risk of it being more
serious. It is estimated that people who misuse alcohol are
three to seven times more likely to die from pneumonia than
the general population. If you drink alcohol, do not
exceed recommended daily limits (three to four units a day
for men and two to three units a day for women).
Prognosis
With treatment, most patients will improve
within 2 weeks. Elderly or very sick patients
may need longer treatment.
Treatment
• Antibiotic, depending on sputum and blood
culture
• Oxygen therapy
• Chest physiotherapy
• Monitor the patient’s ABC levels, especially if
he’s hypoxic.
• Monitor fluid intake and output.
Complication
• Acute respiratory distress syndrome (ARDS)
• Pleural effusion
• Lung abscesses
• Respiratory failure (which requires mechanical
ventilator)
• Sepsis, which may lead to organ fail
Refference
1. Bickey L.S. (2003), Bates Guide to Physical Examination.
Textbook.
2. (8th Ed): Elsevier St Louis, Missouri.
3. Dirksen.L.H (2004), Medical Surgical Nursing. Textbook. (3th
Ed): Elsevier St Louis, Missouri.
4. Fausi. B. (1998), Principles of internal medicine. Volume 2, page
1419-1426. Textbook. (14th Ed): New York. St Louis.
5. Luckman J. (2004) Medical- Surgical Nursing.Volume 4, page
550-557. Textbook. (4th Ed): Elsevier St Louis, Missouri.

Pneumonia

  • 1.
    PRESENTED BY • RN,BScN •ABDULLA KHAMIS NGWALI • FROM • PEOPLES REPUBLICS OF ZANZIBAR
  • 2.
  • 3.
    Objectives At the endof the presentation, we expect the learners to be knowledgeable about: 1. The definition of pneumonia. 2. List the classification of pneumonia. 3. According to causes. 4. According to area involved. 5. Understand the mode of transmission of pneumonia. 6. Illustrate the predisposing factors of pneumonia. 7. Describe the path physiology of pneumonia.
  • 4.
    Conti… 8.List the clinicalmanifestations of pneumonia. 9.Discuss the diagnostic tests of the person with pneumonia. 10.Explain the medical management for the patient with pneumonia. 11.Describe the nursing intervention for the patient with pneumonia. 12.Understand preventive measures of pneumonia. 13.Identify the prognosis of the patient with pneumonia. 14.Analyze the complications of pneumonia.
  • 6.
    Introduction • At theend of the breathing tubes in your lungs are clusters of tiny air sacs. If you have pneumonia, these tiny sacs become inflamed and fill up with fluid. Terms such as bronchopneumonia, lobar pneumonia and double pneumonia are sometimes used, but refer to the same condition with the same causes and treatment.
  • 7.
    Definition • Is aninflammatory process of the lung parenchyma that is commonly caused by infectious agents. OR • Pneumonia is inflammation (swelling) of the tissue in one or both of your lungs. It is usually caused by an infection
  • 8.
    Classification of pneumonia Accordingto causes • Bacterial (the most common cause of pneumonia) • Viral pneumonia • Fungal pneumonia • Chemical pneumonia (ingestion of kerosene or inhalation of irritating substance) • Inhalation pneumonia (aspiration pneumonia). •
  • 9.
    According to areasinvolved • Lobar pneumonia; if one or more lobe is involved. • Broncho-pneumonia; the pneumonic process has originated in one or more bronchi and extends to the surrounding lung tissue.
  • 11.
    Conti… • According tothe manner in which the infection was acquired: This type of infection is acquired in the community and the causative organism is one that is prevalent in the community at the time. • • Hospital acquired /nasocomian pneumonia:-this type of infection is acquired in a health care institution due to cross infection and the causative organism is one that lead to infection. •
  • 12.
    Predisposing factors • Immuno-suppresedpatients. • Cigarette smoking. • Difficult swallowing (due to stroke, dementia,parkinsons disease, or other neurological conditions). • Impaired consciousness ( loss of brain function due to dementia, stroke, or other neurological conditions).
  • 13.
    Conti…. • Chronic lungdisease (COPD, bronchostasis) • Frequent suction • Other serious illness such as heart disease, liver cirrhosis, and DM, recent cold, laryngitis or flu.
  • 14.
    Pathophysiology • The streptococcireach the alveoli and lead to inflammation and pouring of exudates into the air spaces. WBCs migrate to alveoli, the alveoli become thicker due to its filling consolidation, and involved areas by inflammation are not adequately ventilated, due to secretion and edema.
