1. Acute infirammaton of lower lung parenchyma (aiveill andrespratory bronchioies, aspration, inhaiation, or contaminatedrespratory equipment

2. Classified viral versus bacterial,community-acquired versus hospital-acquiredatypical, or pneumocystis

3. Causative agent can be infectious (bacteria,viruses, fungi, and other microbes) ornoninfectious (aspirated or inhaled substances)

4. Most common organism for both community-acquired and hospital-acquired pneumonia isthe Gram-positive bacteria Streptococuspneumoniae

5. Other common organisms associated withcommunity-acquired pneumonia in-cludeKlebsiella pneumoniae, Pseudomonasaeruginosa. Escherichia con, haemophilusinfluenzae, and other influenzae viruses

6. Spread of microbes in alveoli activatesinflammatory and immune response

7. Antigen-antibody response damages mucousmembranes of bronchioles and alveoli resultingin edema

8. Microbe cellular debris and exudate fillalveoli and can impair gas exchange

1. Viral

2. Bacterial

1. Antibiotic terapy, analgesics. antipyretics

2. Oxygen therapy to treat hypoxemia, suctioningas necessary

3.Maintain patent airway: monitor respiratory andoxygenation status

4. Provide supplemental oxygen as indicated

5. Be prepared to initiate mechanical ventilatorysupport

6. Provide nutritional support and fluids(2 litersper 24 hours or greater if no trainclications) viaappropriate route

7. Provide adeuate opportunities for physical rest

8. For all hospitalized Clients, take measures toprevent Pneumonia

9. Macrolides: erythromycin, axithromycin;penicillin G: aminoglycosides or cephalosporins

10. Alternatives: Augmentin: doxycycline; Bactrim;Levaquin

11. Medication therapy: antibiotics or otherantimicrobials as indicated, analgesics,antipyretics

Respirations: Most PNA pts have hypoxemiaand respirator alkalosisHyperventilation = breathing too fast leadsto...Blowing off all your CO2 (acid loss) leads to...Acute alkalosis (left shift)Less intake of 02 combined with...Increased affinity for 02 = less tissueperfusion....Reduced 02. Increased affinity leads tohypoxemiaLess 02 starts hypotension, vasodilation leadsto....Lack of 02 to brain = confusion, headache,blurred vision leads toLow 02 to myocardium = bradycardia,arrhythmias = ischemia, coma

Interventions: VentsIncrease FiO2 (21% on RA) to obtain PO2 (ABG80-100 about 4-5 times FiO2)At 100% 02 and ratio of "21%" to "80 to 100%"PO2 should be 400-500!Increase minute ventilation to remove excessCO2 and increase TV to clear more CO2(16 BPM x TV 400 cc = 6400CC)High levels of FiO2 > 60% oxygen is consideredtoxic and causes fibrotic lung damageTrade PEEP for 02 reducing the amount ofoxygen given on a ventUse pressure-limited ventilation. Pressurecontrolled or Pressure support.

Signs and Symptoms

Nursing Interventions

Outcome

Signs and Symptoms

Nursing Interventions

Intervertions

Signs and Symptoms