Pneumonia Concept Map Nursing

Pneumonia
By: Megan Barton, Kristen bizub,
Audra Blasnig, Kayla Green, Maggie
O'Hara, and Savannah Rivers
Introduction to
pneumonia
  • Acute, lower respiratory tract infection.
  • inflammation in terminal airways & alveoli-
impairing gas exchange.
  • Caused by Bacteria, viruses, fungi, protozoa
and parasites.
  • 6th leading cause of death in US- more
prominent in immunodeficient patients.
  • Higher in elderly and babies
  • different organisms present different S/Sx and
dif. treatment.
  • Commom Organisms:(Gram-negative)
Streptococcus pneumoniae, Staphylococcus
aureus, Pseudomonas aerugimose, Klebsiella
pneumoniae, Escherichia coli.
Pathophysiology
  • Bacterial pneumonia: This
infecition triggers alveolar
inflammtion and edema.
  • Viral pneumonia: This virus first
attacks bronchiolar epithelial
cells and causes interstitial
inflammation and dequamation.
  • Aspirations pneumonia:
INhalation of gastric juices or
hydrocarbon inflammatory
changes and in activates
surfactant over a large area.
Aspirations pneumonia
Decreased surfactant
leads to alveolar
collapse. Acidic gastric
juices may damage the
airflow , leading to secondary bacterial
pneumonia.
Signs and Symptoms
  • Coughing- can be dry and
persistent or it may be productive
  • Sputum production
  • Pleuric chest pain
  • Shaking/ chills
  • Fever
  • Wide range of physical signs:
  • From diffuse, fine crackles
  • To sings of localized or
extensive consolidation and
pleural effusion
  • Dyspnea
  • Tachypnea
  • Malaise
  • Decreased breath sounds
Laboratory & Diagnosticagnostics
  • Chest X- rays are used to confirm
the diagnosis.
  • Sputum speciman, Gram stain, and
culture and sensitivity tests
differentiate the type of infection.
  • WBC count indicates leukocytosis
in bacterial pneumonia.
  • Normal or low WBC count for viral
or mycoplasmal pneumonia.
Risks Factors
Long Term
Hospitalization with
Ventilator
Smoking
Not Being Able to Cough
or Hsving Difficulty While
Swallowing
Chronic Disease
Age
Weakended or Supressed Immune System
HIV/AIDS
organ Transplant
Chemotherapy
Long Term Steroid Use
2 Years Old or Younger
65 Years Old or Older
Asthma
COPD
CFibrosisystic
Heart Disease
Introduction to
pneumonia
  • Acute, lower respiratory tract infection.
  • inflammation in terminal airways & alveoli-
impairing gas exchange.
  • Caused by Bacteria, viruses, fungi, protozoa
and parasites.
  • 6th leading cause of death in US- more
prominent in immunodeficient patients.
  • Higher in elderly and babies
  • different organisms present different S/Sx and
dif. treatment.
  • Commom Organisms:(Gram-negative)
Streptococcus pneumoniae, Staphylococcus
aureus, Pseudomonas aerugimose, Klebsiella
pneumoniae, Escherichia coli.
Bacterial Pneumonia
  • There is lowAcute, low
ventilation with
normal perfusion.
Capillaries become
engored with blood,
causing stasis. As
the alveolocapillary
membrane breaks
down, alveoli fill with
blood and exudate,
resulting in
atelectasis
Viral Pneumonia
The virus also invades
bronchial mucous
glands and goblet
cells. It then spreads
to the alveoli, which fill
with blood and fiuid . In
advanced infection, a
hyaline membrane
may form .
Nursing & Medical Interventions
Treatments:
  • Antimicrobial Therapy
  • Humidified oxygen therapy
  • Mechanical Ventilation
  • High- calorie diet
  • Adequate fluid intake
  • Bed Rest
  • Analgesics
  • Positive end - expiratory pressure
(to facilitate adeqate
oxygenation in patients on
mechanical ventilation for severe
pneumonia)
Nursing Interventions:
''The incidences of ventilator-
associated pneumonia was
significantly reduced using
''bundles'' of care intervention.
These bundi
les... include the
following nursing interventions:(a)
elevate the patient, and (b)
mobilize the patient, and (c)
implement comprehensive oral
care.''
Additional Nursing Interventions:
  • Auscultate lung fields every
1-2 hour
  • Auscultate lung sounds every
1-2 hour
  • Incentive Spirometer
  • ''A' back to basics'
  • approach to nursing
  • care can halp to prevent
  • unnecessarey
  • complications during
  • hospitalization.''
Medications Used to Treat Pneumonia:
  • Ceftriaxone(Broad spectrum
antibiotic)
  • Cefotaxime (Broad Spectrum
antibiotic
  • Levofloxacin (Anti- infective)
  • Moxifloxacin (Anti-infective)
  • Ampicillin/Sulbactam (Anti -infective,
broad spectrum)
  • Ertapenem (anti- infective)
other Medications:
  • Doripenem (anti- infective)
  • Tigecycline(Broad spectrum,
anti- infective)
These medications are currently
being tested as additional treatments for pneumonia.
Signs and Symptoms
Differences with Age
Adults:
in previously healthy
individual adults,
pneumonia may present
with a 1 to 2 day history
of cough, fatigue, rigors
and pleuritic pain
Signs and Symptoms
Differences with Age
On examination respiratory
reat is likely to be repid,
crackles may be audible on
inspiration and there may be
evidence of pleural effusion
(dullness on auscultation or
obvious lack of expansion of
the ribcage on inspiration)
Signs and Symptoms
Upon Examination
Subjective Data:
Sudden onset of fever
accompanied by convulsions
  • Complaints of being weak
  • Shortness of breath
  • Complaining of being tired on
the move
  • Insomnia or can't fall or stay
asleep
  • Coughing with phlegm
  • Nausea, vomiting, no appetite
  • Sometimes diarrhea
  • Weight loss
Laboratory & Diagnosticagnostics
  • Blood cultures reflect bacteremia.
  • Arterial blood gas levels vary.
  • Bronchoscopy or trensteacheal aspiration allows
Collection of material for culture.
  • Pulse oximetry Shows a reduced oxygen saturation level.
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