LESSON PLAN ON PNEUMONIA

SUBJECT:MEDICAL SURGICAL NURSING I

TOPIC:PNEUMONIA

GROUP: M.Sc Nursing (1st year)

PLACE: RUPSONA NURSING COLLEGE

DATE AND TIME:

METHOD OF TEACHING: LECTURE CUM DISCUSSION

DURATION: 45 MINUTES

A.V.AIDS: WHITE BOARD,CHARTS,FLASH CARDS,DEMONSTRATION.

NAME OF THE SPEAKER: Ms. Norene Priya Hembrom

GENERAL OBJECTIVES:
After the completion of the class, The students will gain in depth knowledge on pneumoniaand they will gain knowledge regarding management of
pneumonia

SPECIFIC OBJECTIVE:
After the class, students will be able,
To Introducepneumonia
To Definepneumonia
To Discussed types of pneumonia
To Enumeratecause of pneumonia
To Explainpathophysiology of pneumonia
To Discussed clinical menifestration
To Enumerate diagnostic evaluation
To Discussed management of pneumonia
To Explainprevention of pneumonia
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1. 2 min To Introduce PNEUMONIA lacture cum listen and -
pneumonia discussion participated
Pneumonia is an inflammatory illness of the lung.
Frequently, it is described as lung parenchyma/alveolar
inflammation “and” abnormal alveolar fillimg with fluid what is pneumonia?
2. 3 min To Define (consolidation and exudation)}. Pneumonia is a general
pneumonia term that refers to an infection of the lungs, whitch can be
caused by a variety of microorganisms, including viruses,
bacteria, fungi, and parasites.
The infection causes your lungs air sacs, called alveoll, to
become inflamed. The air sacs may fill up with fluid orr
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pus, causing symptoms such asa cough (with phlegm),
fever, chills, and trouble breathing.

3. 7 min To Discussed TYPES OF PNEUMONIA which are the typ-e

types of of pneumonia ?
pneumonia
PNEUMONIA

Commu Hospital Health

Infectiv nity- - Care- Aspiratio
Fungal
e Acquire Acquire Associate n
d d d whiteboard

