Introduction to Pneumonia
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Questions and Answers

Which of the following is NOT a method by which organisms causing pneumonia can reach the lungs?

  • Inhale microbes present in the air
  • Direct contact with infected surfaces (correct)
  • Aspiration of normal flora from the nasopharynx
  • Hematogenous spread from a primary infection

What happens to the alveoli when streptococci reach them during pneumonia?

  • They expand and increase oxygen exchange
  • They experience complete collapse
  • They develop a protective layer against infections
  • They become inflamed and fill with fluid (correct)

Which condition is NOT associated with pneumonia in an immunocompromised host?

  • Long term mechanical ventilation
  • Use of chemotherapy
  • Nutritional depletion
  • Advanced age (correct)

What is the primary consequence of inadequate ventilation caused by pneumonia?

<p>Partial occlusion of alveoli (B)</p> Signup and view all the answers

Which of the following best describes aspiration pneumonia?

<p>Breathing in food and liquids from the mouth into the lungs (B)</p> Signup and view all the answers

What condition is associated with intubation and mechanical ventilation that leads to pneumonia?

<p>Ventilator-associated pneumonia (C)</p> Signup and view all the answers

What type of pneumonia occurs primarily due to the inhalation of toxic substances, leading to inflammation?

<p>Chemical pneumonia (B)</p> Signup and view all the answers

Which pneumonia classification indicates the infection is patchy and scattered throughout both lungs?

<p>Bronchopneumonia (C)</p> Signup and view all the answers

What characterizes hospital-acquired pneumonia (HAP)?

<p>Develops after 48 hours of hospitalization without infection evidence (B)</p> Signup and view all the answers

What is a primary cause of hypostatic pneumonia?

<p>Prolonged bed rest leading to hypoventilation (D)</p> Signup and view all the answers

Which type of pneumonia is also known as nosocomial pneumonia?

<p>Hospital-acquired pneumonia (D)</p> Signup and view all the answers

Chemical pneumonia can increase the risk of subsequent infection primarily due to what factor?

<p>Inflammation and tissue damage (C)</p> Signup and view all the answers

Which type of pneumonia is most commonly associated with chronic illnesses and requires mechanical ventilation?

<p>Ventilator-associated pneumonia (A)</p> Signup and view all the answers

What is the most common cause of community-acquired bacterial pneumonia?

<p>Streptococcus pneumoniae (C)</p> Signup and view all the answers

Which type of pneumonia is most commonly caused by the influenza virus?

<p>Viral pneumonia (C)</p> Signup and view all the answers

Which microorganism is commonly responsible for fungal pneumonia?

<p>Candida and Aspergillus (B)</p> Signup and view all the answers

Which of the following factors is not considered a predisposing factor for pneumonia?

<p>Olympic athlete training (B)</p> Signup and view all the answers

What pathological process occurs in the alveoli during pneumonia?

<p>Consolidation with fluid and debris (A)</p> Signup and view all the answers

Which type of pneumonia is linked to the inhalation of irritating substances or chemicals?

<p>Chemical pneumonia (A)</p> Signup and view all the answers

What is the primary mode of transmission for infectious pneumonia?

<p>Airborne droplets (B)</p> Signup and view all the answers

What test is primarily used to measure the oxygen level in the blood?

<p>Pulse oximetry (C)</p> Signup and view all the answers

Leukocytosis in bacterial pneumonia is typically indicated by a WBC count greater than what value?

<p>15,000/μL (B)</p> Signup and view all the answers

Which diagnostic test may be ordered if pneumonia does not clear as expected?

<p>CT scan (B)</p> Signup and view all the answers

What is a common complication of pneumonia that involves inflammation of the pleura?

<p>Pleurisy (D)</p> Signup and view all the answers

Which condition requires the drainage of purulent exudate from the pleural cavity?

<p>Empyema (B)</p> Signup and view all the answers

What method is employed to obtain a sample of pleural fluid for analysis?

