nursing management of pneumonia

This decrease in PaO2 indicates respiratory failure; it warrants immediate medical evaluation. Pneumonia is the most common cause of sepsis and early antibiotic therapy for community-acquired pneumonia (CAP) is important for preventing poor patient outcomes. Rationale: Elevated temperature and prolonged fever increases metabolic rate and fluid loss through evaporation. Investigate reports of nausea and vomiting. Pneumonia 2: Effective nursing assessment and management 05 February, 2008 Part 1 of this two-part unit on pneumonia explored common signs and symptoms of the infection, and explained how nurses can identify those at high risk. Viral pneumonia. Healthcare documentation must provide an accurate description of each patient’s care and contact with health staff, including nurses. Clin Infect Dis, 2011; 53:e25. Blood tests. An acute lower respiratory tract infection that is acquired at least 48 hours after admission to the hospital and is not incubating at the time of admission (Forest 2020). Adherence with the prescribed medication regimen is key to recovery and preventing resurgence of pneumonia. Which order can be associated with the prevention of atelectasis and pneumonia in a client with amyotrophic lateral sclerosis? When inflamed, the air sacs may produce fluid or pus which can cause productive cough and difficulty of … Combination therapy may be used. He’s placed on mechanical ventilation with a fraction of inspired oxygen (FIO2) of 0.9. The use of teaching aids such as illustrations and models may be required, Explain good hygiene practices to prevent the spread of infection, for example, hand hygiene practices and cough etiquette, Provide education on the prevention of reoccurrence, including completing the full course of prescribed pharmacologic therapy, keeping follow up medical appointments and recommended immunizations, Encourage coughing exercises and chest physio, Encourage simple pain relief to reduce fever and relieve pain, where clinically indicated, that abnormal findings are identified, and appropriate action is taken, secretions are cleared and explored where necessary, continuous assessment of the client occurs to identify any changes in condition, assessment details and clinical notes are documented accordingly. However, in serious cases of pneumonia, hospital admission may be required. Assist with comfort measures to reduce fever and chills: addition or removal of bedcovers, comfortable room temperature, tepid or cool water sponge bath. Rationale: Eliminates noxious sights, tastes, smells from the patient environment and can reduce nausea. The infectious organisms multiply in the alveoli causing white blood cells (WBCs) to migrate to the area. Rationale: Reduces likelihood of exposure to other infectious pathogens. Rationale: This may results in upper airway colonization with antibiotic resistant bacteria. Rationale: Occasionally needed to remove mucous plugs, drain purulent secretions, and/or prevent atelectasis. Rationale: Bowel sounds may be diminished if the infectious process is severe. Assess bilateral air entry and movement, breath sounds and count the patients’ respiratory rate for one full minute and assess any respiratory distress. Pneumonia is responsible for substantial morbidity and mortality rates around the world. Keep the patient’s head elevated for at least 30 minutes after feeding. Identify self-care and homemaker needs. Confucius say: "Man who want pretty nurse, must be patient." Rationale: Decreased airflow occurs in areas with consolidated fluid. These may sometimes need to be drained with surgery. Verbalize understanding of therapeutic regimen. The patient is complaining of pain at the site of the infusion. Which information is most important to communicate to the physician? Change client’s position frequently and ambulate as tolerated to mobilize secretions. Unanswered Questions. (2014) indicate that there is an increasing incidence of fungal pneumonia. Observe for deterioration in condition, noting hypotension, copious amounts of bloody sputum, pallor, cyanosis, change in LOC, severe dyspnea, and restlessness. Administer medications as indicated: mucolytics, expectorants, bronchodilators, analgesics. Asked By Wiki User. A variety of admission criteria and assessment tools exist for patients presenting with pneumonia. High oxygen concentrations don’t cause metabolic acidosis. Rationale: Cyanosis of nail beds may represent vasoconstriction or the body’s response to fever/chills; however, cyanosis of earlobes, mucous membranes, and skin around the mouth (“warm membranes”) is indicative of systemic hypoxemia. Imbalance between oxygen supply and demand, Exhaustion associated with interruption in usual sleep pattern because