Pneumonia: symptoms, Diagnosis, management, Complications

Pneumonia:

Inflammation of the airway and alvioli of the lung caused by infectious agent is known as pneumonia.

Etiology:

1.     The organism gains access to the lungs through aspiration of oropharynx content

2.     By inhalation of respiratory secretions from infected individuals via the blood stream.

3.     Direct spread to the lungs from surgery or trauma.

4.     Immuno compromised patient. (eg Those receiving carticosteroids or immunosuppressives)

Predisposable factors:

Tumour,  general  anesthesia,  poor  operative  immobility, depression  of  central nervous system,  neurological disorders and intubations.

 People who have over 65 years have a high mortality rate.

Signs and symptoms:

1.     Sudden onset, shaking chill and rapidly rising fever

2.     Cough productive of purulent sputum.

3.     Chest pain aggravated by coughing.

4.     Tachypnoea accompanied by respiratory grunting and nasal flaring.

5.     Rapid bounding pulse.

Diagnosis:

Chest, x-ray to show pressure/extent of pulmonary disease.

Gram' s strain, culture, and sensitivity studies of sputum

Blood culture

Immunologic test

Management:

Antimicrobial therapy - depends on laboratory identification of causative organism and sensitivity to specific antimicrobials.

Oxygen therapy if patient has inadequate gas exchange.(refer practicals)

Nursing management:

1.     Follow ABCs to determine oxygen need and response to oxygen therapy.

2.     Place patient in a fairly upright position to obtain greater lung expansion

3.     Encourage patient to cough

4.     Encourage increased fluid intake

5.     Oxygen therapy to loosen secretions and improve ventilation.

6.     Employ postural drainage.

7.     Ascultate the chest.

8.     Administer cough suppressants.

9.     Place in a  comfortable position

10.      Apply heat and / or cold as prescribed.

11.      Encourage modified bed rest during febrile period.

12.      Monitor vital signs

13.      Encourage breathing exercises

14.      Educate to avoid smoking

15.    Advise patient to keep up natural resistance with good nutrition, adequate rest.

16.      Encourage the early immunization

Complication:

1.     Pleural effusion.

2.     Hypertension and shock.

3.     Meningitis

4.     Delirium.

5.     Atelectasis.