Bronchopneumonia By: Deepak Kapoor Email- firstname.lastname@example.org Designed for nursing curriculum
What is Pneumonia? • Pneumonia is an infection of the lungs • that is caused by: • Bacteria • Viruses • Fungi • Parasites • It is characterized mainly by inflammation • of the alveoli in the lungs or by • alveoli that are filled with fluid (alveoli are • microscopic sacs in the lungs that • absorb oxygen).
Etiology • Bacteria and viruses are the primary causes of pneumonia. • Pneumonia has bacterial, viral, fungal, and other primary causes. A summary is provided below. • Streptococcus pneumoniae is the most common cause of bacterial pneumonia. • A type of pneumonia that typically occurs during the summer and fall months, is caused by the bacteria Mycoplasma pneumoniae. • Another type of bacteria responsible for pneumonia is called Chlamydia pneumoniae. Pneumocystis cariniipneumonia • Viral pneumonias are pneumonias that do not typically respond to antibiotic treatment (in contrast to bacterial pneumonias). Adenoviruses, rhinovirus, influenza virus (flu), respiratory syncytial virus (RSV), and parainfluenza virus are all potential causes of viral pneumonia.
Conditions that increase your chances of getting pneumonia include: • Cerebral palsy • Chronic lung disease (COPD, bronchiectasis, cystic fibrosis) • Cigarette smoking • Difficulty swallowing (due to stroke, dementia, Parkinson's disease, or other neurological conditions) • Immune system problem (See also: Pneumonia in immunocompromised host) • Impaired consciousness (loss of brain function due to dementia, stroke, or other neurologic conditions) • Living in a nursing facility • Other serious illnesses, such as heart disease, liver cirrhosis, or diabetes mellitus • Recent surgery or trauma • Recent cold, laryngitis, or flu
Symptoms / Clinical Manifestation/ Clinical Fetures The most common symptoms of pneumonia are: • Cough (with some pneumonias you may cough up greenish or yellow mucus, or even bloody mucus) • Fever, which may be mild or high • Shaking chills • Shortness of breath (may only occur when you climb stairs) Other symptoms include: • Confusion, especially in older people • Excess sweating and clammy skin • Headache • Loss of appetite, low energy, and fatigue • Sharp or stabbing chest pain that gets worse when you breathe deeply or cough
Diagnosis/ Tests The health care provider will hear crackles when listening to your chest with a stethoscope. Other abnormal breathing sounds may also be heard through the stethoscope or via percussion (tapping on your chest wall). The health care provider will likely order a chest x-ray if pneumonia is suspected. Some patients may need other tests, including: • Arterial blood gases to see if enough oxygen is getting into your blood from the lungs • CBC to check white blood cell count • CT scan of the chest • Gram's stain and culture of your sputum to look for the bacteria or virus that is causing your symptoms • Pleural fluid culture if there is fluid in the space around the lungs
Treatment / Rx/ Medical Management If bacteria are causing the pneumonia, the doctor will try to cure the infection with antibiotics. It may be hard for your health care provider to know whether you have viral or bacterial pneumonia, so you may receive antibiotics. Medical Management/ Medicines recommended for pneumonia- • Erythromycin • Trimethoprim • Vancomycin Hydrochloride Injection • Levofloxacin • Ampicillin Oral Know about Medicines
Nursing Advice / Nursing Management Breathing warm, moist (wet) air helps loosen the sticky mucus that may make you feel like you are choking. These things may help: • Place a warm, wet washcloth loosely over your nose and mouth. • Fill a humidifier with warm water and breathe in the warm mist. Coughing helps clear your airways. Take a couple of deep breaths two or three times every hour. Deep breaths will help open up your lungs. Tap your chest gently a few times a day and lie with your head lower than your chest. This can help bring up mucus from the lungs. If you smoke any tobacco products, STOP. Do not allow smoking in your home. Drink plenty of liquids (as long as your health care provider says it is okay): • Drink water, juice, or weak tea • Drink at least 6 to 10 cups a day • Do NOT drink alcohol • Get plenty of rest when you go home. If you have trouble sleeping at night, take naps during the day.
Expectations (prognosis) With treatment, most patients will improve within 2 weeks. Elderly or very sick patients may need longer treatment. Those who may be more likely to have complicated pneumonia include: • Older adults or very young children • People whose immune system does not work well • People with other, serious medical problems such as diabetes or cirrhosis of the liver Your doctor may want to make sure your chest x-ray becomes normal again after you take a course of antibiotics. However, it may take many weeks for your x-ray to clear up.
Complications Possible complications include: • Acute respiratory distress syndrome (ARDS) • Fluid around the lung (pleural effusion) • Lung abscesses • Respiratory failure (which requires a breathing machine or ventilator) • Sepsis, which may lead to organ failure
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