<p>Thoracentesis (D)</p> Signup and view all the answers

What type of organism is primarily associated with the development of a lung abscess in pneumonia cases?

<p>Staphylococcus aureus (D)</p> Signup and view all the answers

What is a common characteristic of pleural effusion in most pneumonia cases?

<p>It is usually sterile and reabsorbed within 1 to 2 weeks. (D)</p> Signup and view all the answers

What is a characteristic of Acute Respiratory Distress Syndrome (ARDS)?

<p>Sudden and progressive pulmonary edema (A)</p> Signup and view all the answers

Which condition can result from severe sepsis?

<p>Septic shock and MODS (C)</p> Signup and view all the answers

Which treatment is crucial for managing severe pneumonia?

<p>Antibiotic therapy specific to bacterial pneumonia (D)</p> Signup and view all the answers

What is a common complication specifically associated with pneumonia?

<p>Otitis media (A)</p> Signup and view all the answers

How does pneumonia primarily impact lung function?

<p>Reduces the lungs' capacity to exchange oxygen for carbon dioxide (C)</p> Signup and view all the answers

What role does hydration play in the treatment of pneumonia?

<p>It helps thin secretions for easier clearance (D)</p> Signup and view all the answers

What position is most appropriate for IV access during respiratory treatment?

<p>Semi-Fowler’s position at 45 degrees (A)</p> Signup and view all the answers

How often should breath sounds be auscultated in respiratory care?

<p>Every 4 hours (A)</p> Signup and view all the answers

Which of the following is advisable when managing a patient with pneumonia?

<p>Individualized activity based on patient tolerance (A)</p> Signup and view all the answers

What may indicate the need for intubation and mechanical ventilation in a pneumonia patient?

<p>Severe respiratory difficulty with thick, copious secretions (B)</p> Signup and view all the answers

What type of diet is recommended for patients requiring high-caloric intake?

<p>High calorie, high protein soft foods (A)</p> Signup and view all the answers

What should be monitored to prevent aspiration during nasogastric tube feedings?

<p>Position of the tube (C)</p> Signup and view all the answers

Which nursing intervention is crucial for a patient with increased mucus production?

<p>Promoting coughing and expectoration of secretions (B)</p> Signup and view all the answers

What is an important nursing consideration when administering sedatives to a respiratory patient?

<p>Avoiding respiratory depression (C)</p> Signup and view all the answers

Which vaccination is recommended for preventing pneumococcal infections?

<p>Pneumococcal conjugate vaccine (PCV13) (B)</p> Signup and view all the answers

What is crucial to monitor for hydration in a respiratory patient?

<p>Fluid intake and output (A)</p> Signup and view all the answers

Flashcards

Pneumonia Definition

Inflammation of the lung's air sacs, usually caused by infection.

Bacterial Pneumonia Cause

Most commonly caused by Streptococcus pneumoniae (pneumococcus).

Viral Pneumonia Cause

Influenza viruses are a common cause.

Aspiration Pneumonia

Pneumonia caused by foreign material entering the lungs from the mouth or stomach.

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Pneumonia Consolidation

Fluid and debris filling the lung's air sacs, making them solid.

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Predisposing Pneumonia Factors

Conditions that increase the chance of getting pneumonia, like decreased consciousness, impaired cough.

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Types of Pneumonia Causes

Bacterial, viral, fungal, and aspiration are all types of pneumonia, each with its specific cause.

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Pneumonia Pathophysiology

Inflammatory response in lungs, often caused by infectious agents that lead to fluid collection in the air sacs.

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CAP

Community-Acquired Pneumonia. Pneumonia that develops in the community setting or within the first 48 hours after hospitalization, usually less severe than other forms.

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Immunocompromised Pneumonia

Pneumonia occurring in individuals with weakened immune systems, often due to medications, conditions, or treatments.

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Hematogenous Spread Pneumonia

Pneumonia caused by bacteria traveling through the bloodstream from a primary infection site elsewhere in the body.