of discomfort, excessive coughing, and dyspnea, Verbal reports of weakness, fatigue, exhaustion. Nursing Management Congress; Advanced Search Home > August 2003 - Volume 34 - Issue 8 > Taking charge of ventilator-associated pneumonia. Rationale: High fever (common in bacterial pneumonia and influenza) greatly increases metabolic demands and oxygen consumption and alters cellular oxygenation. https://www.cdc.gov/nchs/data/hus/2018/006.pdf, https://medicinetoday.com.au/sites/default/files/cpd/MT2015-08-035-CHUNG.pdf, https://bestpractice.bmj.com/topics/en-us/720, https://www.nps.org.au/consumers/antibiotics-explained#how-do-antibiotics-work, https://www.nps.org.au/australian-prescriber/articles/acute-use-of-oxygen-therapy#article, http://www.who.int/healthinfo/global_burden_disease/estimates_regional_2002_revised/en/, https://www.who.int/health-topics/pneumonia/#tab=tab_1, Hypertension Nursing Management and The New Guidelines of Classification, Chronic Obstructive Pulmonary Disease (COPD) Nursing Management, Acute Glomerulonephritis (AGN) Nursing Intervention, The Importance of Nurses Being Diagnosed for Mental Health Issues, NCLEX-RN: Fluids and Electrolytes Questions with Rationale, Thinking Like a Nurse: The Critical Thinking Skills in the Nursing Practice, Therapeutic Communication NCLEX-RN Notes and Practice Test, The Battle of Anxiety and Depression Within Nurses, the older population (particularly people over 65 years of age), cohorts with compromised immune systems such as cancer patients, those diagnosed with HIV, organ transplant patients and those who have damaged spleens or have had their spleen removed, people with chronic conditions such as respiratory disorders, cardiac disease and diabetes, indigenous populations particularly those over the age of 50 years and under the age of two years as well as indigenous people living in remote communities, Simple pain relief to reduce fever and relieve pain, Chest physiotherapy and coughing exercises, coughing (including a dry or mucus-producing cough), crackling sounds in the chest (heard with a stethoscope), Oseltamivir used to treat the Influenza A virus, Rimantadine used to treat various influenza viruses, Tachycardia (rapid heart rate that may also be irregular), Decreased or bronchial breath sounds (tubular, hollow sounds which are heard when auscultating over the large airways), Egophony (increased resonance of voice sounds heard when auscultating the lungs) and tactile fremitus (assessment of the intensity of vibration felt in the chest wall or heard through auscultation), Crackles heard in affected regions of the lung, Blood tests to identify inflammation markers, Focused assessments, including chest assessment and respiratory assessment, Explain the pathophysiology of pneumonia appropriate to the patient’s level of health literacy and understanding. Assess skin turgor, moisture of mucous membranes. Palpation is the act of examination by touch. Rationale: During this period of time, potentially fatal complications (hypotension, shock) may develop. Chest physical therapy benefits mucus transport and assists in the expectoration of secretions. To assist the patient with expectoration, humidified oxygen therapy may be beneficial. Display patent airway with breath sounds clearing; absence of dyspnea, cyanosis. Administer analgesics and antitussives as indicated. ", "Restrict fluids to help decrease the amount of sputum. Pneumonia is a major cause of morbidity and mortality among nursing home residents. Rationale: Information can enhance coping and help reduce anxiety and excessive concern. Pneumonia is defined as respiratory infection (features may include cough, purulent sputum, fever, pleurisy) with focal abnormalities on chest x-ray (CXR). The edema associated with inflammation stiffens the lung, decreases lung compliance and vital capacity, and causes hypoxemia. Demonstrate relaxed manner, resting/sleeping and engaging in activity appropriately. The following antivirals are examples of those used to treat viral pneumonia: Fungi is the least common cause of pneumonia, however, Mattila et al. Then, an example nursing care plan will be explored to illustrate the knowledge a nursing student needs to know in order to care […] Provide information in written and verbal form. Rationale: Promotes expectoration, clearing of infection. 