asdasdasdasdasdasdPathophysiology of Pneumonia

A. Description: Acute infection of the lung varying in severity and causing fluid accumulation.
B. Etiology: causative organisms include bacteria, viruses, fungi, and protozoan.
C. Pathophysiologic process and manifestations.
1. Organisms may enter the respiratory tract through inspiration or aspiration of oral
secretions; staphylococcus and Gram-negative bacilli may reach the lungs through
circulation in the bloodstream.
2. Normal pulmonary defense mechanisms (cough reflex, mucocilliary transport, and
pulmonary macrophages) usually protect against infection. However, in susceptible
hosts, these defenses are either suppressed or overwhelmed by the invading organism.
3. The invading organism multiplies and releases damaging toxins, causing inflammation
and edema of the lung parenchyma; this results in accumulation of cellular debris and
exudates.
4. Lung tissue fills with exudates and fluid, changing from an airless state to consolidated
state.
5. In viral pneumonia, the ciliated epithelial cells become damaged.
6. Severity of symptoms depends on the extent of pneumonia present (e.g., partial lobe,
full lobe [lobar pneumonia], or diffuse [broncho pneumonia]).
7. Symptoms include:
i. Fever
ii. Chills
iii. Malaise
iv. Cough
v. Pleuritic pain
vi. Increased tactile fremitus on palpitation
vii. Rales and ronchi on auscultation
viii. Dyspnea
D. Overview of nursing interventions
1. Administer antibiotics specific for the causative organism, as prescribed and confirmed
by culture and sensitivity.
2. Control fever with acetaminophen as ordered.
3. Assess vital signs, monitor respiratory status.
4. Monitor pulse oximetry.
5. Monitor exercise tolerance.
6. Monitor breath sounds note changes in sputum production.
7. Encourage adequate fluid intake.
8. Provide bronchial hygiene.
9. Maintain adequate fluid intake.
10. Perform chest physiotherapy (CPT) as indicated.
11. Administer O2 therapy as ordered.
12. Attempt to prevent pneumonia in susceptible hosts. For example:
i. Frequent positioning, deep breathing and coughing exercises in the post-op
patient.
ii. Chest PT
iii. Avoid contact with persons who have respiratory infections, crowds, malls and
shopping center.