discuss about basic concept of lower respiratory disease condition of pnuemonia -describe as definition,classification,etiology,riskfactor, clinical manifestation,diagnostic evaluation,medical management,surgical management,and nursing management and taking care of patient with pnuemonia disease condition

1. Presented by:
Kh kashahungliu inpui
2nd PBBSC
NHCON

2. Introduction:
*Pneumonia is an acute inflammation of
the lung parenchyma caused by a
microbial organism.
*Pneumonia causes inflammation in
the alveoli.

3. Definition:
Pneumonia is an
inflammation process
in lung parenchyma
usually associated with
a marked increase
interstitial and alveolar
fluids.

4. Classification:
1) Segmental pneumonia:-
Pneumonia may involve one or more
lobe segments of the lungs.

5. 2) Lobar pneumonia:-
Pneumonia may involve one or more
entire lobes.
3) Broncho pneumonia:-
Involved the terminal bronchioles
and alveoli.

7. 4) Bilateral pneumonia:-
Lobes in both lungs are involved.

8. 5) Interstitial pneumonia:-
Involves inflammatory responses within lungs
tissue surrounding the air spaces or vascular
structures rather than the air passage themself.
6) Alveolar pneumonia:-
There is fluids accumulation in a lungs distal
air spaces.

9. ETIOLOGY:
The cause of pneumonia are as follows:
Community acquired pneumonia
*Streptococcus pneumonia
*Haemophilis influenza
*Mycoplasm pneumonia
*Respiratoryvirus
*Fungus
*Enterobactor
*Oral anaerobe

10. #.Major risk factor for pneumonia:
-Advanced age.
-History of smoking.
-Upper respiratory
infection.
-Tracheal intubation.
-Prolonged immobility.
-Immunosuppression
therapy

11. -Malnutrition.
-Dehydration.
-Chronic disease :- Diabetes
and heart disease.

12. When the pathogens enter ina patient whose
resistance has been altered.(by aspiration,blood
born organisms)
Affects both ventilation and diffusion
Inflammation occurs in alveoli.

13. White blood cells, mostly neutrophils also
migrate into the alveoli and normally fills air
spaces.
Decreased alveolar oxygen tension.
A ventilation perfusion mismatch occurs in the
affected area of the lung

14. The mixing of oxygenated and unoxygenated
Arterial hypoxemia
If one or more lobes are involved it is known as
Lobar pneumonia
If bronchi involves, it is known as Broncho pnuemoni

15. Clincal manifestation:
*Fever, chills and sweats.
*Sore throat.
*Confused mental state.
*Chest pain.
*pleuritic chest pain and cough.
*Sputum productionand
hemoptysis.

16. *Dyspnea, headache , fatigue and
weakness.
* Chest auscultation reveals bronchial
breath sounds over areas of
consolidation.
* crackling sounds and whispered
pectoriloqruy ( transmission of the
sound of whispered words through the
chest wall)may be heard over affected
areas

17. DIAGNOSTIC EVALUATION:
* History collection and physical
examination.
*Blood and urine cultures to assess
systemic spread.
*ABG analysis.
*Sputum culture and sensitivity test.
*Chest X-ray provide information about the
location and extent of pneumonia.

18. MANAGEMENT:
Medical management:
*Antibiotics therapy.
*Oxygen therapy.
*Analgesic for chest pain . Eg: Acetylsalicylic
acid.
*Codeine may be administered because, it is
less likely to inhibit cough reflex then more
potent narcotics.

19. SURGICAL MANAGEMENT:
* Partial pneumonectomy.
* Complete pneumonectomy.

21. NURSING MANAGEMENT:
* Administered oxygen.
*Place the patient in high Fowler's
position.
*Assist the patient in deep breathing
exercises.
*Suction as indicated.
*Administer 3000 ml of fluid / day. (
unless contraindicated)

22. *Elevate the head of bed.
*Change position frequently.
*Monitor ABG , pulse oxymetry readings.
*Administer nebulization and other
respiratory physiotherapy.
*Assess level of anxiety.
*Assist with self-care activities.
*Provide calm and quiet environment
minimize the visitors.

23. *Review the importance of
sensation of smoking.
*Administer antibiotics,
antipyretics, antiemitics etc.

24. NURSING DIAGNOSIS:
1) Ineffective breathing pattern related to
inflammation and pain as manifested by rapid
respiration,dyspnea,tachypnea, nasal flaring,
altered chest excursions.
INTERVENTION:
a) establish a rapport with patient .
b) Instruct patient to do deep breathing exercise
after demonstrating proper technique.

25. 2) Ineffective airway clearance related to
thick secretions as manifested by
ineffective cough , sputum, abnormal
breath sounds , dyspnea.
INTERVENTION:
a) monitor respiration and breath sound.
b) provide high fowler position.
c) Administerthe oxygen.

26. 3) Acute pain related to inflammation and
ineffective pain management as manifested by
pleuritic chest pain , plueral friction rub, shallow
respirations , decreased breath sounds.
INTERVENTION:
a) allow the client to verbalize expression about
pain.
b) allow the client to rates the intensity of pain in
a scale 0-10.

27. 4) Imbalanced nutrition less than body
requirements related to increased
metabolism, fatigue, and anorexia as
manifested by weight loss.
INTERVENTION:
a) assess the weight of the client.
b) determine client nutritional history.
c) Determine the client attitude toward
eating.

28. 5) Activity intolerance related to
interrupted sleep/ wake cycle , hypoxia,
and weakness as manifested by fatigue ,
unwillingness or inability to exert self ,
dyspnea, increased pulse and respiration,
dizziness on exertion.

29. INTERVENTION:
a) Assess the ability to perform ADL.
b) Assess physical mobility status.
c)Assist to do active range of motion
exercise like flexing of both extremities

30. COMPLICATION:
* Pleurisy.
*Plueral effusion.
*Atelectasis.
*Bacteremia.
*Lung abscess.
*Empyema.
*Paricarditis.
*Meningitis.
*Endocarditis.

31. BIBLIOGRAPHY:
*TEACHER BIBLIOGRAPHY:
# A text book of medical surgical nursing by
Lewis 6th edition
Page no. 593- 601
# A text book of Medical surgical nursing 9th
edition by Smeltzer.l
Page no.426-436
# Text book of medical surgical nursing by
Vijayam. Page no. 8.39- 8.41.

32. STUDENT BIBLIOGRAPHY:
#. A text book of medical
Surgical nursing by Lewis
6th edition
Page no. 593-601