Perform treatments between meals and limit fluids when appropriate. Rationale: Mouth breathing and oxygen therapy can irritate and dry out mucous membranes, potentiating general discomfort. Nursing Management Congress; Advanced Search Home > August 2003 - Volume 34 - Issue 8 > Taking charge of ventilator-associated pneumonia. Viral pneumonia. 1, pp. 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. Then, an example nursing care plan will be explored to illustrate the knowledge a nursing student needs to know in order to care […] Which client should be seen first? Fungi and parasites can also a cause of pneumonia, however, these causes are less common. Symptoms of pneumonia include cough with sputum production, fever, and sharp chest pain on inspiration (breathing in). What is the best management for the child? Nurses play a pivotal role in improving patient outcomes. 1. Verbalize understanding of condition, disease process, and prognosis. Definition of pneumonia Image credit: newtimes.co.rw. Nurse Betty is assessing tactile fremitus in a client with pneumonia. Pneumonia is an infection in one or both of the lungs. Instruct and assist patient in chest splinting techniques during coughing episodes. Maintain bedrest. Alveolar-capillary membrane changes (inflammatory effects), Altered oxygen-carrying capacity of blood/release at cellular level (fever, shifting oxyhemoglobin curve), Altered delivery of oxygen (hypoventilation). Rationale: The purpose of oxygen therapy is to maintain PaO, Excessive fluid loss (fever, profuse diaphoresis, mouth breathing/hyperventilation, vomiting). Pneumonia complications commonly occur in young children, older people and those with pre-existing chronic health conditions, such as diabetes and cardiac conditions. Schedule respiratory treatments at least 1 hr before meals. Maintain adequate nutrition to offset hypermetabolic state secondary to infection. Meningitis and pulmonary edema aren’t associated with influenza. ", "Splint your chest wall with a pillow for comfort.". Provide information in written and verbal form. It is important that the multidisciplinary team are involved in the discharge planning process to ensure that all discharge needs and priorities are identified. These are infrequent, but serious, complications of pneumonia. Administer the protease inhibitor indinavir (Crixivan) 800 mg PO. 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. Rationale: Tachycardia is usually present as a result of fever and/or dehydration but may represent a response to hypoxemia. We’ll give supplemental O2 as needed, and we’ll give them vaccines. PRIYATMA KHINCHA 2. Supportive treatment includes hydration, antipyretics, antihistamines, or nasal decongestants. Which order can be associated with the prevention of atelectasis and pneumonia in a client with amyotrophic lateral sclerosis? Recent viral respiratory infection (common cold, laryngitis, influenza), Difficulty swallowing (due to stroke, dementia, Parkinson’s disease, or other neurological conditions), Chronic lung disease (COPD, bronchiectasis, cystic fibrosis), Other serious illnesses, such as heart disease, liver cirrhosis, or diabetes mellitus, Impaired consciousness (loss of brain function due to dementia, stroke, or other neurologic conditions), Respiratory failure, which requires a breathing machine or ventilator. Sputum cultures and sensitivities reveals presence of infecting organisms. after IM and 30 min – 1 hr. Nurse Oliver learns that the client lives alone and hasn’t been eating or drinking. Rationale: Decreased airflow occurs in areas with consolidated fluid. However, pneumonia causes death in more severe cases with atypical forms such as Legionnaires’ disease and severe acute respiratory syndrome (SARS) causing fatal outbreaks. Blood tests are used to confirm an infection and to try to identify the type of organism causing the infection. Bacterial pneumonia is commonly caused by the Streptococcus pneumoniae (pneumococcus) bacteria. Monitor and record color, consistency, and amount of sputum. Infuse pentamidine (Pentam-300) 300 mg IV over 60 minutes. Respiratory symptoms may be slow to resolve, and fatigue and weakness can persist for an extended period. Rationale: These measures may enhance intake even though appetite may be slow to return. Encourage him to do so often. Nursing Management of Pneumonia Pathophysiology: Pneumonia can be caused by a variety of microorganisms that enter the airway and invade the alveolar space. Assess pain characteristics: sharp, constant, stabbing. Showing this patient how to splint his chest wall will help decrease discomfort when coughing. Patients with aspiration pneumonia often require intensive nursing care. The blood pressure decreased to 104/76 during administration. Provide a balance of rest and activity, increasing activity gradually. Rationale: Presence