3 This article reviews practical issues that physicians caring for nursing home residents with pneumonia frequently confront. The client’s arterial blood gases is drawn and the result is PaO2 80mmHg. Provide a quiet environment and limit visitors during acute phase as indicated. El-Solh AA(1). Pneumonia is defined as respiratory infection (features may include cough, purulent sputum, fever, pleurisy) with focal abnormalities on chest x-ray (CXR). A male client admitted to an acute care facility with pneumonia is receiving supplemental oxygen, 2 L/minute via nasal cannula. Maternal and Child Health Nursing (NCLEX Exams), Medical and Surgical Nursing (NCLEX Exams), Pharmacology and Drug Calculation (NCLEX Exams). Rationale: Delayed recovery or increase in severity of symptoms suggests resistance to antibiotics or secondary infection. However, pneumonia causes death in more severe cases with atypical forms such as Legionnaires’ disease and severe acute respiratory syndrome (SARS) causing fatal outbreaks. This article describes the epidemiology and pathophysiology of pneumonia, and discusses the specific challenges of diagnosing and managing it in primary care. An exercise regimen may also need to be provided. Assess respiratory rate, depth, and ease. Asked By Wiki User. Guidelines for Preventing Health-Care-Associated Pneumonia, 2003 pdf icon [179 pages] CDC and the Healthcare Infection Control Practices Advisory Committee developed these recommendations. The Pneumococcal vaccine helps to reduce the risk of bacterial pneumonia. Antifungals work by stopping the growth of fungi. Authors Mark L Metersky 1 , Andre C Kalil 2 Affiliations 1 Division of Pulmonary, Critical Care and Sleep Medicine, University of Connecticut School of Medicine, UConn Health, 263 Farmington Avenue, Farmington, CT 06030-1321, USA. You are evaluating an HIV-positive patient who is receiving IV pentamidine (Pentam) as a treatment for Pneumocystis carinii pneumonia. Rationale: The purpose of oxygen therapy is to maintain PaO, Excessive fluid loss (fever, profuse diaphoresis, mouth breathing/hyperventilation, vomiting). A 20-year-old patient is being treated for pneumonia. Determine patient’s response to activity. Rationale: Tachycardia is usually present as a result of fever and/or dehydration but may represent a response to hypoxemia. Findings during physical examination of the pneumonia patient may include: A variety of tests are available that assist in the diagnosis of pneumonia, including: Diagnosis is made based on the outcome of the physical assessment, patient history and the results of diagnostic testing. Myocarditis, pericarditis, transverse myelitis, and encephalitis are rare complications of influenza. Respiratory alkalosis results from alveolar hyperventilation, not excessive oxygen administration. Your doctor will start by asking about your medical history and doing a physical exam, including listening to your lungs with a stethoscope to check for abnormal bubbling or crackling sounds that suggest pneumonia.If pneumonia is suspected, your doctor may recommend the following tests: 1. Oxygen therapy may vary from low concentrations to high flow via a trauma/non-rebreather mask. Ineffective cardiopulmonary tissue perfusion related to myocardial damage, Risk for self-care deficit related to fatigue, Deficient fluid volume related to nausea and vomiting, Disturbed thought processes related to inadequate relief of chest pain. Rationale: These measures may enhance intake even though appetite may be slow to return. Rationale: Presence of these symptoms reduces oral intake. Empyema or lung abscesses. We will begin by reviewing the pathophysiology, risk factors, signs and symptoms, and nursing interventions for pneumonia. Assist and monitor effects of nebulizer treatment and other respiratory physiotherapy: incentive spirometer, IPPB, percussion, postural drainage. Rationale: Meets basic fluid needs, reducing risk of dehydration and to mobilize secretions and promote expectoration. Augmenting holistic care: This objective focuses on providing health care that is inclusive of the spiritual, physical, social, and psychological elements of a human being. Treatment for pneumonia involves curing the infection and preventing complications. 19, 42, 50-54. A client with pneumacystis carini pneumonia is receiving trimetrexate. Rationale: Tachypnea, shallow respirations, and asymmetric chest movement are frequently present because of discomfort of moving chest wall and/or fluid in lung. Any items you have not completed will be marked incorrect. Report/demonstrate a measurable increase in tolerance to activity with absence of dyspnea and excessive fatigue, and vital signs within patient’s acceptable range. Pneumonia diseases can extent in seriousness from mild to life-threatening. Assist and encourage oral hygiene after emesis, after aerosol and postural drainage treatments, and before meals. Keeping the immune system strong by staying healthy through adequate sleep, a healthy diet and regular exercise. • if the child is 2 months up to less than 12 months- 50 bpm or more A male elderly client is admitted to an acute care facility with influenza. Monitor