PNEUMONIA
-inflammation of alveolar lung spaces resulting into consolidation of the lung as exudates fill alveoli
CAUSES:
-infections
-aspiration of food
-inhalation of toxic or caustic substances
Common Infecting Organisms:
GRAM POSITIVE
-Strep pneumonia: community acquired pneumonia (cap)
-Staph. Aureus:DM, drug users, patient's on hemodialysis
GRAM NEGATIVE
-H. influenza: children
-P.aeroginosa:hospital acquired
-L.pneumophila:inhalation with airconditioning units
FUNGAL
-P. carinii:AIDS, transplanted, chemotherapy or corticosteroid therapy, malnourished infants
Tx: cotrimoxazole
-H. capsulatum:bird & bat manure
S/SX:
-cough with sputum -respiratory distress -rales/crackles
-fever & chills -cyanosis -pleuritic chest pain
-tachycardia -hemoptysis
Diagnosis:
- CXR-->hazy infiltrates on lower lung fields -CBC (increase WBC)
-Dullness on percussion -definitive: sputum c & s
Nursing Care:
a. facilitate adequate ventilation
b.facilitate removal of secretions
c. isolation precautions
-MRSA: contact precaution--private room
d. administer medications as ordered
e. deep breathing exercises
Chest Physiotherapy -used to mobilize secretions
Techniques:
a.postural drainage :uses gravity & various positions
b.percussion :clapping with cupped hands
c.vibration :flat hand firmly pressed over affected segment with use of isometric contraction
Nursing Care:
a. done before meals or 2-3 hours after meals to decrease the risk of aspiration
b. dilators given about 20-30 mins prior
c. remove all tight / constricting clothings
d. postural drainage position:3-5 mins
e. percussion: 2-3 minutes duration
f. perform vibration during exhalation
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4 comments :
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