Pneumonia: nursing management

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Pneumonia nursing management
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Definition

• Pneumonia is a pulmonary infection with
  inflammation that develops after someone inhales
  airborne pathogens or aspirates pathogens in
  secretions from the upper respiratory or
  gastrointestinal tract.

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Classification

• bacterial
• viral
• fungal
• Depending on the patient's clinical and X-ray
  findings, pneumonia is further classified as
  lobar pneumonia (affecting one or more lobes),
  bronchopneumonia (affecting the terminal
  bronchial tree, distal airways, and alveoli), or
  inflammation of the interstitial space.

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• Community-acquired pneumonia is pneumonia that
  someone contracts outside the hospital setting.
  In many cases, a respiratory virus, such as
  influenza or adenovirus, is the infectious
  organism. The most common bacterial cause is
  Gram-positive Streptococcus pneumoniae.
• Nosocomial (hospital-acquired) pneumonia
  develops more than 7 days after hospital
  admission. It's likely to be caused by different
  pathogens, including Staphylococcus aureus and
  Klebsiella.

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Risk factors for CAP

• a. Elderly
• b. Very young
• c. Cystic fibrosis
• d. Respiratory conditions
• e. Smoking
• f. Immunocomprompromised
• g. Heart disease
• h. Diabetes

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Signs and symptoms

• a. Cough
• b. Sputum
• c. Dyspnea
• d. Pleuritic chest pain
• e. Crackles (auscultation)
• f. Dullness (percussion)
• g. Fever or hypothermia
• h. Low or high WBC count

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Less common signs and symptoms

• a. Increased heart rate
• b. Cyanosis
• c. Retractions (infants and children)
• d. Lung secretions
• e. Dehydration
• f. Anorexia
• g. Behavior changes

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X-ray findings

• a. Viral
• b. Bacterial
• c. Uncommon organism

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Treatment

• 1. Antibiotic therapy if applicable
• 2. Maintain oxygenation
• 3. Maintain airway clearance
• 4. Maintain adequate hydration
• 5. Monitor temperature

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Patient education

• 1. Hand hygiene
• 2. Asthma control
• 3. Yearly flu immunization