PNEUMONIA. Diagnosis Definition & Explanation of Diagnosis Etiology & Risk Factors Incidences Among Gender, Age, & Ethnicity Prognosis Signs & Symptoms. By: Marjorie Johnson. definition. Pneumonia : inflammation of the respiratory bronchioles and alveoli
Definition & Explanation of Diagnosis
Etiology & Risk Factors
Incidences Among Gender, Age, & Ethnicity
Signs & Symptoms
Pneumonia: inflammation of the respiratory bronchioles and alveoli
Either infectious or non-infectious
Infectious: bacteria, viruses, fungi, protozoa and other microbes
Non-infectious: aspiration of gastric contents and inhalation of toxic or irritating gases
Pneumonia is often diagnosed with difficult breathing because the airway is filled with mucus and fluid
A person with pneumonia often produces delicate crackling noises or wheezing in the area of the lung affected by pneumonia
In a lung with pneumonia, the sound can be dull or muffled because the air sacs are filled with fluid instead of air
A doctor may take a chest x-ray to confirm a diagnosis of pneumonia
People with problems with heart, liver, or kidneys.
Patient with HIV/AIDS whose immune system are very weak.
Patient who taking medication that weaken the immune system such as cancer patients.
Patients that smoke, abuse alcohol.
Exposure to certain chemicals, past surgery
Patients hospitalized in an intensive care of certain disease (ex: coma)
More than a million people are hospitalized each year for pneumonia
1 in 4 people who had pneumonia died
Community-acquired pneumonia is responsible for 350,000 to 620,000 hospitalizations
Older adults have lower survival rates than younger people
Pneumonia kills between 40,000 to 70,000 people each year
Most people who develop pneumonia initially have symptoms of a cold which are followed by:
Sharp chest pain
Cough with sputum production
Diagnostic tests (include rationale & nursing implications
Medical Treatment and Nursing Implications
Surgical Treatment and Nursing Implications
With medical treatment the patient with pneumonia is generally treated with:
Medical Surgical Nursing 1
July 23, 2007
( www.american heart.org; National Institutes of Health)
Main manifestations to watch out for:
Fatigue and dyspnea ( difficulty breathing) = Due to excess fluid in the body and fluid in the lungs that causes congestion.
= Mostly observable when a person is walking halfway and gets tired easily eventhough he just walk halfway.
Edema or swelling of the ankle and feet) = Due to fluid overload in the tissue which causes congestion.
= mainly observe during the day and every time the feet is used.
Other symptoms include:
Nausea, abdominal pain and decreased appetite.
Tests to confirmed the presence of congestive heart failure:
EKG or EGC ( Electrocardiogram)
2. X-ray examination
4. Cardiac catherization
Purpose: Evaluate heart function and valve dysfunction.
Discuss situation with the client the procedure.
Distinguish the possible effects of the procedure to the well-being of the patient.
Discussing will help the client to be more familiar with the procedure hence, it will decrease anxiety.
Client will be able to deal with her fear by the information gathered from the nurse.
= slows heart rate.
= stimulate heart muscle which increases the force of systole.
=Decreased the workload of the heart.
= Monitor apical pulse before administering the medication.
= If less than 60 bpm, withhold the medication, then notify MD.
=Help fluid from building up
=Decrease fluid retention
= make the fluids run through the kidneys
Monitor BP, I&O, daily weight.
Assess feet, legs, and sacral area for edema DAILY>
Congestive heart failure has a very poor prognosis.
Only 50% of CHF patients lives within 5 years.
On the other hand, only 20% survive within 8 to 12 years prior to diagnose.
HALF OF THE PATIENT WILL DIE IN 5 years.
Surgical Treatment/ Nursing Implications
by Marie Jimenez
Types of surgical treatment for CHF:
Primary treatment for end-stage heart failure
Transplanted organs are from young accident victims with no evidence of cardiac trauma
Client or (recipient) heart is removed, leaving posterior atria intact
Donor heart is sutured to the remaining atrial walls
Risks for surgical treatment of CHF:
Rejection of donor’s heart
Monitor for infection
Administering immunosuppresive drugs to prevent the rejection of the transplanted organ
Route: IV, PO, IM
Dynamic cardiomyoplasty involves using the client’s own skeletal muscle (particularly the latissimus dorsi) to enhance the function of the heart and improve circulation.
The muscle is positioned around the heart or aorta, and a cardiomyostimulator and leads are implanted to stimulate muscle contractions.
This type of surgical procedure may be implemented as an alternative to cardiac transplantation for clients who refuse organ transplantation.
The prevention of CHF includes modifiable lifestyle changes relating to diet, smoking, alcohol, and exercise
Limit sodium intake
Alcoholics Anonymous & Smoking cessation programs
Providing awareness of the negative effects of smoking and alcohol and recommending “regular, moderate exercise to improve their overall fitness” will greatly reduce in the prevention of congestive heart failure. (Merck Manual, 1997)
Hepatomegaly (enlargment of the liver)
Spenomegaly (enlargement of the spleen)
Thrombus & emboli
Cardiogenic shock which “occurs when the left ventricle is unable to supply the tissues with enough oxygen and nutrients to meet their needs. [It] is a life-threatening condition that requires immediate treatment (Williams, 2003, p. 332)
Picture on right: IABP (intra-aortic balloon pump) to increase coronary perfusion
Nursing interventions for discharge:
Explain heart failure and its effects on the client’s life – this helps the client understand the reasons for ordered treatments
Stress the importance of medications in managing heart failure and provide verbal and written information regarding each specific medication to encourage compliance
Teach the client and family about the prescribed diet
Instruct to keep regular follow-up appointments to monitor disease progression and effects of therapy
Student Name: Na Pang
Student Practical Nurse, Anaïse Ikama
Spring II 2007
a spirometry is used to identifies how much air your lung can hold and how fast you can blow the air out of your lung
helps in the identification of emphysema (causes large abnormal air spaces in the lungs by destroying alveolar walls)
to screen the enzyme deficiency that can cause lung tissue destruction
measures deficiency of oxygen
to relax the muscles that wrap around the airways
allow tubes to become larger and easier to breath through
reduces swelling in the breathing tube
The removable of the inflated air sacs that causes healthy air sacs to work poorly
Replacement of one or both lungs
Administer inhaler and oxygen as ordered before activity
Assist the pt. with the use of a spirometer, percussion and postural drainage
Reassure and provide emotional support (r/t fear of death)
*Respiratory infection such as influenza
and pneumonia can develop
*Increase BP in pulmonary veins
*Feeling of depression (from progressive &
a- Teach effective coughing and breathing mechanism
b- Advice client to maintain fluid
intake of 2 to 2 ½ quarts daily
c- Discuss aerobic physical exercise (e.g.:
20 mn walk
d- Stress the importance of eating
small frequent meal
e- Reinforce teaching about prescribed medication
TO TEACH YOUR CLIENT TO NEVER SMOKE
- surgery done by an incision into the thorax or chest cavity to perform surgery on the lungs - incision is made between the ribs and all or part of the infected lung is removed depending on the location, size and type of lung cancer that is present