1.Infective Pneumonia: Inflammation and infection of

the lungs and bronchial tubes that occurs when a bacteria
(bacterial pneumonia) or virus (viral pneumonia) gets into
the lungs and starts to reproduce. The most common
cause of bacterial pneumonia in adults is a bacteria called
 streptococcus pneumonias or Pneumococcus.
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2.Community-Acquired Pneumonia: Community- lacture cum listen and flash cards -
Aquired pneumonia (CAP) occurs out-sides of hospitals discussion participated
and other health care settings. Most people get CAP by
breathing in germs (especially while sleeping) that live in
the mouth, nose, or throat. CAP is the most common type
of pneumonia. Most cases occur during the winter.
3.Hospital-Acquired Pneumonia: Some people catch
Pneumonia during a hospital stay for another illness. This
is called hospital-acquired pneumonia (HAP). Patients are
at higher risk for getting HAP if on a mechanical
ventilator. HAP tends to be more serious than CAP.
4.Health Care-Associated Pneumonia: Patients also
may get pneumonia in other health care setting, such as
nursing homes, dialysis centers, and outpatient clinics.
This is called health care-associated pneumonia.
5.Fungal pneumonia: Candida and Aspergillus are two
types of fungi that can causes pneumoniaPneumocyitis
carinil is a fungusthat typically causes pneumonia in
patients with with AIDS.
6.Aspiration Pneumonia: This type of pneumonia occurs
when person accidentally inhalofood, drink, vomit, or
saliva from mouth into lunges. This usually happens when
something disturbs normal gag reflex, such as a brain
injury. Swallowing problems, or excessive use of alcohol
or drugs. Aspiration can cause pus to form in a cavity in
the lug. This is called a lung abscess.
7.Atypical Pneumonia: Several types of bacteria-
Legionella pneumophila, mycoplasnsms pneumonia, and
Chlamydrophila pneumonise –cause this type of CAP.
Atypical pneumonia is passed from person to person.
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4. 7 min To Enumerate CAUSES OF PNEUMONIA lacture cum listen and what are the causes
cause of Pneumonia can be due to a variety of bacteria and viruses, discussion participated of pneumonia ?
pneumonia less commonly due to fungi and rarely due to other
microorganisms or parasites. Likely causes are associated
with the age of the person, the season, the person’s health
status, and /or where the infection was contracted.
RISK FACTORS
 Age: 65 or older what are the risk
 Cligarette smoking factors of
 Chronic illness, such as heart or lung disease, pneumonia ?
liver ciorrhosis, or diabetes mellitus whiteboard
 Stoke (aspiration pneumonia due to difilcult
swallowing)
 Weakened immune system caused by AIDS
or chemotherapy treatment
 Recent viral respiratory infection (common
cold, laryngitis, influenza)
 Chronic exposure to certain chemicals
 Cerebral palsy
 Impaired consciousness
 Recent surgery or trauma
 Malnutrition
 Pregnancy
 Infants and very young children
 Alcohol or drug abuse
 Hospitalization in an intensive care unit
5. 7 min To Explain PATHOPHYSIOLOGY OF PNEUMONIA what is
pathophysiolo Pneumonia is an acute infection of the lungs, occurring pathophysiology of
gy of when an infectious agent enters and multiplies in the pneumonia ?
pneumonia lungs of a susceptible person. When the microorganisms
multiply, they release toxins that induce inflammation in
 the lung tissue, causing damage to mucous and alveolar
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membranes. This leads to the development of edema and lacture cum listen and -
exudate, which fills the alveoli and reduces the surface discussion participated
area available for exchange of carbon dioxide and
oxygen. Some bacteria also cause necrosis of lune tissue.
Pneumonia may be confined to one lobe, or it may be
scattered throughout the lungs. If it affects only one lobe,
it is called lobar pneumonia. Generalized pneumonia is
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much more seriousand is called bronchopneumonia.
Bronchopneumonia occurs more often as a nosocomial
(hospital acquired) infection in hospitalized patients.
Pathyophysiology of pneumonia is characterized by four
stages. The first stage of the disease occurs within 24
hours of infection and it is distinguished by vascular
congestion and alveolar derma. The lungs are also
invaded by bacteria and few neutrophils. Typical
symptorms include cough, fever, and sputum production,
usually developing over days and sometimes
accompanied by pleurisy.
The second stage of the disease is called “red
hepatization”. In this stage lungs are similar to the
consistency of liver, with the presence of many
erythrocytes, neutrophils, desquamated epithelial cells,
and fibrin within the alveoli.
The third stage is the “gray hepatization” in the lung is
gray-blown to yellow because of fibrinopurulent
exudates, disintegration ofred cells, and hemosiderian.
The fourth, and the final, stage is called “resolution” and
it is characterized by breakdown of the substances
causing inflammation. In this stage, white blood cells are
fighting off invading micro-organisms, and the remains
are usually coughed up. This stage is characterized by
restoration of the pulmonary architecture.
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6. 5 min To CLINICAL MANIFESTATIONS lacture cum listen and which are the
discussedclini Symptoms of pneumonia vary, depending on the age of discussion participated clinical
cal the child and the cause of the pneumonia. Common manifestation of
manifestation symptoms include: pneumonia ?
of pneumonia

bacterial viral pneumonia atypical

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pneumonia pneumonia
nasal congestion nasal congestion nasal congestion
and sore throat and sore throat and sore throat
fever fever fever ,often low
grade
shaking chills chills chills
dyspnea , shortness dyspnea, shortness dyspnea, shortness
of breath of breath of breath
cough that dry cough coughing; may be
produces violent at times;
green,yellow, or produce white
rust-coloured mucus
mucus
chest pain headache possible nausea or
vomiting
perfuse sweating muscle pain weakness
bluish color of bluish color of
nails or lips : nails or lips :
cyanosis , cyanosis ,
hypoxemia hypoxemia
confused mental weakness
status
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7. 3 min To enumerate DIAGNOSTIC EVLUATIONS lacture cum listen and which are
diagnostic The doctor will ask about symptoms and medical history. discussion participated diagnostic
evaluation of A physical exam wil be done. Diagnosis is based on evaluation for
pneumonia symptoms and listening to chest. Tests may be include: pneumonia ?
 Chest x-ray
 CT scan whiteboard
 Blood test
 Bronchoscopy – Direct examination of airways
 Sputum culture – Testing mucus coughed up
from deep in the lungs
 Pulse oximetry – Measurers the amount of
oxygen in the blood
 Pleural fluid culture – If there is fluid in
thespacesurrounfing the lungs
 Arterial blood gas – Measure oxygen, carbon
dioxide, and acid in the blood

