Nursing Management of Pneumonia and Tuberculosis

Study Notes

Compare pulmonary infections regarding causes, manifestations, nursing management, complications, and prevention.
Use the nursing process in caring for pneumonia and tuberculosis patients.
Identify risk factors and preventive measures for tuberculosis.
Understand the nurse's role in diagnosing tuberculosis.

Inflammation of lung parenchyma that causes alveolar edema and congestion, impairing gas exchange.
Caused by bacterial or viral infections, spread through droplets or contact.
Classified into four main types:
- Community-Acquired Pneumonia (CAP)
- Healthcare-Associated Pneumonia (HCAP)
- Hospital-Acquired Pneumonia (HAP)
- Ventilator-Associated Pneumonia (VAP)

Occurs outside a healthcare setting or within the first 48 hours of hospitalization.
Common causative agents include:
- Streptococcus pneumoniae
- Haemophilus influenzae
- Legionella
- Pseudomonas aeruginosa
Specific etiologic agents identified in only about 50% of cases.

Develops in non-hospitalized patients with recent extensive healthcare contact.
Includes subcategories like pneumonia in immunocompromised hosts and aspiration pneumonia.

Occurs more than 48 hours after hospital admission, with no infection evidence at admission.
Most lethal nosocomial infection and a leading cause of death in hospital-acquired infections.
Common microorganisms causing HAP include:
- Enterobacter species
- Escherichia coli
- Influenza
- Klebsiella species
- Proteus
- Serratia marcescens
- Staphylococcus aureus
- Streptococcus pneumoniae
Usual presentation includes new pulmonary infiltrate on chest x-ray and evidence of infection.

A specific type of HAP developing 48 hours or more after the insertion of an endotracheal tube.

Caused by normal flora in patients with impaired resistance or aspiration of oropharyngeal flora.
Inflammatory reactions produce exudates in alveoli, hindering gas exchange.
White blood cells invade alveoli, filling air spaces, and mucosal edema causes ventilation issues.
Resulting hypoventilation leads to ventilation-perfusion mismatch, deoxygenated blood entering pulmonary circulation can cause arterial hypoxemia.

Symptoms vary based on the type, organism, and underlying disease.
Streptococcal pneumonia typically presents with:
- Sudden chills
- Fever
- Pleuritic chest pain
- Tachypnea
- Respiratory distress
Viral, mycoplasma, or Legionella infections may show relative bradycardia.
Other signs can include respiratory infection symptoms, headache, low-grade fever, and pleuritic pain.