I.

PNEUMONIA- inflammation of the lung parenchyma leading to pulmonary consolidation

because alveoli is filled with exudates

A. ETIOLOGIC AGENTS
1. Streptococcus pneumoniae ( pneumococcal pneumonia )
2. Hemophilus influenzae ( bronchopneumonia )
3. Klebsiella pneumoniae
4. Diplococcus pneumoniae
5. Escherichia coli
6. Pseudomonas aeruginosa

B. HIGH RISK GROUPS

1. Children less than 5 y/o
2. Elderly

C. PREDISPOSING FACTORS
1. Smoking
2. Air pollution
3. Prolonged immobility ( hypostatic pneumonia )
4. Aspiration of food ( aspiration pneumonia )
5. Over fatigue

D. SIGNS AND SYMPTOMS

1. Productive cough, greenish to rusty
2. Dyspnea with prolong expiratory grunt
3. Fever, chills, anorexia, general body malaise
4. Cyanosis
5. Pleuritic friction rub
6. Rales/ crackles on ausculatation
7. Abdominal distentionparalytic ileus

E. DIAGNOSTICS
1.Sputum GS/CSconfirmatory; type and sensitivity;
(+) to cultured microorganis
2. CXR- (+) pulmonary consolidation
3. CBC
▪ Elevated ESR ( rate of erythropoeisis )N = 0.5-
1.5 ( compensatory mech to decrease O2 )
▪ Elevated WBC
4. ABG- PO2 decreased ( hypoxemia )

F. NURSING MANAGEMENT
1. Enforce CBR ( consistent to all respiratory disorders )
2. Strict respiratory isolation
 3. Administer medications as ordered
▪Broad spectrum antibiotics
°Penicillin- pneumococcal infections
°Tetracycline
°Macrolides
Azithromycin ( OD x 3/days )
1. Too costly
2. Only se: ototoxicity- transient hearing loss

▪ Anti-pyretics
▪ Mucolytics/ expectorants

4. Administer O2 inhalation as ordered

5. Force fluids to liquefy secretions
6. Institute pulmonary toilet- measures to promote expectorate of secretions
▪DBE, Coughing exercises, CPT (clapping/vibration ), Turning and repositioning
7. Nebulize and suction PRN
8. Place client of semi-fowlers to high fowlers
9. Provide a comfortable and humid environment
10. Provide a dietary intake high in CHO, CHON, Calories and Vit C
11. Assist in postural drainage
▪Patient is placed in various position to drain secretions via force of gravity
▪Usually, it is the upper lung areas which are drained
▪Nursing management:
° Monitor VS and BS
° Best performed before meals/breakfast or 2-3 hours p.c. to prevent
gastroesophageal reflux or vomiting ( pagkagising maraming secretions diba?
Nakukuha? )
°Encourage DBE
°Administer bronchodilators 15-30 minutes before procedure
°Stop if pt. can’t tolerate the procedure
°Provide oral care after procedure as it may affect taste sensitivity
°Contraindications:
-Unstable VS
-Hemoptysis
-Increased ICP
-Increased IOP ( glaucoma )
12. Provide pt health teaching and d/c planning
▪Avoidance of precipitating factors
▪Prevention of complications
°Atelectasis

°Meningitis
▪Regular compliance to medications
▪Importance of ffup care

°
II.