of chronic conditions (COPD or alcoholism) or financial limitations can contribute to malnutrition, lowered resistance to infection, and/or delayed response to therapy. Any items you have not completed will be marked incorrect. The others are more stable. :-). • if the child is 12 months to 4 y/o- 40 bpm or more. Guidelines for Preventing Health-Care-Associated Pneumonia, 2003 pdf icon [179 pages] CDC and the Healthcare Infection Control Practices Advisory Committee developed these recommendations. In accordance with the guidelines developed by the American Thoracic Society for the management of CAP patients should be treated for the possibility of an atypical pathogen infection (Niederman et al., 2001). Initial antibiotic: macrolides including erythromycin, azithromycin, roxithromycin and clarithyromycin. A variety of organisms, including bacteria, viruses and fungi, can cause pneumonia.Pneumonia can range in seriousness from mild to life-threatening. Increase fluids: It includes- Offer the child extra to drink. It is essential that the patient is aware of their medication regimen and understands the importance of medication compliance, administration processes and potential side effects, Referrals to appropriate health professionals and other relevant organizations should be made and communicated to the patient, It is imperative that the patient is aware of any follow-up appointments and that the patient is encouraged to maintain any follow-up appointments in order to gain the best health outcomes, In order to improve the capacity of the lungs and promote clearance of secretions breathing exercises should be provided for the patient. Also referred to as nosocomial pneumonia. Pneumonia is defined as respiratory infection (features may include cough, purulent sputum, fever, pleurisy) with focal abnormalities on chest x-ray (CXR). Nursing Management of Pneumonia: Various nursing management ways have discussed in the following: 1. The nurse should ensure that all the necessary information has been collected, is complete, and has been documented appropriately. Consideration should be given to the use of humidified oxygen therapy to help facilitate easier expectoration. Bacterial pneumonia usually presents with a productive cough, not a nonproductive cough, making answer B incorrect. A relatively inoffensive form of pneumonia results that rarely involves hospitalization. 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. See Risk Stratification under Clinical Presentation. Patient education is essential to ensuring satisfactory health outcomes. INVESTIGATIONS 3. The bronchi are tiny tubes and alveoli are the small sacs at the end of the bronchi tube. 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. Once appropriate pharmacologic treatment is commenced patients will generally recover in around seven to 10 days. People who have community-acquired pneumonia usually can be treated at home with medication. As such, annual vaccination against influenza should be encouraged. According to the World Health Organization (2019) pneumonia accounts for 15% of all deaths worldwide in children under the age of five years. Because of restricted respiratory movement, a recumbent, immobilize patient is at particular risk for respiratory acidosis from poor gas exchange; atelectasis from reduced surfactant and accumulated mucus in the bronchioles, and hypostatic pneumonia from bacterial growth caused by stasis of mucus secretions. Maternal and Child Health Nursing (NCLEX Exams), Medical and Surgical Nursing (NCLEX Exams), Pharmacology and Drug Calculation (NCLEX Exams). If the child has bacterial pneumonia, a high fever is usually present. The client at highest risk for complications is the client with multiple sclerosis who is being treated with cortisone via the central line. 2018 Dec;39(4):797-808. doi: 10.1016/j.ccm.2018.08.002. Adherence with the prescribed medication regimen is key to recovery and preventing resurgence of pneumonia. Pneumonia is a major cause of morbidity and mortality among nursing home residents. Instruct patient to avoid using antibiotics indiscriminately during minor viral infections. Administer medications as indicated: antipyretics, antiemetics. Also, this page requires javascript. Announcement!! http://www.nlm.nih.gov/medlineplus Pneumonia is classified based on the type of organisms responsible for the infection and the location where or the way in which the infection was acquired. Administer medications as indicated: mucolytics, expectorants, bronchodilators, analgesics. 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. Rationale: Eliminates noxious sights, tastes, smells from the patient environment and can reduce nausea. Client’s having the insertion of a central venous catheter are at risk for tension pneumothorax. 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