RESPIRATORY DISORDERS PNEUMONIA GNS11 Certificate

RESPIRATORY
DISORDERS
MODULE 2
Pneumonia
General Nursing Science 2

Definition:
Pneumonia is an inflammation of the
lung caused by various micro
organisms including bacteria,
mycobacteria, fungi and viruses.
(Brunner & Suddarths p 554)
Classification
•Community Acquired Pneumonia
(CAP)
- Within community settings.
- 48 Hours after discharged from
institution.
Causal Organism
- Bacteria - Klebsiella.
- Staphylococcus Aureus.
- Staphylococcus Pneumoniae.
- Staphylococci.
Cause
- Combination of pathogens.
- Hand hygiene of utmost importance.
- Overuse and misuse of antimicrobial agents.
• Pneumonia in Immunocompromised Host:
- HIV/AIDS.
- Chemotherapy and Radio Therapy.
- Nutritional depletion.
- Generic Immune Disorders.
Pathophysiology and Aetiology
1. The development of community Acquired Pneumonia
is normally due to a defect in the host defence,
exposure to a virulent microorganism or an
overwhelming exposure.
2. Risk factors for pneumonia include altered mental
status, smoking, alcohol use, hypoxemia, underlying
diseases e.g. Cystic Fibrosis.
3. When bacterial pneumonia occurs in a healthy person
there is usually a history of viral illness.
Pathophysiology and Aetiology
4. Other predisposing factors include conditions
interfering with normal drainage of the lung
such as a tumour, general anaesthesia, post
operative immobilization.
5. Pneumonia divided into three groups.
- Community acquired Pneumonia.
- Hospital or institutional Acquired pneumonia.
- People older than 65 years.
Clinical Manifestations:
1.Defined by clinical signs and
symptoms. Fever, cough, pleuritic
pain, sputum production.
Local epidemiology, travel history,
local and national outbreaks.
2.Pleuritic pain aggravated by
Clinical Manifestations:
2.respiration/coughing.
3.Dyspnoea and tachycardia, respiratory
grunting,
nasal flaring, use of accessory
muscles and fatigue.
4. Tachycardia may be present.
Pneumonia Cont…
Diagnostic Evaluation
1. Chest X-Rays – consolidation.
2. Patients with CAP should be investigated for specific
pathogens.
3. Endo-bronchial sputum specimens should be obtained
from patients intubated etc.
4. Pre-treatment blood samples for culture from
patients with leukopenia, severe liver diseases.
5. Immunologic tests.
6. Severity-of-illness scores.
Management
1. Antimicrobial therapy.
2. Oxygen therapy.
3. Non-invasive ventilation or incubation for severe
hypoxia or acute respiratory failure.
4. Low ventilation (6mL/kg ideal body weight).
Management
4. Early mobilization and reduces length of stay
in hospital.
6. Influenza and pneumococcal vaccination.
7. Respiratory hygiene measures, hand hygiene.
8. Encourage/advice smokers to quit smoking.
Complications:
1.Pleural effusion.
2.Sustained hypotension and shock
especially gram-negative bacterial
disease and in older people.
3.Superinfections e.g. pericarditis,
bacteraemia, meningitis.
4.Delirium – medical emergency.
3.Atelectasis due to mucus plug.
4.Delayed resolution.
Complications
Nursing Assessment:
1. Take the history to help establish aetiology
diagnosis.
- Resent respiratory illness, onset, medical history.
- Presents of purulent sputum, fever, chills.
- Family illness.
- Medications, recent antibiotics, alcohol use.
2. Observe for signs of illness.
3. Auscultate for lung sounds, crackles, consolidation,
bronchial sounds.
Nursing Diagnosis:
1.Impaired Gas Exchange related to
decreased ventilation secondary to
inflammation and infection.
2.Ineffective Airway Clearance related
to excessive tracheobronchial
secretions.
Nursing Diagnosis:
1.Acute pain related to

inflammatory process and
dyspnoea.
2.Risk for injuries secondary to
complications.
Nursing Interventions
1. Improving gas exchange.
- Observe for cyanosis, dyspnoea, confusion
indicating worsening of condition.
- Check SaO2 levels to determine oxygen need
and response to oxygen.
- Administered oxygen as been prescribed.
- Use caution with high oxygen concentration in
patients with COPD.
- Positioning the patient as needed.
2. Enhancing Airway Clearance.
- If ordered obtain sputum specimen for culture
and sensitivity.
- Encourage patient to cough, retained secretions
interfere with gas exchange. Suction if needed.
- Encourage fluid intake unless contraindicated.
- Humidified air/oxygen therapy.
- Employ chest wall percussion and postal drainage
when appropriate.
- Auscultate the chest for crackles and rhonchi.
- Cough suppressants may be appropriate in case
of non-productive cough.
- Mobilize patient to improve ventilation and
secretion clearance and reduce risk for atelectasis
and worsening pneumonia.
3. Relieving Pleuritic Pain.
- Place patient in a comfortable

position.
- Change position frequently.
Monitoring for complications.
Fatal complications may develop at an early

4. -
stage.
- Monitor temperature, pulse, respiration,
blood
pressure, oximetry for evidence of
dyspnoea.
Patient Education and Health Maintenance
1.Advice patient to complete course of
antibiotics.
2.Inform patient that fatigue and
weakness may
prolonged.
3.Once clinically stable encourage
4. Encourage breathing exercises to clear lungs
and promote full expansion and function.
5. Explain that chest X-Rays is taken 4-6 weeks
after
recovery to evaluate for clearing .
6. Advice smoking cessation.
7. Advice patient to keep up with good
nutrition,
adequate rest and physical exercises.
8. Patient should avoid fatigue, extremes in
temperatures and excessive alcohol intake.
9. Assess and encourage influenza/
Pneumococcal vaccinations.
Patient Education and Health
Maintenance
10. Advice avoidance of contact of
people with upper respiratory
infections.
11. Support hand and respiratory
hygiene especially after contact with
others.
References
1 .Nettina, S.M. 2014. Lippincott Manual of Nursing Practise. 10 th Ed. Tokyo: Wolters Kluwer/
Lippincott Williams & Wilkens.
2. Smeltzer, S.C., Bare, B.G., Hinkle, J.L.& Cheever, K. H. (2010) 12 th Ed. Brunner & Suddarth’s
Textbook of Medical-Surgical Nursing. Tokyo: Wolters Kluwer Health.
3. Vlok, M. E. 1998. Manual of Nursing, 9th Ed. Volume 1. Basic Nursing, Cape Town: Juta & Co
4. Viljoen, M. J. 2000. Nursing Assessment: History Taking and physical Assessment. Cape Town.
Kasigo.
5. Mogotlane, S., Chauke, M, C., Matlaka, m., Mokoena, J., Young, A. Tuta’s Complete Textbook

RESPIRATORY DISORDERS PNEUMONIA GNS11 Certificate

Uploaded by

Copyright:

Available Formats

RESPIRATORY DISORDERS PNEUMONIA GNS11 Certificate

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

RESPIRATORY DISORDERS PNEUMONIA GNS11 Certificate

Uploaded by

Copyright:

Available Formats

RESPIRATORY

General Nursing Science 2

1.Acute pain related to

- Place patient in a comfortable

Fatal complications may develop at an early

You might also like