8. 5 min To discussed MANAGEMENT lacture cum listen and what is the

management Most cases of pneumonia can be treated without discussion participated management of
of pneumonia hospitalization. Typically, oral antibiotics, rest, fluids, and pneumonia ?
home care are sufficient for complete resolution.
However, people with pneumonia who are having trouble
breathing, people with other medical problems, and the
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elderly may need more advanced treatment. If the
symptoms get worse, the pneumonia does not improve
with home treatment, or complications occur, the person
will often have to be hospitalized.
NON PHARMACOLOGIC INTERVENTIONS :

PHARMACOLOGIC INTERVENTIONS : lacture cum listen and -

discussion participated
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NURSING MANAGEMENT
NURSING DIAGNOSIS :
1. Imparied gas exchanges relate to decreased ventilation
2. Ineffective airway clearance related to excessive
tracheobronchial secretions
3. Ineffective breathing pattern related to chest pain and
hypoxia.
4. Activity intolerance related to impaired respiratory
function
5. Risk for deficient fluid volume related to fever and
dyspnea
6. Deficient knowledge about the treatment regimen and
preventive health measures
NURSING INTERVENTION :
1.Perform assessments every 4 hours of respiratory rate,
temperature, and signs of airway effectiveness.
2.perform scheduled chest physiotherapy. removing the
secretion of the airway, preventing obstruction
3.encourage her to take several deep breaths.deep

Demonstration

Charts
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breathing promotes oxygenation before controlled -
coughing.encourage her to take a deep breath, hold for 2
seconds,and cough two or three times in
successsion.controlled coughing is accomplished by
closure of the glottis and the explosive expulsion of air
from the lungs by the work of abdominal and chest
muscles.
4.encourage use of incentive spirometry, as appropriate.
Breathing exercises help maximize ventilation
5.promote systemic fluid hydration, as appropriate.
Adequate fluid intake enhances liquefaction pf pulmonary
secretions and facilitates expectoration of mucus.
6.give oxygen.increased lung tissue oxygen supply
7.give antibiotics and antipyretics; assess the
effectiveness and side effects (rash, diarrhea)
8.perform a gradual suction.helping airway clearance
9.record the results of the pulse oximeter when installed,
every 2-4 hours. periodically evaluate the success of
therapy/health team action.
10.institute respiratory therapy (e.g., nebulizer) as
needed.A varitey of respiratory therapy treatments may be
used to open constricted airways and liquefy secretions.

9. 6 min To explain PREVENTION lacture cum listen and what are prevantion
prevention of 1.Get vaccinated discussion participated for pneumonia ?
pneumonia 2.Wash hands
3.Don’t smoke
4.Proper rest and a diet rich in fruits, vegetables and
whole grains
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5.Moderate exercise
6.Get treatment for GERD
 BIBLIOGRAPHY

 BT Basavanthappa,”Text book of nursing foundation ”published by Jaypee brothers medical

publishers (p) LTD .
 Javed ansari and davinder kaur,” Medical surgical nursing I “ published by pee vee books.page no :359
 Kochuthresiamma thomas,” Medical surgical nursing”Volume I published by Jaypee brothers medical
publishers (p) LTD .page no:130
 potter and perry,s,” Text book of fundamental of nursing published by elsevier .
 I clement,”Basic concepts of NURSING PROCEDURES” 3rd Edition , published by Jaypee brothers
medical publishers (p) LTD . page no : 272