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Tuesday, October 18, 2011

Pneumonia

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

4 comments :

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