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What are some common etiologies of pneumonia?
Lack of normal defense mechanisms
Acquisition of infectious organisms, ie Bacteria, Viruses,Mycoplasma, Fungi, Parasites, Chemicals
Treated with sulfa drugs, PCN, and new antibiotics
Classifications of Pneumonias
: Onset in community or within 2 days of hospitalization. It is assumed that it was aquired within the community and only displayed symptoms after admission.
: Occurs after 48 hours of hospitalization
: inhaled pathogen or obstruction-->accumulation of mucous/area of opportunity for pathogen.
: depressed immune system-->opportunity for nfxn.
--Deficient immune system
--Radiation, chemotherapy or steroids
Pathophys of pneumonia
Congestion outpouring of fluid into alveoli
Microrganism multiplication & spread of infection
Overwhelm with growth & interfere with function of lung(s)
pathophys of pneumonia
: Dilation of capillaries
--Alveoli fill with microrganisms, neutrophils, RBCs, & fibrin
--Lung appears liver-like, red & granular
: Decreased circulation
--Consolidation of leukocytes & fibrin
If no complications, recovery will progress
Exudate is lysed & removed by macrophages and expelled via ciliary movement and cough.
Normal lung tissue restored, very resilient.
Gas exchange returns to normal
SnSs of pneumonia
: fever, chills, dyspnea, productive cough
Pleuritic chest pain. Unique to pneumonia. Pain upon deep breathing.
Adventitious breath sounds, ie wheezes, deminished breath sounds. With flu, lung sounds are typically clear.
Diagnostics for pneumonia
H&P (Hx and physical), ie "have you been out of the country recently?"
: best diagnostic tool.
Sputum C&S (culture and sensitivity)
Pulse oximetry, ABGs
WBC, ESR (Erythrocyte Sedementation Rate), CBC
Collaborative care of pt with pneumonia
Analgesia & Antipyretics
Influenza meds & vaccine
Pneumococcal meds & vaccine
--^fluid intake to loosen mucous. >3L/day.
-- >1500 cal/day
Antibiotic treatment for pt with pneumonia
Many can be treated w/oral antibiotics as outpatients
Some need inpatient care & IV therapy (esp fluids).
: Multidrug resistant microorganisms
Nursing intervensions for pt w/pneumonia
VS (vital signs), ABGs