LEARNING CONTENT

I. Pneumonia

Pneumonia is a serious infection or inflammation of one or both lungs. It is caused

by the inhalation of infected microorganisms (tiny, single-celled living organisms,
such as bacteria, viruses, fungi or protozoa) spread through contact with an
infected person. The microorganisms enter the body through the mouth, nose and
eyes. If the body's resistance is down, the natural process of fighting off diseases is
weakened and the microorganisms are free to spread into the lungs and the lungs'
air sacs. The air sacs become filled with fluid and pus from the infectious agent,
making it more difficult for the body to get the oxygen it needs, and the person
may become sick.

II. Causes and Risk Factors of Pneumonia

There are over 30 different causes of pneumonia, but the most common causes are
bacteria (including mycoplasma) and viruses. Corresponding to these causes are
the most common types of pneumonia - bacterial pneumonia, viral pneumonia and
mycoplasma pneumonia.

1. Bacterial pneumonia

Pneumonia-causing bacteria is present in many throats, but when the body's

defenses are weakened (for example, by illness, old age, malnutrition or impaired
immunity) the bacteria can multiply, working its way into the lungs, inflaming the
air sacs and filling the lungs with liquid and pus. The bacteria that cause bacterial
pneumonia are streptococcus pneumonia (resulting in lobar pneumonia),
hemophilus influenza (resulting in bronchopneumonia), legionella pneumophilia
(resulting in Legionnaires' disease) and staphylococcus aureus.

2. Viral pneumonia

Half of all pneumonias are believed to be caused by viruses, such as influenza (flu),
adenovirus, coxsackievirus, chickenpox, measles, cytomegalovirus and respiratory
syncytial virus. These viruses invade the lungs and multiply.

III. Symptoms of Pneumonia

Symptoms vary, depending on the type of pneumonia and the individual.

With bacterial pneumonia, the person may experience:

  shaking
 chills
 chattering teeth
 severe chest pain
 cough that produces rust-colored or greenish mucus
 very high fever
 sweating
 rapid breathing
 rapid pulse rate

With viral pneumonia, the person may experience:

 fever
 dry cough
 headache
 muscle pain and weakness

These flu-like symptoms may be followed within one or two days by:

 increasing breathlessness
 dry cough becomes worse and produces a small amount of mucus
 higher fever
 bluish color to the lips

With mycoplasma pneumonia, the person may experience:

 violent coughing attacks

 chills
 fever
 nausea
 vomiting
 slow heartbeat
 breathlessness
 bluish color to lips and nailbeds
 diarrhea
 rash
 muscle aches

Regardless of the type of pneumonia, the person may also experience the following
symptoms:

 a loss in appetite
 feeling ill
  clammy skin
 nasal flaring
 fatigue
 mental confusion
 joint and muscle stiffness
 anxiety, stress and tension
 abdominal pain

IV. How do people "catch pneumonia"?

1. Some cases of pneumonia are contracted by breathing in small droplets that

contain the organisms that can cause pneumonia.
2. coughs or sneezes.
3. In other cases, pneumonia is caused when bacteria or viruses that are
normally present in the mouth, throat, or nose inadvertently enter the lung.
4. If a person is in a weakened condition from another illness, a severe
pneumonia can develop.
5. People with recent viral infections, lung disease, heart disease, and
swallowing problems, as well as alcoholics, drug users, and those who have
suffered a stroke or seizure are at higher risk for developing pneumonia than
the general population.
6. As we age, our swallowing mechanism can become impaired as does our
immune system. These factors, along with some of the negative side effects
of medications, increase the risk for pneumonia in the elderly.
7. Once organisms enter the lungs, they usually settle in the air sacs and
passages of the lung where they rapidly grow in number. This area of the
lung then becomes filled with fluid and pus (the body's inflammatory cells) as
the body attempts to fight off the infection.

V. Prevention of Pneumonia

1. Practice good hygiene.

2. Get an influenza shot each fall.
3. Get a pneumonococcal vaccine. People who stand to benefit most from
vaccination are those over the age 65; anyone with chronic health problems
(such as diabetes, kidney disease, heart disease, etc.); anyone who has had
their spleen removed; anyone living in a nursing home or chronic care
facility; caregivers of the chronically ill (healthcare workers or family
caregivers); children with chronic respiratory diseases (such as asthma), and
anyone who has had pneumonia in the past (due to increased risk of
 reinfection). The pneumonococcal vaccine is 90 percent effective against the
bacteria and protects against infection for five to 10 years.
4. Practice good preventive measures by eating a proper diet, getting regular
exercise and plenty of sleep.
5. Avoid contact with people who have respiratory tract infections, such as colds
and influenza (flu). Pneumonia may develop after these types of infections.
6. If you have not had measles or chickenpox or gotten vaccines against these
diseases, avoid contact with people who have these infections. Pneumonia
can be a complication of measles or chickenpox, so getting these infections
can put you at risk for getting pneumonia.
7. Do not smoke.