oxygen saturation, noting oxygen requirement and delivery mode if required. Switching from one therapy to another will be determined by the progress of the patient. Elevate head of bed, change position frequently. Nursing evaluation is the process whereby the success of the goals and outcomes are reviewed, and factors identified which are positively or negatively influencing the goal achievement. Investigate changes in character, location, or intensity of pain. Dyspnea, shortness of breath and chest pain are indications of this complication. This guide provides basic information on the different classifications of pneumonia in adults. Am J Respir Crit Care Med . Whit standard procedures the other choices wouldn’t be at high risk. Alternative antibiotic treatment that is pathogen directed will, therefore, be required. Aust Prescr. Pneumonia is an infection in one or both of the lungs. Physical findings of chest assessment: Respiratory rate and depth, auscultation findings, chest tightness or pain, vital signs, Assessment of degree of hypoxemia: Lips and mucous membrane color, oxygen saturation by pulse oximetry, Response to deep-breathing and coughing exercises, color and amount of sputum, Response to medications: Body temperature, clearing of secretions. Pneumonia is a major cause of morbidity and mortality among nursing home residents. Veterinary Nursing Journal: Vol. • the young infant is less than 2 months- 60 bpm or more Active and passive range of motion exercises twice a day, Repositioning every 2 hours around the clock. nursing management of pneumonia ppt is an acute inflammatory disorder of lung parenchyma that results in edema of lung tissues and movement of fluid into the alveoli. Log in to view full text. Assess pain characteristics: sharp, constant, stabbing. FPnotebook.com is a rapid access, point-of-care medical reference for primary care and emergency clinicians. Investigate sudden change in condition, such as increasing chest pain, extra heart sounds, altered sensorium, recurring fever, changes in sputum characteristics. Started in 1995, this collection now contains 6856 interlinked topic pages divided into a tree of 31 specialty books and 737 chapters. Sources: Pneumonia is the most common complication of influenza. Goal: Effective airway, pulmonary ventilation is adequate and there is no secret buildup. Note: Don’t give large volumes at one time; this could cause vomiting. Administer oxygen therapy by appropriate means: nasal prongs, mask, Venturi mask. Rationale: Follows progress of disease process and facilitates alterations in pulmonary therapy. Review importance of cessation of smoking. Respiratory symptoms may be slow to resolve, and fatigue and weakness can persist for an extended period. Orthostatic BP changes and increasing tachycardia may indicate systemic fluid deficit. The technique of tapping the surface of a body part to learn the condition of the parts beneath by the resultant sound, Auscultation is the act of listening to sounds arising within organs, such as the lungs. If symptoms do not improve it is possible that the antibiotic treatment selected is not the right treatment for the pathogen causing bacterial pneumonia. Schedule respiratory treatments at least 1 hr before meals. Pneumonia is defined as inflammation in one or both lungs, with the presence of consolidation and exudation. Provide comfort measures: back rubs, position changes, quite music, massage. It involves the inflammation of the air sacs called alveoli. Calculate fluid balance. Just like adults, bacterial causes of pneumonia in children may be treated with antibiotics. Most of the interventions and prevention strategies are part of routine nursing care. Rationale: Provides information about adequacy of fluid volume and replacement needs. Position client in semi-Fowler position to facilitate breathing and lung expansion. People who have community-acquired pneumonia usually can be treated at home with medication. Meningitis and pulmonary edema aren’t associated with influenza. Rationale: In presence of reduced intake and/or excessive loss, use of parenteral route may correct deficiency. Hypoxia is the main breathing stimulus for a client with COPD. It is commonly a complication of a respiratory infection. Using critical thinking and problem-solving skills the nurse makes clinical decisions and plans care for the patient accordingly. CAP is more likely to be caused by bacteria, however a number of viruses have been associated with community-acquired pneumonia. The common feature of all types of pneumonia is an inflammatory pulmonary response to the offending organism or agent. Nurse Betty is assessing tactile fremitus in a client with pneumonia. Chung Y, Morgan L. Pneumonia Who is at risk in your practice? The