CASE STUDY :

Pediatric Community
Acquired Pneumonia
(PECAP)
It then has to decide the means it will use to
achieve those ends, draw up a plan and devise a
strategy.
Also known as a targets.
By setting aims and objectives, companies give
themselves a sense of purpose and direction.

OBJECTIVES
 Define the meaning of pediatric community acquired
pneumonia (PCAP), signs and symptoms and its
environmental factors
 Review and discuss the data gathered of nursing history,
risk factors and laboratory result
 Discuss the anatomy and pathophysiology of pedi8atric
community acquired pneumonia
 Formulate an effective nursing care plan for the patient
with a indicate of disease process
 Identify and enumerate the various drugs prescribed,
side effects, nursing responsibilities and their action.
 Construct an appropriate health teaching plan in
relation to a client's present situation
 It is important because they provide a first
impression, establish credibility with your
audience, and prepare the audience for
the content of the case study.

INTRODUCTION
 Pediatric Community-acquired pneumonia is a
potentially serious infection in children and
often results in hospitalization.
 Pneumonia is a number of infectious agents
including viruses, bacteria and fungi.
 Environmental Risk Factors include : indoor air
pollution caused by cooking and heating with
biomass fuel (such as woods and dung), living
in crowded homes and parental smoking
 Signs and Symptoms : vary depending on the
age of the child and cause of the pneumonia.
 Uses for nursing documentation and the broader patient
record, nurses have a ritual of using a paper-based report
sheet that is not part of the medical record during handoffs.
 Nurses often use these unique, personal notes to store
information that is communicated by the patient’s care
nurse from the prior shift.
 The paper-based report sheet appears to be used as a key
information source to support knowing the patient.

PATIENT’S PROFILE
 NAME Patient X

AGE 68 yrs. old

SEX Female

STATUS Married

RELIGION Roman Catholic

NATIONALITY Filipino

ADDRESS San Gregorio, Laurel Batangas

ADMISSION DATE September 1, 2019 1:38 pm

CHIEF COMPLAINT Cough

ADMISSION DIAGNOSIS Pneumonia

 is the study of how often diseases occur in different
groups of people and why.
 Epidemiological information is used to plan and
evaluate strategies to prevent illness and as a guide
to the management of patients in whom disease
has already developed.

EPIDEMIOLOGY
 PHYSICAL ASSESSMENT of a patient serves many
purposes:
1. Screening of general well-being. The findings will
serve as baseline information for future assessments.
2. Validation of the complaints that brought the
patient to seek health care.
3. Monitoring of current health problems.
4. Formulation of diagnoses and treatments.

PHYSICAL ASSESSMENT
INTEGUMENTARY ASSESSMENT OBSERVATION
Skin Normal
Color Reddish
Moisture Sweating
Temperature Cold
Terture Smooth
Turgor Normally
Vascularity Reddish
Edema None
Hair Color Grey
Nails Normal
Color Transparent
Length Approximately 160-degree
Cleanliness Clean
HEAD & NECK Symmetry
Head Rounded/symmetrical
Neck No Abnomality of superficial lymph nodes
EYES AND VISION

Eyebrows Symmetrical aligned

Eyelids Normal
Pupil Respond to light
Irises Clearly visible
EARS AND HEARING Responsive symmetrical
Equal movement No edema or tenderness
 Nose No discharges/symmetrical
Mouth Lips uniformly pink
Teeth and gums Normal
Gums is pink

Tongue Tongue is pink

Uvula is positioned

THROAT/NECK No palpable lymph nodes

Neck can move freely
AXILLA Skin is smooth
Symmetrical
No tenderness
No masses or nodules
 CHEST AND RESPIRATORY Skin is intact
No lesion
No tenderness
No masses

Rhythm of breathing Tachypnea

Wheezes
CARDIOVASCULAR ASSESSMENT OBSERVATION
Anatomic landmarks of the heart
Aortic Palpable
Pulmonic Palpable
Tricuspid Palpable
Palpable
Mitral
Palpable
Apical
Palpable
Epigastric
 ABDOMEN
Inspection Uniform skin color in the abdomen
Rounded
Palpation No lesion
No tenderness

EXTREMITIES
Muscles Symmetrical size
Has a firm grip, can crawl
Uniform in skin color
Bone Develop
Joints Joints move normally

REPRODUCTIVE NOT ASSESSED

 SOUNDS PRODUCED BY PERCUSSION

Sound Intensity Pitch Duration Quality Example

Tympany Loud High Moderate Drum like Large
pneumothorax

Resonance Moderate to Low Long hollow Normal lung

loud
Hyper- Very loud Very Longer than Booming Emphysematous
resonance low resonance lung

Dullness Soft to High Moderate Thud like Liver

moderate
Flatness Soft High Short Flat Muscle
Whereas anatomy is about structure, physiology is
about function.
Human physiology is the scientific study of the
chemistry and physics of the structures of the body
and the ways in which they work together to
support the functions of life.