VI. DEEP BREATHING AND COUGHING EXERCISES

Remember, control your coughing as uncontrolled coughing can make you short of
breath. Discuss with your physician which type of coughing exercise is best for you.

You should perform these coughing maneuvers whenever you feel the need to
cough or as instructed by your physician. A good controlled cough is especially
helpful when you first get up in the morning and about an hour before bedtime.
Have a cup of coffee or tea first (or other drink recommended by your physician)
and relax.

Sit up straight in a chair when attempting these coughing exercises. Have a tissue
handy.

Exercise A

1.    Sit up straight on a hard-backed, stable chair, relax.

2.    Take in 2-3 deep breaths through your nose and

exhale slowly through pursed lips. You can do this
while your arms are raised over your head.

3.    Fold your arms across your abdomen.

4.    Take in a comfortable deep breath through your

nose.

5.    Lean forward, pressing your arms against your

abdomen and cough while leaning forward.

6.    Relax, rest 5-10 minutes

 7.    Perform again if needed.

Exercise B

1.    Sit up straight, relax.

2.    Take in 2-3 breaths through your nose and exhale slowly through pursed
lips.

3.    Take in a moderately deep breath, hold breath, expel air while saying “H”
or “K” once.

4.    When you feel comfortable with this exercise, try and say the “H” or “K” 3-4
times while exhaling.

References:

http://www.medicinenet.com/pneumonia/article.htm
http://www.webmd.com/lung/tc/pneumonia-prevention
http://www.healthscout.com/ency/416/205/main.html#PreventionofPneumonia
http://www.childrensmn.org/Manuals/PFS/ChildDev/015535.pdf
 Saint Louis University
School of Nursing
Baguio City

Teaching Plan
Pneumonia, Deep Breathing
And Coughing Exercises

Cawayan, Ghentle
October 29, 2010

Submitted by:

COSME, Amiel Rafael

BSN-4-N4

Submitted to:

Mrs. Rachel Alfonso

Clinical instructor
LEARNING NEED: Pneumonia (etiology, prevention), Coughing Exercise (CE), Deep Breathing Exercises(DBE);
since the patient is still a child, the teaching will be performed to the parents/SO.

>S: “pneumonia daw yung sakit nya. Pano ba nakukuha yun at ano ba yun?”
LEARNING DIAGNOSIS: Knowledge Deficit related to lack of information resources
GOAL: Patient’s SO will verbalize understanding of pneumonia.
Patient and the parents will be able to demonstrate and perform CE and DBE

BEHAVIORAL LEARNING TEACHING RESOURCES METHOD OF

LEARNING CONTENT STRATEGY/ NEEDED EVALUATION
OBJECTIVES OUTLINE METHODS AND
ACTIVITIES
After 35 minutes of 1. Definition of Pneumonia Discussion (3  Outline of the Oral feedback:
nursing education, the minutes) topic to be The patient’s
patient’s parents will be 2. Causes and Risk Factors discussed. parents will be
able to: of Pneumonia Discussion (7 able to answer
 Patient and asked questions
minutes)
nurse and will be able to
1. verbalize a. bacterial pneumonia throw questions
understanding of b. viral pneumonia for further
 Visual aid made
pneumonia by the information.
3. Symptoms of educator.
2. state the two pneumonia The patient’s
major causes of  Time and parents will
pneumonia 4. How do we participation of verbalize
catch Pneumonia? Discussion (5 both learner understanding of
3. state at least 15 minutes) and educator. importance CE and
signs and symptoms 5. Prevention of DBE
of pneumonia Pneumonia Discussion (5
The patient will be
minutes)
able to
4. state at least 5 6. Deep
demonstrate
reasons how we catch Breathing and Coughing coughing and deep
pneumonia Exercises Discussion (5 breathing
minutes) exercises
5. state at least 5
prevention of Discussion and
pneumonia demonstration (10
minutes)
6. demonstrate how
to do Coughing and
Deep Breathing
exercises