PATHOPHYSIOLOGY

Pneumonia is an acute inflammation of the lung parenchyma caused by a microorganism.

It can be caused by bacteria, viruses, Mycoplasma, fungi, parasites, and chemicals. It can be
Community-Acquired or Health Care-Acquired. Organisms that cause pneumonia reach the
lungs by aspiration from the nasopharynx or oropharynx, inhalation of microbes present in air, or
hematogenous spread from a primary infection elsewhere in the body.

NURSING CONSIDERATIONS
S&S cough, fever, shaking chills, dyspnea, tachypnea, and pleuritic chest pain.
Respiratory assessment includes lung sounds (rhonchi and crackles), RR, SpO2 (hypoxia),
incentive spirometer, coughing/deep breathing exercises, sputum production (green, yellow, or
rust colored); diagnostic studies include chest x-ray, sputum culture, blood cultures, arterial
blood gases (ABGs), WBC; oxygen therapy, antibiotic therapy, analgesics, antipyretics,
hydration oral and IV (with caution in heart failure patients), small frequent meals; complications
include pleurisy, pleural effusion, atelectasis, bacteremia, lung abscess, pericarditis, meningitis,
sepsis, and acute respiratory failure.

PATIENT TEACHING
Coughing and deep breathing exercises, incentive spirometer use, take all prescribed
antibiotic doses, antipyretic, adequate rest, plenty of fluids, avoid alcohol and smoking
(cessation), cool mist humidifier or warm bath to help breathe easier, influenza and
pneumococcal vaccines, cough and cover, and hand hygiene
PATHOPHYSIOLOGY

Hypothyroidism is a common endocrine disorder resulting from deficiency of thyroid

hormone. In the United States and other areas of adequate iodine intake, autoimmune thyroid
disease (Hashimoto disease) is the most common cause of hypothyroidism; worldwide, iodine
deficiency remains the foremost cause.

NURSING CONSIDERATIONS

Hypothyroidism commonly manifests as a slowing in physical and mental activity but

may be asymptomatic. Signs and symptoms are often subtle and neither sensitive nor specific;
the list includes fatigue, loss of energy, lethargy, weight gain, decreased appetite, cold
intolerance, dry skin, hair loss, sleepiness, muscle pain, joint pain, weakness in the extremities,
depression, emotional lability, mental impairment, forgetfulness, impaired memory, inability to
concentrate, constipation, menstrual disturbances, impaired fertility, decreased perspiration,
paresthesia and nerve entrapment syndromes, blurred vision, decreased hearing, fullness in the
throat, and hoarseness.

PATIENT TEACHING

Monotherapy with levothyroxine (LT4) remains the treatment of choice for

hypothyroidism.
PATHOPHYSIOLOGY

Hyperthyroidism is a set of disorders that involve excess synthesis and secretion of

thyroid hormones by the thyroid gland, which leads to the hypermetabolic condition of
thyrotoxicosis. [1] The most common forms of hyperthyroidism include diffuse toxic goiter
(Graves disease), toxic multinodular goiter (Plummer disease), and toxic adenoma.

NURSING CONSIDERATIONS
Signs are Tachycardia or atrial arrhythmia, systolic hypertension with wide pulse
pressure, lid lag, stare, hand tremor, muscle weakness, weight loss despite increased appetite,
reduction in menstrual flow or oligomenorrhea, and warm, moist, smooth skin. Symptoms
nervousness, anxiety, increased perspiration, heat intolerance, hyperactivity, and palpitations.

PATIENT TEACHING

Symptom relief, as well as therapy with antithyroid medications, radioactive iodine-131

(131I), or thyroidectomy.