Anda di halaman 1dari 8

Predisposing Factors Factor Age Present Rationale Since our client is still an infant, 3 months old, his immune

system has not yet fully developed and he is still more prone to infection causing bacteria. Physical Weakness This is not present in our client but physical weakness will promote more accumulation of secretions in the lungs causing pneumonia. Certain Diseases This too is not present because there are no underlying diseases that have caused the clients pneumonia. Impaired cilia Impaired ciliary action will develop into pneumonia because the cilia are unable to propel foreign debris that may cause inflammation and infection of the bronchi. This is not in our client. Immobility Immobility will promote pooling of secretions in the lungs. Medications This is not present in our client because he is not taking medications such as corticosteroids that will suppress the immune system. Sex This is present because it is said that the disease is more prevalent in males than in females.

Precipitating Factors Factor Environment Present Rationale Our client lives in Indangan, Panacan. This place is above sea level and humid. This promotes bacterial colonization. The father of the client also smokes and they have pets like cats, dogs,vgoats, and pigs. Manner of feeding Our clients mother feeds him in a manner where in aspiration of the child is avoided. Diet Our client is breastfed which is the ideal food for infants because of the antibodies produced. Hygiene The clients mother does not clean her nipples prior to feeding which may cause the infection.

Symptomatology Signs and Symptoms Cough Present Rationale Our client had cough because the body is trying to eliminate the excess production of secretions. Dyspnea There is difficulty of breathing because of the constricted airways and the excessive production of mucus. Chills Chills is present when there is fever. However, our client did not experience chills. Fever Fever will be present because there is infection. This fever is a symptom that the client already has an infection

particularly in the lungs. Vomiting It is seldom related to food intake, is usually the result of irritation of the vagal centers in the medulla. Loss of Appetite There will be loss of appetite since the client is experiencing difficulty in breathing. Instead of eating the client will focus more on breathing properly. Eating also will worsen the difficulty in breathing. Cyanosis Cyanosis will be present is more serious types of pneumonia. There will be a decrease in oxygen supply because of bronchial constriction and an increase in oxygen demand due to the increased metabolism of the cells. However it is not observed in our client. Sputum production Excess production of sputum is an effect of the infection. The body compensated by increasing mucus production as a mechanism of eliminating the bacteria.

Schematic Diagram

Predisposing Factors: Age Sex Certain Diseases Physical Weakness Immobility Medications Impaired cilia

Precipitating Factors: Environment Diet Hygiene Manner of feeding

Streptococcus Pneumoniae

Inhalation of pathogen, Aspiration of previously colonized upper airway, Direct spread from contagious infected sites, or hematogenous spread

Pathogen enters theupper respiratory system

Pathogen encounters a series of primary host defenses like cilia, cough reflex, etc.

Bacteria enters lower respiratory tract and adhere to alveoli

Bacterial multiplication in the alveoli

Fever

Inflammatory Response

Attraction of neutrophils Release of inflammatory mediators


Excessive mucus Cough Crackles/wheezes Dyspnea

Exudation of fluid into the air-filled spaces of the alveoli

Red hepatization and consolidation of lung parenchyma

Leukocyte Infiltration

Pleuritic pain

Pathogen encounters immune defenses such as immunoglobulins (IgA, IgG), phagocytic cells (macrophages), T-cell-mediated cellular immunity.

Gray hepatization and deposition of fibrin on pleural spaces, phagocytosis in alveoli

Resolution of infection

Exudate is digested by enzymatic activity, and cleared by macrophages or by cough mechanism.

If treated:

If not treated: Pleural effusion Empysema Lung abcess Bacteremia Septicemia Meningitis

Medical management: Antibiotic therapy Antipyretcs Bronchodilators Oxygen therapy

Nursing Management: Moderate high back rest Increase OFI Breathing exercises Suctioning secretions

Septic arthritis Endocarditis Pericarditis

Death

Good Prognosis

Narrative Pathophysiology

Pneumonia is the infection of the lower respiratory system. It is one of the leadin causes of death in children. Pneumonia is caused by bacteria, viruses, inhaled chemicals, fungi and as a complication of immunosuppression brought about by medications or diseases such as AIDS. Risk factors of pneumonia include age, sex, medication, hygiene, diet, physical weakness, the environment, and the manner of feeding in the case of our pediatric client. The causative agent, specifically S. Pneumoniae enters the body through aspiration, inhalation, direct spread from contagious infected sites, or hematogenous spread. As the pathogen travels down the lower respiratory tract, the pathogen will encounter a number of defense mechanisms such as the cough reflex, the ciliary action in the URT, and the mucus secretions. If the pathogen can pass through all these defense mechanisms, it then travels down into the lower respiratory system where it adheres to the alveolar wall and will colonize and multiply there. This will trigger the bodys inflammatory response. Neutrophils will go to the site of inflammation and there will be a release of inflammatory mediators. Exudation of fluid into the air-filled alveoli will occur thus red hepatization happens. With this, consolidation will be present in chest x-rays. The bacteria will then have a portal of entry into the blood flow via the lymphatic drainage. Immunoglobulins and other immune bodies like the macrophages take action and will try to destroy the pathogens. Gray hepatization occurs when the fibrin will undergo phagocytosis by macrophages. After this, resolution of the infection happens. Pneumonia is a very treatable disease in most people. It could be managed through antibiotics, antipyretics and bronchodilators. Oxygen therapy could also be administered to compensate with the increase in O2 supply. Increasing the fluid intake of the client will also help in relieving excess mucus production. Placing the client on moderate high back rest will promote proper lung expansion. With all these interventions, the client will have a good prognosis.

However, there are instances wherein pneumonia can cause death. Pneumonia has a high mortality rate especially in immunocompromised individuals because of the decrease in antibodies or overproduction of immature antibodies. It will cause Pleural effusion, Empysema, Lung abcess, Bacteremia, Septicemia, Meningitis, Septic arthritis, Endocarditis, Pericarditis and will eventually cause death.

Anda mungkin juga menyukai