Pneumonia
Definition
- A form of acute respiratory infection that affects the lungs. (Pneumonia is a lung infection
caused by bacteria, viruses or fungi.)
- Pneumonia can affect one or both lungs. (Pneumonia in both of your lungs is called
bilateral or double pneumonia.)
- Based on preliminary data from the Philippine Statistics Authority (PSA), as of August
2022, pneumonia ranked sixth as the top 10 causes of mortality in the country, causing
the deaths of 13,536 people. Most common cause of death among children<5 years
of age.
https://newsinfo.inquirer.net/1693038/fighting-for-breath-pneumonia-continues-to-kill-children-
worldwide
Risk Factors/ Causes
- Bacteria ( The most common type of bacterial pneumonia is called pneumococcal
pneumonia [caused by streptococcus pneumoniae]. This type of pneumonia can
occur on its own or after you've had a cold or the flu. It may affect one part (lobe)
of the lung, a condition called lobar pneumonia.)
- Fungi ( This type of pneumonia is most common in people with chronic health problems
or weakened immune systems, and in people who have inhaled large doses of the
organisms. The fungi that cause it can be found in soil or bird droppings and vary
depending upon geographic location.)
- Viruses, including COVID-19 (one of the viruses that cause colds and the flu can
cause pneumonia. Viruses are the most common cause of pneumonia in children
younger than 5 years. Viral pneumonia is usually mild. But in some cases, it can
become very serious. Coronavirus 2019 (COVID-19) may cause pneumonia,
which can become severe.)
- Children who are 2 years old or younger ( more vulnerable / Weak immune
system)
- People who are age 65 or older ( The immune system naturally weakens with
age, making age a risk factor regardless of health status.)
- Smoking. Smoking damages your body's natural defenses against the bacteria
and viruses that cause pneumonia.
https://www.mayoclinic.org/diseases-conditions/pneumonia/symptoms-causes/syc-
20354204
Disease Process (Anatomy of the lungs)
- Pneumonia causes lung tissue to inflammation (swell) and can cause lung fluid or pus.
( That can make it hard for the oxygen you breathe to enter your bloodstream.)
- Bacterial pneumonia is usually more severe than viral pneumonia. ( While all pneumonia
is inflammation caused by an infection in your lungs, you may have different symptoms
depending on whether the root cause is a virus, bacteria, or fungi. ( Bacterial pneumonia
tends to be more common and more severe than viral pneumonia. It’s more likely to
require a hospital stay. Providers treat bacterial pneumonia with antibiotics. Viral
pneumonia causes flu-like symptoms and is more likely to resolve on its own. You
usually don’t need specific treatment for viral pneumonia.)
Complications:
Most people with pneumonia respond well to treatment, but pneumonia can be very serious and
even deadly. You are more likely to have complications if you are an older adult, a very young
child, have a weakened immune system, or have a serious medical problem like diabetes or
cirrhosis. Complications may include:
- Acute respiratory distress syndrome (ARDS). This is a severe form of respiratory failure.
- Lung abscesses. These are pockets of pus that form inside or around the lung. They
may need to be drained with surgery
- Respiratory failure. This requires the use of a breathing machine or ventilator.
- Sepsis. This is when the infection gets into the blood. It may lead to organ failure.
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Anatomy of the Lungs:
Pneumonia that caused by bacteria. Figure A shows pneumonia affecting part of the left lung.
Figure B shows healthy alveoli (air sacs). Figure C shows alveoli filled with mucus.
Medical Management (Lab Test, Chest x-ray)
- Blood tests. such as a complete blood count (CBC) to see whether your immune system
is fighting an infection. Blood tests are used to confirm an infection and to try to identify
the type of organism causing the infection. However, precise identification isn't always
possible.
- Chest X-ray. A chest X-ray is often used to diagnose pneumonia. It is used to looks for
inflammation in your lungs. This helps your doctor diagnose pneumonia and determine
the extent and location of the infection. However, it can't tell your doctor what kind of
germ is causing the pneumonia.
- Pulse oximetry. This measures the oxygen level in your blood. Pneumonia can prevent
your lungs from moving enough oxygen into your bloodstream.
- Sputum test. A sample of fluid from your lungs (sputum) is taken after a deep cough
mucus from your cough and may be used to find out what germ is causing your
pneumonia
Your doctor might order additional tests if you're older than age 65, are in the hospital, or have
serious symptoms or health conditions. These may include:
- CT scan. If your pneumonia isn't clearing as quickly as expected, your doctor may
recommend a chest CT scan to obtain a more detailed image of your lungs.
- Pleural fluid culture. A fluid sample is taken by putting a needle between your ribs from
the pleural area and analyzed to help determine the type of infection.
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%20provider,germ%20is%20causing%20your%20pneumonia.
Sign & Symptoms
The signs and symptoms of pneumonia may include:
- Cough, which may produce greenish, yellow, or even bloody mucus
- Fever, sweating, and shaking chills
- Shortness of breath
- Rapid, shallow breathing
- Sharp or stabbing chest pain that gets worse when you breathe deeply or cough
- Loss of appetite, low energy, and fatigue
- Nausea and vomiting, especially in small children
Medication of Choice Available in the Philippine Market
Antibiotics kill bacteria or render them unable to replicate. Your doctor may prescribe one of
many antibiotics for pneumonia.
- Amoxicillin
- cephalexin (was the most commonly available antibiotic for sale at the stands (60% and
21%, respectively).
- Azithromycin
Nursing Management
This section contains ineffective airway clearance nursing interventions and actions for
pneumonia and its rationales or scientific explanations.
- Elevate the head of the bed and change position frequently. Doing so would lower the
diaphragm and promote chest expansion, aeration of lung segments, mobilization, and
expectoration of secretions.
- Teach and assist the patient with proper deep-breathing exercises. Demonstrate proper
splinting of the chest and effective coughing while in an upright position. Encourage the
patient to do so often.
2.1. Deep breathing exercises facilitate the maximum expansion of the lungs and
smaller airways and improve the productivity of cough.
2.2. Coughing is a reflex and a natural self-cleaning mechanism that assists the cilia in
maintaining patent airways. It is the most helpful way to remove most secretions.
2.3. Splinting reduces chest discomfort and an upright position favors deeper and more
forceful cough effort making it more effective.
- Suction as indicated: frequent coughing, adventitious breath sounds, desaturation
related to airway secretions. Stimulates cough or mechanically clears airway in a patient
who cannot do so because of ineffective cough or decreased level of consciousness.
Note: Suctioning can cause increased hypoxemia; hyper oxygenate before, during, and
after suctioning.
- Maintain adequate hydration by forcing fluids to at least 3000 mL/day unless
contraindicated (e.g., heart failure). Offer warm, rather than cold, fluids. Fluids,
especially warm liquids, aid in the mobilization and expectoration of secretions. Fluids
help maintain hydration and increase ciliary action to remove secretions and reduce
viscosity. Thinner secretions are easier to cough out.
- Administer medications
- Anticipate the need for supplemental oxygen or intubation if the patient’s condition
deteriorates. These measures are needed to correct the hypoxemia. Intubation is
needed for deep suctioning efforts and provides a source for augmenting oxygenation.
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%20pneumonia%20and,secretions%2C%20and%20assisting%20in%20suctioning.