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Ventilator-Associated Pneumonia (VAP)

A type of aspiration pneumonia that develops in intubated and mechanically ventilated patients.

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Chemical Pneumonia

Pneumonia caused by inhaling toxic chemicals.

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Radiation Pneumonia

Pneumonia caused by radiation therapy damage to lung tissue.

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Hospital-acquired Pneumonia (HAP)

Pneumonia that develops more than 48 hours after hospital admission in patients without pre-existing infection at admission.

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Community-acquired Pneumonia (CAP)

Pneumonia that occurs in patients who haven't been hospitalized.

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Bronchopneumonia

Patchy, diffuse infection scattered throughout both lungs that starts in the bronchi.

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Hypostatic Pneumonia

Pneumonia that develops from hypoventilation in bedridden patients, where secretions pool in the lungs.

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ARDS

A severe form of acute lung injury causing sudden and progressive pulmonary edema.

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Sepsis and Pneumonia

Bacteria from the lungs enter the bloodstream, causing sepsis, which can lead to shock and multi-organ dysfunction.

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Endocarditis, Pericarditis, Arthritis

Infections from pneumonia can spread to the heart and joints causing inflammation of the heart lining, sac around the heart, and joints.

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Respiratory Failure

The lungs can't exchange oxygen and carbon dioxide effectively due to damage caused by pneumonia, leading to difficulty breathing.

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Pneumonia Treatment: Antibiotics

Doctors use antibiotics to treat pneumonia caused by bacteria.

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Pneumonia Treatment: Antivirals and Antifungals

For viral or fungal pneumonia, doctors may use antiviral or antifungal medications.

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Pneumonia Treatment: Supportive Care

Treatments include fluids, oxygen, rest, and physical therapy to help the body recover.

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Intubation and Mechanical Ventilation

If breathing is severely affected, a tube is inserted into the airway and a machine helps with breathing.

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X-ray for Pneumonia

A medical imaging technique used to diagnose pneumonia and determine its extent and location. It can also reveal pleural effusions (fluid buildup around the lungs).

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Pulse Oximetry

A non-invasive test that measures the oxygen level in your blood, helping to assess the severity of pneumonia.

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Arterial Blood Gases (ABGs)

A blood test that measures the levels of oxygen and carbon dioxide in the blood. It helps determine the severity of pneumonia and assess lung function.

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Sputum Test

A test involving a sample of fluid coughed up from the lungs (sputum) that is analyzed to identify the organism causing pneumonia.

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Blood Tests for Pneumonia

Blood tests are conducted to confirm a pneumonia infection, identify the type of organism involved, and assess the body's response.

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CT Scan for Pneumonia

A detailed imaging technique used when pneumonia does not improve as expected. It provides a more comprehensive view of the lungs than X-rays.

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Pleural Fluid Culture

A test that involves analyzing fluid from the pleural space around the lungs to determine the type of infection causing pneumonia.

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Pleurisy

Inflammation of the pleura, the membrane lining the lungs. It is a common complication of pneumonia and can cause chest pain.

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Pneumonia Positioning

Patients with pneumonia should be positioned upright, side-lying, or in a semi-Fowler's position (45 degrees) to promote drainage and improve breathing.

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Pneumonia Respiratory Monitoring

Regularly assess a pneumonia patient's breathing. Auscultate (listen to) their lung sounds every 4 hours, and monitor their blood gas levels.

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Pneumonia Diet

Provide patients with pneumonia a high-calorie, high-protein diet of soft foods to maintain their strength and energy.

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Pneumonia Fluid Intake

Encourage increased fluid intake in pneumonia patients unless contraindicated, as it helps to thin mucus and replace lost fluids.

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Pneumonia Prevention: Coughing

Encourage patients to cough and expectorate secretions to help clear the airways.

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Pneumonia Prevention: Position Changes

Change the position of patients frequently, especially if they are immobile, to prevent secretions from pooling in the lungs.

