PNEUMONIA-24.pdf

PNEUMONIA Prepared By: SHERWIN GALZOTE-MAPUTOL, RN, MAN Instructor 9/10/2024 ST. A L E X I U S C O L L E G E Sherwin G. Maputol, RN,MAN 1 www.stalexiuscollege.edu.ph  PNEUMONIA Is inflammation of the lung tissue. Predispos...

PNEUMONIA Prepared By: SHERWIN GALZOTE-MAPUTOL, RN, MAN Instructor 9/10/2024 ST. A L E X I U S C O L L E G E Sherwin G. Maputol, RN,MAN 1 www.stalexiuscollege.edu.ph  PNEUMONIA Is inflammation of the lung tissue. Predisposing Factors: ✓ Aging ✓ Air pollution ✓ Altered LOC, alcoholism, Head injury seizures ✓ Altered oropharyngeal flora secondary to antibiotics 9/10/2024 ST. A L E X I U S C O L L E G E Sherwin G. Maputol, RN,MAN 2 www.stalexiuscollege.edu.ph  PNEUMONIA Predisposing Factors: ✓ Bed rest & prolonged immobility ✓ Chronic diseases ✓ Debilitating disease ✓ HIV infection ✓ Immunosuppressive drugs ✓ Inhalation or aspiration of noxious substances 9/10/2024 ST. A L E X I U S C O L L E G E Sherwin G. Maputol, RN,MAN 3 www.stalexiuscollege.edu.ph  PNEUMONIA Predisposing Factors: ✓ Intestinal & gastric feedings ✓ Malnutrition ✓ Smoking ✓ Tracheal intubation ✓ URTI 9/10/2024 ST. A L E X I U S C O L L E G E Sherwin G. Maputol, RN,MAN 4 www.stalexiuscollege.edu.ph  When to see a doctor? difficulty breathing, chest pain, persistent fever of 39 C or higher, or persistent cough, especially if you're coughing up pus. 9/10/2024 ST. A L E X I U S C O L L E G E Sherwin G. Maputol, RN,MAN 5 www.stalexiuscollege.edu.ph  PNEUMONIA Acquisition of Organisms: 1. Aspiration from nasopharynx or oropharynx. 2. Inhalation of microbes present in the air. 3. Hematogenous spread from a primary infection 9/10/2024 ST. A L E X I U S C O L L E G E Sherwin G. Maputol, RN,MAN 6 www.stalexiuscollege.edu.ph  TYPES of PNEUMONIA: 1. Community-Acquired Pneumonia (CAP) A lower respiratory tract infection of lung tissues with the onset in the community or during the FIRST 2 days of hospitalization. 9/10/2024 ST. A L E X I U S C O L L E G E Sherwin G. Maputol, RN,MAN 7 www.stalexiuscollege.edu.ph  TYPES of PNEUMONIA: 1. Community-Acquired Pneumonia (CAP) Organisms associated: ✓ Streptococcus pneumoniae ✓ Mycoplasma pneumoniae ✓ Hemophilus influenzae ✓ Respiratory viruses ✓ Chlamydia pneumoniae ✓ Legionella pneumophila 9/10/2024 ST. A L ESherwin X I G.UMaputol, S RN,MAN COLLEGE 8 www.stalexiuscollege.edu.ph  TYPES of PNEUMONIA: 1. Community-Acquired Pneumonia (CAP) Organisms associated: ✓ Oral anaerobes ✓ Moraxella catarrhalis ✓ Staphylococcus aureus ✓ Nocardia ✓ enteric gram (-) bacteria (Klebsiella) ✓ Fungi ✓ Mycobacterium tuberculosis 9/10/2024 ST. A L E X I U S C O L L E G E Sherwin G. Maputol, RN,MAN 9 www.stalexiuscollege.edu.ph  TYPES of PNEUMONIA: 2. Hospital-Acquired Ventilator-Associated & Health- Care associated Pneumonia ❖ Hospital-Acquired Pneumonia (HAP) Pneumonia occurring 48 hours or longer after hospital admission and not incubating at the time of hospitalization 9/10/2024 ST. A L E X I U S C O L L E G E Sherwin G. Maputol, RN,MAN 10 www.stalexiuscollege.edu.ph  TYPES of PNEUMONIA: 2. Hospital-Acquired Ventilator-Associated & Health- Care associated Pneumonia ❖ Ventilator-Associated Pneumonia (VAP) Pneumonia occurs more than 48 to 72 hours or longer after endotracheal intubation 9/10/2024 ST. A L E X I U S C O L L E G E Sherwin G. Maputol, RN,MAN 11 www.stalexiuscollege.edu.ph 9/10/2024 ST. A L E X I U S C O L L E G E Sherwin G. Maputol, RN,MAN 12 www.stalexiuscollege.edu.ph 9/10/2024 ST. A L E X I U S C O L L E G E Sherwin G. Maputol, RN,MAN 13 www.stalexiuscollege.edu.ph 9/10/2024 ST. A L E X I U S C O L L E G E Sherwin G. Maputol, RN,MAN 14 www.stalexiuscollege.edu.ph  TYPES of PNEUMONIA: 2. Hospital-Acquired Ventilator-Associated & Health- Care associated Pneumonia ❖ Health Care-Associated Pneumonia (HCAP) Includes any patient with a new onset pneumonia who: a. Was hospitalized in an acute care hospital for 2 or more days within 90 days of the infection. 