  • 15.
    Conti…. • This willlead to partial occlusion of alveoli and bronchi causing a decrease in alveolar oxygen content. Venous blood that goes to affected areas without being oxygenated and returns to the heart. This will lead to arterial hypoxemia and even death due to interference with ventilation.
  • 17.
    Sign and Symptoms •Shaking chills • Rapidly rising fever ( 39.5 to 40.5 degree) • Stabbing chest pain aggravated by respiration and coughing • Tachypnea, nasal flaring • Patient is very ill and lies on the affected side to decrease pain • Use of accessory muscles of respiration e.g. abdomen and intercostals muscles • Cough with purulent, blood tinged, rusty sputum. • Shortness of breath. • Flushed cheeks. • Loss of appetite, low energy, and fatigue. • Cyanosed lips and nail beds.
  • 18.
    Physical Examination • • Chestx-ray • Blood test • History taking • Sputum culture •
  • 19.
    Nursing management • Maintaina patent airway and adequate oxygenation. • Obtain sputum specimens as needed. • Use suction if the patient can’t produce a specimen. • Perform chest physiotherapy. • Provide a high calorie, high protein diet of soft foods. • To prevent aspiration during nasogastric tube feedings, check the position of tube, and administer feedings slowly. • Provide a quiet, calm environment, with frequent rest periods. • Monitor the patient’s ABG levels, especially if he’s hypoxic. • Assess the patient’s respiratory status, auscultate breath sounds at least every 4 hours
  • 20.
    Preventive measures • Youcan help stop germs spreading to others by practising good hygiene, For example: When you cough or sneeze, cover your mouth and nose with a tissue to catch the germs Throw used tissues away immediately, in a bin or toilet – germs can live for several hours after they leave your nose or mouth. Wash your hands regularly, to avoid transferring germs to anyone else or other objects. • Frequent turning of bed ridden patients and early ambulation as much as possible. • Coughing and breathing techniques. • Sterilization of respiratory therapy equipment • Suctioning of secretion in the unconscious who have poor cough and swallowing reflexes, to prevent aspiration of secretions and its accumulation.
  • 21.
    Conti…. Vaccinations To help protectagainst pneumonia, people in higher risk groups should be vaccinated. The recommended vaccinations are: The pneumonia jab (pneumococcal vaccination), which protects against pneumococcal infection Life style Smoking, alcohol misuse and intravenous drug abuse can increase your risk of developing pneumonia.
  • 22.
    Conti… Smoking • Smoking damagesyour lungs, which means they become infected more easily. • If you smoke, the best thing you can do to prevent pneumonia is quit smoking.
  • 23.
    Conti…. • Alcohol misuse Excessiveand prolonged alcohol misuse is known to weaken your lungs' natural defenses against infections, making you more vulnerable to pneumonia. One study found 45% of people admitted to hospital with pneumonia had an alcohol misuse problem. Alcohol misuse is defined as regularly drinking over the recommended weekly limits (21 units of alcohol for men and 14 units of alcohol for women). • Not only does alcohol misuse increase your risk of developing pneumonia, it also increases your risk of it being more serious. It is estimated that people who misuse alcohol are three to seven times more likely to die from pneumonia than the general population. If you drink alcohol, do not exceed recommended daily limits (three to four units a day for men and two to three units a day for women).
  • 24.
    Prognosis With treatment, mostpatients will improve within 2 weeks. Elderly or very sick patients may need longer treatment.
  • 25.
    Treatment • Antibiotic, dependingon sputum and blood culture • Oxygen therapy • Chest physiotherapy • Monitor the patient’s ABC levels, especially if he’s hypoxic. • Monitor fluid intake and output.
  • 26.
    Complication • Acute respiratorydistress syndrome (ARDS) • Pleural effusion • Lung abscesses • Respiratory failure (which requires mechanical ventilator) • Sepsis, which may lead to organ fail
  • 27.
    Refference 1. Bickey L.S.(2003), Bates Guide to Physical Examination. Textbook. 2. (8th Ed): Elsevier St Louis, Missouri. 3. Dirksen.L.H (2004), Medical Surgical Nursing. Textbook. (3th Ed): Elsevier St Louis, Missouri. 4. Fausi. B. (1998), Principles of internal medicine. Volume 2, page 1419-1426. Textbook. (14th Ed): New York. St Louis. 5. Luckman J. (2004) Medical- Surgical Nursing.Volume 4, page 550-557. Textbook. (4th Ed): Elsevier St Louis, Missouri.