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Pneumonia Prevention: Deep Breathing

Encourage deep breathing and coughing exercises to help expand the lungs and clear secretions.

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Pneumonia Prevention: Cleaning Respiratory Equipment

Clean respiratory equipment routinely to reduce the risk of infection.

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Study Notes

Introduction to Pneumonia

  • Pneumonia is the inflammation of lung tissue (alveoli and bronchioles)
  • It's mainly caused by infectious agents like bacteria, mycobacteria, fungi, parasites, and viruses.

Objectives

  • Define pneumonia.
  • Classify pneumonia based on causes, affected areas, and when the illness started.
  • Identify the mode of transmission of pneumonia.
  • List predisposing factors for pneumonia.
  • Explain the pathophysiology of pneumonia.
  • Describe the clinical manifestations of pneumonia.
  • State the diagnostic evaluations for pneumonia.
  • Explain the medical management of pneumonia.
  • Detail nursing interventions for pneumonia.
  • Outline preventive measures for pneumonia.
  • Detail the prognosis of pneumonia.

Definition of Pneumonia

  • Pneumonia is an inflammation of the lung tissue.

Classification of Pneumonia (According to Causes)

  • Bacterial: The most common cause of community-acquired pneumonia (CAP). Streptococcus pneumoniae is a common bacteria type.
  • Viral: Influenza viruses often cause viral pneumonia.
  • Fungal: Candida and Aspergillus are two types of fungi that can cause pneumonia.
  • Chemical: Caused by ingestion of kerosene or inhalation of irritating substances.
  • Aspiration: Results from abnormal entry of material from the mouth or stomach into the trachea and lungs. Usually bacterial.
  • Ventilator-associated (VAP): A type of aspiration pneumonia, pneumonia that develops in intubated and mechanically ventilated patients.
  • Chemical: Inhalation of toxic chemicals can cause inflammation and tissue damage.
  • Radiation: Results from damage to the lung mucosa during radiation therapy for breast or lung cancer.
  • Hypostatic: Hypoventilation of lung tissue over a prolonged time. May occur in bedridden patients breathing with only part of their lungs.

Classification of Pneumonia (According to Areas Involved)

  • Lobar: Inflammation confined to one or more lobes of the lung.
  • Broncho: Patchy, diffuse, and scattered throughout both lungs. Pneumonia originates in bronchi and extends to surrounding lung tissue. This type is more common.
  • Interstitial: Interstitial pneumonia.

Classification of Pneumonia (According to Location of Illness Onset)

  • Hospital-acquired (HAP) or Nosocomial: Onset of pneumonia more than 48 hours after admission in a patient with no evidence of infection when admitted.
  • Ventilator-associated (VAP): A type of HAP.
  • Health care-associated (HCAP): Pneumonia that develops in outpatient settings or nursing homes.
  • Community-acquired (CAP): Acute lung infection in patients who haven't been hospitalized, or within the first 48 hours of hospitalization.

Pneumonia in Immunocompromised Hosts

  • Occurs with corticosteroid, immunosuppressive agent, chemotherapy, nutritional depletion, or broad-spectrum antimicrobial use.
  • Or when patients have AIDS, genetic immune disorders, or long-term advanced life support technology.

Mode of Transmission

  • Droplet infection: Bacteria and viruses in the nose, sinuses, and mouth can spread directly to the lungs.
  • Aspiration: Food, liquids, vomit, or fluids from the mouth can be inhaled into the lungs.
  • Organisms reach the lung by aspiration, inhalation, or hematogenous spread.

Pathophysiology

  • Streptococci reach the alveoli and lead to inflammation and exudative pouring into the air spaces.
  • White blood cells (WBCs) migrate to the alveoli, leading to consolidation.
  • Involved areas become inadequately ventilated due to secretions and edema.
  • Partial occlusion of alveoli and bronchi leads to a decrease in alveolar oxygen content, impacting venous blood oxygenation and leading to arterial hypoxemia.