9/10/2024 ST. A L E X I U S C O L L E G E Sherwin G. Maputol, RN,MAN 15 www.stalexiuscollege.edu.ph  TYPES of PNEUMONIA: ❖ Health Care-Associated Pneumonia (HCAP) Includes any patient with a new onset pneumonia who: b. Reside a long-term care facility. c. Attended a hospital or hemodialysis clinic. 9/10/2024 ST. A L E X I U S C O L L E G E Sherwin G. Maputol, RN,MAN 16 www.stalexiuscollege.edu.ph  TYPES of PNEUMONIA: ❖ Health Care-Associated Pneumonia (HCAP) Includes any patient with a new onset pneumonia who: d. Received recent IV antibiotics therapy, chemotherapy or wound care within the past 30 days of the current infection. 9/10/2024 ST. A L E X I U S C O L L E G E Sherwin G. Maputol, RN,MAN 17 www.stalexiuscollege.edu.ph  TYPES of PNEUMONIA: 2. Hospital-Acquired Ventilator-Associated & Health- Care associated Pneumonia ❖ Microorganisms responsible for HAP, VAP, & HCAP ✓ Bacteria ✓ Virus ✓ fungi 9/10/2024 ST. A L E X I U S C O L L E G E Sherwin G. Maputol, RN,MAN 18 www.stalexiuscollege.edu.ph  TYPES of PNEUMONIA: 2. Hospital-Acquired Ventilator-Associated & Health- Care associated Pneumonia ❖ Microorganisms associated with HAP. ✓ Pseudomonas; Klebsiella ✓ Enterobacter; staphylococcus aureus ✓ Escherichia coli; oral anaerobes ✓ Staphylococcus pneumoniae 9/10/2024 ST. A L E X I U S C O L L E G E Sherwin G. Maputol, RN,MAN 19 www.stalexiuscollege.edu.ph  Signs & Symptoms of PNEUMONIA: ❖ Hypertrophy of mucous membrane: ✓ Increased sputum production ✓ Wheezing ✓ Dyspnea ✓ Cough ✓ Rales ✓ Rhonchi 9/10/2024 ST. A L E X I U S C O L L E G E Sherwin G. Maputol, RN,MAN 20 www.stalexiuscollege.edu.ph  Signs & Symptoms of PNEUMONIA: ❖ Increased Capillary Permeability: ✓ Increased fluid in ISC ✓ Consolidation ✓ Hypoxemia 9/10/2024 ST. A L E X I U S C O L L E G E Sherwin G. Maputol, RN,MAN 21 www.stalexiuscollege.edu.ph  Signs & Symptoms of PNEUMONIA: ❖ Inflammation of the Pleurae: ✓ Chest pain ✓ Pleural effusion ✓ Dullness ✓ Diminished breath sounds ✓ Decreased vocal fremitus 9/10/2024 ST. A L E X I U S C O L L E G E Sherwin G. Maputol, RN,MAN 22 www.stalexiuscollege.edu.ph  Signs & Symptoms of PNEUMONIA: ❖ Hypoventilation: ❖ Protective Mechanism ✓ Decreased ✓ Increased WBC chest expansion ✓ Increased RR ✓ Respiratory ✓ Fever acidosis 9/10/2024 ST. A L E X I U S C O L L E G E Sherwin G. Maputol, RN,MAN 23 www.stalexiuscollege.edu.ph  COMMON Diagnostic tests X-ray Blood culture Sputum culture test Urine test Pulse oximetry CT-scan Bronchoscopy 9/10/2024 ST. A L E X I U S C O L L E G E Sherwin G. Maputol, RN,MAN 24 www.stalexiuscollege.edu.ph  Complication of PNEUMONIA: 1. Pleurisy 2. Pleural effusion 3. Atelectasis 4. Bacteremia 5. Lung abscess 9/10/2024 ST. A L E X I U S C O L L E G E Sherwin G. Maputol, RN,MAN 25 www.stalexiuscollege.edu.ph  Complication of PNEUMONIA: 6. Empyema 7. Pericarditis 8. Meningitis 9. Endocarditis 9/10/2024 ST. A L E X I U S C O L L E G E Sherwin G. Maputol, RN,MAN 26 www.stalexiuscollege.edu.ph Collaborative Mgt. for PNEUMONIA: Promote rest. Provide adequate fluids. Incentive spirometry. Oxygen therapy. Positioning. Bronchial hygiene measures. Oral hygiene. 9/10/2024 ST. A L E X I U S C O L L E G E Sherwin G. Maputol, RN,MAN 27 www.stalexiuscollege.edu.ph Collaborative Mgt. for PNEUMONIA: Humidifier Splint chest when coughing. Monitor : chest x-ray, temperature Pharmacotherapy ✓ Antibiotics Influenza & Pneumococcal Vaccine 9/10/2024 ST. A L E X I U S C O L L E G E Sherwin G. Maputol, RN,MAN 28 www.stalexiuscollege.edu.ph