Nursing Care and Pathophysiology of Pneumonia

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Jon Haws
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Study Tools For Nursing Care and Pathophysiology of Pneumonia

Pneumonia Risk Factors (Mnemonic)
Pneumonia Pathochart (Cheatsheet)
Pneumonia Xray (Image)
Pneumonia Symptoms (Image)
Pneumonia (Image)
Mycoplasma Pneumoniae (Picmonic)
Pneumonia Assessment (Picmonic)
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Outline

Overview

  1. Inflammatory condition of the lungs
  2. Primarily affecting the alveoli
    1. May fill with fluid or pus
  3. Infectious vs Noninfectious
    1. Infectious
      1. Bacterial v. Viral
    2. Non-infectious
      1. Aspiration

Pathophysiology:

Pneumonia is an inflammatory response. This can be caused by an infection or things like aspiration where fluid gets into the lungs, which causes the alveoli to fill with fluid or pus. When the alveoli are filled with fluid or pus then proper gas exchange does not occur as well.

Nursing Points

General

  1. Diagnosis
    1. Chest X-ray
    2. Sputum culture to identify organism
  2. Causes
    1. Community Acquired
    2. Hospital Acquired
      1. Ventilator Associated
    3. Opportunistic

Assessment

  1. Viral
    1. Low grade fever
    2. Non productive cough
    3. WBCs normal to low elevation
    4. Chest X-ray shows minimal changes
    5. Less severe than bacterial
  2. Bacterial
    1. High fever
    2. Productive cough
    3. WBCs elevated
    4. Chest X-ray shows infiltrates
    5. More severe than viral
  3. Both
    1. Chills
    2. Rhonchi/Wheezes
    3. Sputum production

Therapeutic Management

  1. Medications
    1. Antibiotics
    2. Analgesics
    3. Antipyretics
  2. Supplemental O2
  3. Assess and maintain respiratory status
  4. Encourage activity as soon as possible
  5. Instruct on chest expansion exercises
    1. Incentive Spirometry
    2. Turn, cough, deep breathe
  6. Obtain vaccinations for influenza and pneumococcal pneumonia
  7. Proper hand hygiene
  8. Encourage 3 L/day of fluids unless contraindicated
    1. Thin secretions

Nursing Concepts

  1. Oxygenation
    1. Monitor SpO2
    2. Monitor airway and breathing
    3. Apply O2 as needed
  2. Gas Exchange
    1. Monitor RR
    2. Monitor LOC (↓ LOC may indicate gas exchange issues)
    3. Monitor ABG & P/F ratio
  3. Infection Control
    1. Hand Hygiene
    2. Prevent aspiration
    3. VAP bundle (to prevent Ventilator Associated Pneumonia)
    4. Administer Antibiotics

Patient Education

  1. Good hand hygiene
  2. Preventing community acquired pneumonia
  3. s/s to report to PCP
  4. Incentive spirometry and breathing exercises

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