Clinical Manifestations

  • Shaking chills
  • Rapidly rising fever
  • Stabbing chest pain
  • Tachypnea
  • Use of accessory breathing muscles
  • Cough with purulent, blood-tinged, or rusty sputum
  • Shortness of breath
  • Flushed cheeks
  • Loss of appetite
  • Low energy and fatigue
  • Cyanosis (blue discoloration) of lips and nail beds
  • Crackles and wheezes on lung auscultation

Diagnostic Evaluations

  • History (recent respiratory infections)
  • Physical Exam (Vitals)
  • Chest X-ray
  • Sputum examination (under microscope, culture, Gram stain)
  • Pulse oximetry
  • Arterial Blood Gas (ABGs)
  • Complete blood count (CBC)
  • Sputum cultures
  • Bronchoscopy
  • CT Scan
  • Pleural fluid culture (thoracentesis)

Complications

  • Pleurisy (inflammation of the pleura)
  • Pleural effusion (fluid in the pleural space)
  • Atelectasis (collapsed alveoli)
  • Empyema (purulent exudate in pleural cavity)
  • Lung abscess
  • Sepsis (spread of bacteria)
  • Acute respiratory distress syndrome (ARDS)
  • Endocarditis (inflammation of the endocardium)
  • Pericarditis (inflammation of the pericardium)
  • Purulent arthritis

Medical Management

  • Initiation of antibiotic treatment (depending on cultures)
  • Antiviral or antifungal therapy
  • Hydration to thin secretions
  • Supplemental oxygen
  • Individualized bed rest and activity
  • Chest physical therapy and postural drainage
  • Bronchodilators, Corticosteroids.
  • Cough expectorants/suppressants
  • Analgesics (for pain)
  • Antipyretics (fever reducers)

Nursing Diagnoses

  • Ineffective airway clearance
  • Activity intolerance
  • Imbalanced nutrition (less than body requirements)
  • Deficient knowledge about treatment and preventive measures
  • Risk for deficient fluid volume

Nursing Interventions

  • Maintain a patent airway and adequate oxygenation.
  • Obtain sputum specimens.
  • Use suction if needed.
  • Perform chest physiotherapy.
  • Provide high-calorie, high-protein diet of soft foods.
  • Prevent aspiration during feeding tubes.
  • Administer appropriate medications.
  • Control infection spread, dispose of secretions properly
  • Provide a quiet, calm environment with frequent rest.
  • Monitor ABG levels, especially in hypoxic patients.
  • Assess the patient's respiratory status and auscultate breath sounds.
  • Increase fluid intake.
  • Monitor intake and output, skin turgor, vital signs, serum electrolytes.
  • Evaluate medications effectiveness.
  • Explain all procedures to the patient and family.

Preventive Measures

  • Promote coughing and expectoration of secretions
  • Change positions frequently
  • Encourage deep-breathing and coughing exercises
  • Administer chest physical therapy when indicated
  • Suction patient if unable to cough.
  • Prevent aspiration
  • Prevent infections
  • Cleanse respiratory equipment regularly
  • Promote frequent oral hygiene
  • Administer prescribed sedatives/opioids carefully to avoid respiratory depression

Prevention (Vaccines)

  • Pneumococcal conjugate vaccine (PCV13): Given to children and adults of certain age groups, and those with compromised immune systems.
  • Pneumococcal polysaccharide vaccine (PPSV23): Given to adults 65 years and older and children/younger adults with high-risk factors
  • Seasonal Influenza vaccines

Prognosis

  • With treatment, most patients show improvement within 2 weeks.
  • Some patients (elderly or very ill) might take longer.

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Description

This quiz covers the essential aspects of pneumonia, including its definition, causes, classification, and clinical manifestations. You will also explore the pathophysiology, diagnostic evaluations, medical management, and nursing interventions related to pneumonia. Prepare to deepen your understanding of this important respiratory condition.

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