ANATOMY and
PHYSIOLOGY
 THE
RESPIRATORY
SYSTEM
 AVEOLI
SHOWING
CAPILLARY
NETWORK
INSPIRATION AND EXPIRATION
GASEOUS EXCHANGE
Some lab tests are used to help diagnose, screen, or
monitor a specific disease or condition.
Other tests provide more general information about
your organs and body systems.
Lab tests play an important role in your health care.
But they don't provide a complete picture of your
health.

LABORATORY RESULTS
 TEST REFERENCE RESULT INTERPRETATION RATIONALE

Red Blood 4-610^12/L 4.46 Normal -it ranges from 4-610^12/L therefore normal
Cell -to see if you have another health issue or to explain symptoms like weakness, fever,
bruising, or feeling tired
WBC 5-10x10^9/L 11.80 Above Normal -it ranges from 5-10x10^9/L therefore abnormal
-to detect hidden infections within your body
Hematocrit 0.37 – 0.45 0.37 Normal -it ranges from 0.37 – 0.45 therefore normal
-to measure how much of your blood is made up of red blood cells; and determine if
the result indicate a blood disorder, dehydration, or other medical conditions

Hemoglobin 120 – 150g/dl 118 Below Normal -it ranges from 120 – 150g/dl therefore below normal
-to screen for a variety of disorders, such as anemia

MCV 86 – 110fL 82.5 Below Normal -it ranges from 86 – 110fL therefore below normal
-to help classify the cause of anemia based on red cell morphology

MCH 26 – 38 pg 26.5 Normal -it ranges from 26 – 38 pg therefore normal

-to help classify the cause of anemia based on red cell morphology
MCHC 310 – 370 g/L 321 Normal -it ranges from 310 – 370 g/L therefore normal
-to evaluate the severity and cause of anemia
Segmenters 38.3 – 73% 57 Normal -it ranges from therefore normal

Lymphocytes 18.0 – 48.3% 37 Normal -it ranges from 38.3 – 73% therefore normal
-to determine if a body is dealing with an infection or other inflammatory condition
Basophils 4.40 – 12.7% 6 Normal -it ranges from 4.40 – 12.7% therefore normal
-to determine if there is a sign of an allergic reaction or another condition
Platelet 150 – 450 x 358 Normal -it ranges from 150 – 450 x 10^9/L therefore normal
Count 10^9/L -to monitor or diagnose diseases, or to look for the cause of too much bleeding or
clotting.
Pathophysiology is a medical discipline that focuses on
the function and symptoms of diseased organs,
generally for purposes of diagnosis and patient care.
Pathophysiology differs slightly from pathology, which
studies all aspects of disease, not just organic function.

PATHOPHYSIOLOGY
 Pediatric Community
Acquired Pneumonia
(PCAP)

Risk Factors

NERVOUS SYSTEM HEART OR LUNG DISEASE

PREMATURE BIRTH
PROBLEMS PRESENT AT BIRTH

Some premature babies are born

Respiratory distress with pneumonia; pneumonia Usually caused by a
syndrome (RDS). Babies occurs later because the breathing bacteria or virus. Some
born before 34 weeks tube provides a passageway for babies get pneumonia
pf pregnancy often infection to enter immature lung. while they are still in the
develop this serious womb. Some may also
breathing problem. develop pneumonia
Symptoms several weeks after
delivery.
Fever, sweating and shaking chills.

Very fast breathing

Cough and stuffy nose

.
 RISK FACTORS
■ Being younger than 6 months of age
■ Being born prematurely
■ Birth defects, such as cleft palate
■ Nervous system problems, such as seizures or cerebral palsy
■ Heart or lung disease present at birth
■ Weak immune system (this can occur due to cancer treatment or
disease such as HIV/AIDS)
■ Recent surgery or trauma
■ Environmental risk factors such as; smoke , outdoor air pollution, indoor
pollution, passive smoking, and overcrowding
■ Low birth weight, malnutrition, measles, breastfeeding and vitamin A
deficiency
Is a general term for using medication to treat
disease.
Drugs interact with receptors or enzymes in
cells to promote healthy functioning and
reduce or cure illness

DRUG STUDY
GENERIC BRAND DOSAGE CLASSIFICATION INDICATION CONTRA- MECHANISM SIDE NURSING
NAME NAME INDICATION OF EFFECTS CONSIDER-
ACTION ATIONS

