Pneumonia Overview and Community Acquired Pneumonia
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Pneumonia Overview and Community Acquired Pneumonia

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Questions and Answers

Which type of pneumonia is caused by organisms that are often multiple drug resistant?

  • Community-acquired pneumonia (CAP)
  • Ventilator-assisted pneumonia (VAP)
  • Health care–associated pneumonia (HCAP) (correct)
  • Hospital-acquired pneumonia (HAP)
  • What is the most common causative agent of community-acquired pneumonia in adults younger than 60 without comorbidities?

    S.pneumoniae

    ____ is a type of pneumonia that develops 48 hours or more after patient admission.

    Hospital-acquired pneumonia (HAP)

    What are the main classifications of pneumonia?

    <p>Health care–associated pneumonia (HCAP)</p> Signup and view all the answers

    Viruses are the most common cause of pneumonia in adults.

    <p>False</p> Signup and view all the answers

    Which organism is a common cause of pneumonia that often affects older adults with comorbidities?

    <p>H.influenzae</p> Signup and view all the answers

    What is a characteristic symptom of pneumonia caused by inflammatory response?

    <p>Exudative congestion</p> Signup and view all the answers

    Which of the following is a key component of supportive treatment for viral pneumonia?

    <p>Hydration</p> Signup and view all the answers

    What pharmacologic therapy may be included in the treatment of pneumonia with known multidrug resistance?

    <p>Fluoroquinolone and linezolid</p> Signup and view all the answers

    Which position is recommended to promote rest and ease breathing in pneumonia patients?

    <p>Semi-Fowler’s position</p> Signup and view all the answers

    What is the primary transmission method for pulmonary tuberculosis?

    <p>Airborne transmission</p> Signup and view all the answers

    Which of the following statements about sputum in pneumonia is true?

    <p>Sputum is often purulent.</p> Signup and view all the answers

    What is a common consequence of impaired host defenses in patients that may lead to hospital-acquired pneumonia?

    <p>Greater risk of aspiration</p> Signup and view all the answers

    Which organism is specifically associated with causing pneumonia in patients with chronic obstructive pulmonary disease (COPD)?

    <p>H.influenzae</p> Signup and view all the answers

    Why is initial antibiotic treatment for healthcare-associated pneumonia often different from that for community-acquired pneumonia?

    <p>MDR bacteria may be involved in HCAP</p> Signup and view all the answers

    Which characteristic distinguishes ventilator-associated pneumonia from other types?

    <p>It affects patients who have been intubated for at least 48 hours</p> Signup and view all the answers

    What type of pneumonia predominantly results in interstitial infiltrate rather than alveolar infiltrate?

    <p>Mycoplasma pneumonia</p> Signup and view all the answers

    Study Notes

    Pneumonia

    • Pneumonia is an inflammation of the lung parenchyma.
    • Caused by various microorganisms, including bacteria, mycobacteria, fungi, and viruses.
    • Classified into four types:
      • Community-acquired pneumonia (CAP),
      • Health care–associated pneumonia (HCAP),
      • Hospital acquired pneumonia (HAP), and
      • Ventilator Assisted Pneumonia (VAP)
    • Resident macrophages play a key role in protecting the lung from foreign pathogens.
    • Macrophages engulf pathogens and trigger inflammatory cells like neutrophils, causing inflammation of the lung parenchyma and making the capillaries “leaky” resulting in exudative congestion.

    Community Acquired Pneumonia (CAP)

    • Occurs in the community setting or within the first 48 hours after hospitalization or institutionalization.
    • Streptococcus pneumoniae (pneumococcus) is the most common cause in people younger than 60 without comorbidity and in those 60 years and older with comorbidity.
    • Haemophilus influenzae is a common cause in older adults and those with chronic illnesses like COPD, alcoholism, and diabetes.
    • Mycoplasma pneumonia caused by M. pneumoniae is spread through person-to-person contact.
    • Viruses are the most common cause of pneumonia in infants and children.

    Health Care Associated Pneumonia (HCAP)

    • Causative pathogens are often MDR (Multiple drug resistant).
    • Often difficult to treat.
    • Initial antibiotic treatment is different from CAP due to the possibility of MDR bacteria.

    Hospital Acquired Pneumonia (HAP)

    • Develops 48 hours or more after admission.
    • Predisposing factors include impaired host defenses, comorbid conditions, supine positioning, aspiration, coma, malnutrition, prolonged hospitalization, hypotension, and metabolic disorders.
    • Common organisms responsible for HAP include Enterobacter species, Escherichia coli, H. influenzae, Klebsiella species, Proteus, Serratia marcescens, Pseudomonas aeruginosa, methicillin-sensitive or methicillin-resistant Staphylococcus aureus (MRSA), and S. pneumoniae.

