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BRONCHOPNEUMONIA

Bronchopneumonia is a severe type of pneumonia that is


characterized by an inflammation of the lung generally associated
with, and following a bout with bronchitis. This is really a specific type
of pneumonia that is localized in the bronchioles and surrounding
alveoli. This article provides a general overview of this condition,
including symptoms and treatment options for those who have been
diagnosed with bronchopneumonia. The most common pneumonia-
causing bacterium in adults is Streptococcus pneumoniae
(pneumococcus).

Etiology

Bronchopneumonia is closely associated with hospital-acquired


pneumonia. In a person suffering from bronchopneumonia, bacteria
invade the lungs, which results to an inflammatory immune response.

This reaction of the lungs leads to the filling of the alveolar sacs
with exudates. As a result, consolidation takes place: a condition
wherein the air space in the lungs is replaced with fluids.

Causative organisms:

1) Staphylococci ; 4) Haemophilus
influenzaea ;
2) Streptococci ;
5) Pseudomonas
3) Pneumococci ; aeruginosa ;

6) Coliform bacteria

Pathophysiology

The usual mechanisms of spread are inhaling droplets small


enough to reach the alveoli and aspirating secretions from the upper
airways. Other means include hematogenous or lymphatic
dissemination and direct spread from contiguous infections.
Predisposing factors include upper respiratory viral infections,
alcoholism, institutionalization, cigarette smoking, heart failure,
chronic obstructive airway disease, age extremes, debility,
immunocompromise (as in diabetes mellitus and chronic renal failure),
compromised consciousness, dysphagia, and exposure to transmissible
agents.

Typical symptoms include cough, fever, and sputum production,


usually developing over days and sometimes accompanied by pleurisy.
Physical examination may detect tachypnea and signs of consolidation,
such as crackles with bronchial breath sounds.

Clinical Manifestation

• Cough with greenish or yellow mucus


• Fever
• Pleuric chest pain
• Rapid, shallow breathing
• Shortness of breath
• Headache
• Loss of appetite
• Fatigue

Diagnostic Tests

History and Medical exam


CBC
Urinalysis
Blood Cheminstry
CXR

Nursing Management

INDEPENDENT
• positioning of the patient with head on mid line, with slight
flexion
rationale: to provide patent, unobstructed airway , maximum
lung excursion

• auscultating patient’s chest


rationale: to monitor for the presence of abnormal breath sounds

• provide chest and back clapping with vibration


rationale: chest physiotheraphy facilitates the loosening of
secretions

• considering that the patient is an infant, and has developed a


strong stranger anxietyas manifested by “white coat
syndrome” , it is a nursing action to play with the patient.
rationale: to establish rapport, and gain the patients trust

DEPENDENT
• administer due medications as ordered by the physician,
bronchodilators, anti pyretics and anti biotics
rationale: bronchodilators decrease airway resistance,
secondary to bronchoconstriction,anti pyretics alleviate fever,
antibiotics fight infection

• placing patient on TPN prn


rationale: to compensate for fluid and nutritional losses during
vomiting

COLLABORATIVE
• assist respiratory therapist in performing nebulization of the
patient
rationale: nebulization is a favourable route of administering
bronchodilatorsand aid in expectorating secretions, hence patient’s
breathing

Medical Management

Patients with mild pneumonia who are otherwise healthy are


sometimes treated with oral macrolide antibiotics (azithromycin,
clarithromycin, or erythromycin).

Patients with other serious illnesses, such as heart disease, chronic


obstructive pulmonary disease, or emphysema, kidney disease, or
diabetes are often given one of the following:

• Fluoroquinolone (levofloxacin (Levaquin), sparfloxacin (Zagam),


gemifloxacin (Factive), or moxifloxacin (Avelox)
• High-dose amoxicillin or amoxicillin-clavulanate, plus a macrolide
antibiotic (azithromycin, clarithromycin, or erythromycin)
• Cephalosporin antibiotics (for example, cefuroxime or
cefpodoxime) plus a macrolide (azithromycin, clarithromycin, or
erythromycin)
BRONCHOPNEUMONIA
Submitted by:
Valerie Joy Rivera

Submitted to:
Sir Ike Ty, RN, MAN, RM, MD