Parace- Tylenol Paracetamol Analgesic Temporary - Antipyretic -head ache -Do not
tamol drops 1ml q4 reductions of Contraindica reduces fever exceed the
Tablet Antipyretic - chest pain
fever, relief of ted with by acting recommend
•325mg minor aches allergy to directly on the -hepatic ed dosage.
•500mg
and pains acetaminop hypothalamic toxicity and
Caplet - Reduce
caused by hen. heat failure
•325mg dosage with
•500mg common regulating jaundice
-Use hepatic
•650mg cold nd center to
cautiously -acute renal inpainment.
Capsule influenza, cause
•325mg with impared failure renal
headache, vasodilation - Avoid using
•500mg hepalic tubular
sore throat, and sweating multiple
Tablet function, neurosis-
toothache, which helps preparations
chewable chronic Hypersensiti
•80mg back ache, dissipate heat. containing
alcoholism. vity
Liquid oral menstrual acetaminop
160mg/5ml cramps. hen carefully
check all the
OTC
products.
GENERIC BRAND DOSAGE CLASSIFICATION INDICATION CONTRA- MECHANISM SIDE NURSING
NAME NAME INDICATION OF EFFECTS CONSIDER-
ACTION ATIONS

monowel Cefoxitin Monowel 250 Cefoxitin for Lower Hypersensitivit Cefoxitin is a -Injection -Ask for drug
mg q8 injection is a semi- respiratory y to bacterial cell side allergies
regular synthetic, tract infection cephalosporin wall synthesis. reaction(swe
1g -Assess for
broad - spectrum including g and related lling,redness,
Cefoxitin has infection. -IV
2g cephaantibiotic pneumonia antibiotics. pain)
activity in the change sites
sealed under and lung
10g presence of -skin rash every 48-72 hr
nitrogen for abcess.
some to prevent
intravenous -vaginal
1g/50ml betalactamase phlebitis
administration. itching or
s, both
2g/50ml discharge Monitor site
It is derived from penicillinses
frequently for
cephamycin C, and -loss of
thrombophleb
which is produced cephalosporina appetite
itis
by streptomyces ses of Gram
lactamdyrans. negative and - nausea
(pain, redness,
gram positive swelling)
- vomiting
bacteria.
-stomach Advise patient
pain to report sign
of super
- diarrhea or infection and
headache allergy
 GENERIC BRAND DOSAGE CLASSIFICATION INDICATION CONTRA- MECHANISM SIDE NURSING
NAME NAME INDICATION OF EFFECTS CONSIDER-
ACTION ATIONS

salbutamol Albuterol Salbutamol neb Used to treat wheezing Typically used to Albuterol or It is essentially headache Asess lungs
q4 and shortness of treat levalbuterol relaxing the sounds, pulse
breath caused by bronchopspasm hypersensitivity smooth muscles of anxiety and blood
Oral breathing problems due to cause congenital long the airways. pressure before
dry mouth
such as asthma. It is allergic asthma QT syndrome, administration
2,4 mg tablets It activates beta Z
quick relief or exercise Use of oral syrup tachycardia and during peak
medication. It works in induced,as well in children. adrenergic of medication.
(3-4 PRN)
the airway by opening as chronic receptors in the palpation Note amount,
Inhaler breathing passages obstructive lungs which color and
begins a cascade arrytmia
and relaxing muscles. pulmonary character of
200-400mg 4 times of action that
disease. It is also flushing of skin sputum
a day results in
one of the most produced.
common bronchodilation. behavior
IV infusion
medicines used Observe for
3-20mcg/min in rescue inhales. paradoxical
bronchospasm
Subcutaneous (wheezing) if
condition
500mcg q4
occurs, with hold
medication and
notify physician
or other health
care professional
immediately.

Inform the
mother not to
smoke near the
child and to
avoid respiratory
irritants.
NURSING CARE PLAN (NCP)
 Patient’s Name: Baby J
 Medical Diagnosis: Pediatric Community Acquired
Pneumonia (PCAP)
 Nursing Diagnosis: Impaired gas exchanged
related to collection of secretions affecting
oxygen exchange across alveolar membrane.
ASSESSMENT DIAGNOSIS PLANNING IMPLEMENTATI RATIONALE EVAULATION
ON

>S: <Impaired gas < After 8 hours < Assess <Manifestation of <After 8 hours
“Nahihirapanh exchange of nursing respiratory respiratory distress is of nursing
umingaang interventions, rate, depth dependent on interventions,
indicative of the
baby the patient will and ease the patient
degree of lung
kodahilsaubo” achieve timely involvement. will achieve
as verbalized resolution of <Elevate head timely
by the mother. current of the bed and < Promotes resolution of
infection change expectoration, current
>O: without position clearing or infection
complications. frequently infection without
*Dyspnea complications
< reduces
*Tachycardia <Limit visitors as
likelihood of
* V/S taken as indicated exposure to other
follows: infectious
T: 36.5 ®C <Institute pathogens
PR: 160 bpm isolation
RR: 31 bpm precaution <To prevent spread
BP: 90/60 and protect patient
from other
infectious process
HEALTH TEACHING/ RECOMMENDATION
■ Breath warm and moist air.
■ Take deep breaths.
■ Drink liquid as directed.
■ Gently tap your chest.
■ Get plenty of rest. Rest help your body heal.
■ Wash hands often with soap and water.
■ Clean environment.
■ Avoid people who have a cold or flu.
■ Ask about vaccines.