    Ventilator Associated Pneumonia (VAP)

    • Occurs in patients who have been endotracheally intubated and on mechanical ventilation for at least 48 hours.
    • Can be a complication in up to 28% of patients on mechanical ventilation.

    Community Acquired Pneumonia

    • S. pneumoniae is the most common cause in people younger than 60 without comorbidity and those 60 and older with comorbidity.
    • H. influenzae is a common cause in older adults and people with chronic illnesses.
    • Mycoplasma pneumoniae is spread through respiratory droplets and causes mainly interstitial inflammation.
    • Viruses are the most common cause among infants and children.

    Hospital-Acquired Pneumonia (HAP)

    • HAP develops 48 hours after admission.
    • Patients with impaired host defenses, multiple chronic conditions, being supine, coma, etc. are predisposed to HAP.
    • Common HAP organisms include Enterobacter species, Escherichia coli, H. influenzae, Klebsiella species, Proteus, Serratia marcescens, Pseudomonas aeruginosa, methicillin-sensitive or methicillin-resistant Staphylococcus aureus (MRSA), and S. pneumoniae.

    Health Care Associated Pneumonia (HCAP)

    • Causative pathogens are often multidrug resistant (MDR).
    • Initial antibiotic treatment for HCAP is often different than CAP because of the possibility of MDR bacteria.

    Ventilator-Associated Pneumonia (VAP)

    • The patient must have been intubated and on mechanical ventilation for at least 48 hours.
    • Sputum is often purulent.

    Pneumonia Assessment and Diagnostic Findings

    • History is important
    • Sputum analysis is critical
    • A physical exam, chest x-ray, and blood culture are all utilized.

    Pneumonia Preventive Measures

    • Vaccination is important, especially for high-risk individuals.
    • Handwashing frequently
    • Avoid close contact with sick people.
    • Keep vaccinations up-to-date.

    Pneumonia Medical Management

    • Goal is to improve oxygenation, reduce inflammation, and combat infection.

    Pneumonia Pharmacologic Treatment

    • Antibiotics are the mainstay of treatment, chosen based on culture and sensitivity results.
    • A three-drug regimen may be used for known MDR cases.
    • Viral pneumonia is primarily managed supportively with hydration, antipyretics, and cough suppressants.

    Pulmonary Tuberculosis

    • M. tuberculosis is the causative organism.
    • It mainly affects the lung parenchyma, but can also spread to meninges, kidneys, bones, and lymph nodes.
    • Airborne transmission occurs through droplet nuclei released by coughing, sneezing, etc.
    • Risk factors include close contact with someone with active TB, overcrowded housing, and HIV infection.

    Pulmonary Tuberculosis Assessment and Diagnostic Findings

    • A sputum culture, chest x-ray, and tuberculin skin test are used for diagnosis.

    Tuberculosis Classification

    • Pulmonary tuberculosis refers to TB of the lungs
    • Extrapulmonary tuberculosis refers to the TB affecting other parts of the body, including the lymph nodes, meninges, kidneys, bones, and joints

    Pulmonary Tuberculosis Medical Management

    • Directly observed therapy (DOT) is typically used for TB.
    • Multidrug therapy is essential for treatment.
    • Treatment regimens vary based on the category of TB.

    Pulmonary Tuberculosis Nursing Management

    • Encourage hydration through increased fluid intake.
    • Adherence to medication regimen is critical.
    • Promote rest and activity schedule to manage activity tolerance.
    • Emphasize proper hygiene to prevent transmission.

    Ebola

    • Fruit bats are the natural reservoir host.
    • Humans are infected through contact with infected bodily fluids or animals.
    • The first outbreak was in 1976 near the Ebola River.
    • The 2014 outbreak in West Africa was particularly severe.
    • Transmission is primarily via direct contact with blood, bodily fluids of infected individuals, and potentially semen of a recovered individual.

    H1N1 (Swine Flu)

    • Swine influenza is a respiratory disease in pigs caused by Type A influenza viruses.
    • H1N1 influenza A virus was first detected in humans in the United States in 2009.
    • Symptoms include fever, lethargy, cough, runny nose, sore throat, eye irritation, nausea, and vomiting.

    H1N1 (Swine Flu) Management

    • Antiviral medications (oseltamivir, peramivir, zanamivir, baloxavir) are recommended for treatment.
    • Vaccination is advised for those in contact with pigs, as well as those at increased risk for complications.
    • Safe handling and preparation of pork are essential to prevent the spread.
    • Avoid exposure to pigs for those at increased risk of complications.

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    Description

    This quiz covers the key aspects of pneumonia, including its definition, causes, and types. Focus is given to Community Acquired Pneumonia (CAP), its common causative agents, and the role of resident macrophages in lung defenses. Test your understanding of these crucial topics related to lung health.

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