Pneumonia

Pneumonia

1. Diagnostic Tests

   • Cultures and sensitivities
   • Chest x-ray essential for early diagnosis
   • Pulse Oximetry
     • (Copstead & Banasik.2013)
   • CBC, electrolyte levels BUN and creatinine

2. Causative Factors

   • Hospital acquired
     • Infectious organism
       • Bacteria, viruses, mycoplasmas, fungi, rickettsiae, protozoa, and helminths
         • People
         • Equipment and supplies
           • (Lopez, Struckey & Mallory, 2016)
         • Invasive devices
         • Environment
     • Noninfectious agents
       • Inflammation in the interstitial spaces, the alveoli and often the bronchioles
         • By surviving lung defenses including inflammation, Organisms penetrate airway mucosa and multiply in alveolar spaces
           • WBCs migrate to infection causing a capillary leak, edema and exudate
             • Fluids collect in and around alveoli and the walls thicken reducing gas exchange
               • The capillary leak spreads infection to other areas of the lung and if the organisms move into the bloodstream sepsis results
                 • (Lewis, Heitkemper, Dirksen,& Bücher.2012)
               • Fibrin and edema of inflammation stiffen lung reducing vital capacity
                 • Alveolar collapse further reducing gas exchange to blood causing hypoxemia
                   • Park, & Kim 2015
       • Aspiration of fluid, food, and vomitus
         • GERD
       • Inhalation of toxic gases, chemicals, smoke
   • Community acquired

3. Signs and Symptoms

   • Flushed cheeks, bright eyes, anxious expression
     • (Merai, Siegel, Rakotz, Busch, Wright, Wong & Thorpe 2016)
   • Myalgia, headache, chills, fevers, cough, and sputum
   • Pain or discomfort in chest or pleura
   • Tachycardia, dyspnea, tachypnea
   • Crackles are heard when assessing breathing
   • Hypoxemia
     • Arterial oxygen less than 80 mm Hg

4. Pathophysiology

   • Fluid in the lungs

5. Treatments

   • Fluid and oxygen management
     • Pulm. Toilet
     • Nasal & Oral Suctioning
       • Doyle-Cox, Brousseau, Tullouch, Mielniczuk, Davies, Sherrard, & Clark, 2016
   • Pain control
   • Anti-infective drugs
   • Maintain patent airway
     • Cough &deep breathe every 2hrs
     • Bronchodilators help when bronchospasm or wheezing is present
       • Albuterol
         • (Copstead & Banasik.2013)
   • Health promotion education for caregivers
     • Hand Washing

6. Risk Factors

   • Older adult
     • (Lewis, Heitkemper, Dirksen,& Bücher.2012)
   • Exposure to viral or influenza infections
     • Mechanical ventilation
     • Adenovirus