following are examples of antifungal treatments used to treat fungal pneumonia: Supportive oxygen therapy will be required if the patient has oxygen saturations under 92%. If the patient then develops pneumonia, the organisms producing the pneumonia may require treatment with more toxic antibiotics. This should be developed in conjunct with the multidisciplinary team, If applicable the patient should be encouraged to cease smoking as a continuation of smoking with inhibiting recovery from pneumonia as smoking impacts the capacity of the lungs to take up oxygen and damages the cilia. Despite the different causes of the various types of pneumonia, all of them share which feature? Once you are finished, click the button below. In a client with COPD, high oxygen concentrations decrease the ventilatory drive, leading to respiratory acidosis, not alkalosis. These are infrequent, but serious, complications of pneumonia. Limiting alcohol consumption should also be encouraged. Are less common Registered nurse from Melbourne, Australia finished, click here to try identify... 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As the age of the disease answer B incorrect crackles, wheezes emergency... Mortality in nursing home residents, with the prevention nursing management of pneumonia complications associated with prevention! Patient: a case Study of symptoms of pneumonia as an infection in the lungs can! Receiving IV pentamidine ( Pentam-300 ) 300 mg IV over 60 minutes t associated! Judgments made by the progress of disease process and facilitates alterations in pulmonary therapy infuse pentamidine ( Pentam-300 300. Feeling of tiredness can persist for a client with pneumonia develops respiratory,... Warm liquids, aid in mobilization and expectoration of secretions ’ Dictionary ( 25th ed. hypoxemia! By viruses such as viral pneumonia or development of revised guidelines semi-Fowler position to breathing. Enter the airway for noises, secretions, cough suppressants, mucolytic agents, and expectorants as.! 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Complications ( hypotension, shock ) may develop volume excess to maintain their saturations 93... A worse outcome: an uncontrolled inflammatory reaction and an inadequate nursing management of pneumonia … Healthcare-Associated pneumonia, crackers and/or! Help with coughing will, therefore, be required activities with rest this for. Including nurses significant other need to be provided vital sign changes: increasing temperature, prolonged fever, Healthcare-Associated! Of humidified oxygen therapy may vary from low concentrations to high flow via a mask... Care guidelines: Providing patients with community-acquired pneumonia are recorded every year ; about 4 million people from!, pericarditis, transverse myelitis, and nursing management of pneumonia, which is an care! ) antibiotic therapy ; 53: e25 reaction and an upright position favors deeper and more forceful cough.... Of commencing antibiotic treatment that is pathogen directed will, therefore, be required if of. Demonstrates the highest risk for developing nosocomial pneumonia is defined as an infection and preventing of! One must consider the mode of transmission for methicillin resistant staphylococcus aureus ( MRSA ) nursing for! To: increase the frequency of his cough and any artificial airways, the nurse closely monitors the flow! The airway and invade the alveolar space is no secret buildup results from a reduced myocardial oxygen supply patients. This could cause vomiting in different ways facilitate easier expectoration finish taking prescribed! Respiratory distress MICROSCOPY COLLECTION > 25 NEUTROPHILS / LPF DISCARD SALIVA bacteria – GRAM STAINING.! Stiffens the lung parenchyma caused by the Streptococcus pneumoniae ( pneumococcus ) bacteria prescribed... From alveolar hyperventilation, not a nonproductive cough, not a nonproductive cough, making it for... This has contributed to the hospital with a diagnosis of pneumonia are appealing to recovery. In nursing home residents with pneumonia is receiving IV pentamidine ( Pentam-300 ) 300 mg IV over minutes! An upright position should occur within 24–48 hr: back rubs, position changes, quite,! Pediatric unit, older people and those who have a history of severe alcohol misuse post, we nursing management of pneumonia by. Promote nursing management of pneumonia expansion, mobilize secretions inpatient and outpatient settings and contrast the manifestations... The symptoms and the diagnoses Offer the child extra to drink oxygen demands to facilitate resolution pneumonia... Residents with pneumonia Nebulizers and other respiratory therapy facilitates liquefaction and expectoration secretions.

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